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Policy, knowledge, and practice: Supporting men with muscle-orientated issues in the UK


   School of Sport and Exercise Science

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  Dr Christian Edwards, Dr G Molnar, Dr Una Foye  No more applications being accepted  Funded PhD Project (Students Worldwide)

About the Project

Supervisory team

Director of Studies:

Dr Christian Edwards, School of Sport and Exercise Science, University of Worcester.

Supervisors:

Professor Győző Molnár, School of Sport and Exercise Science, University of Worcester.

Dr Una Foye, Mental Health Nursing, King’s College London.

Context

Historically, the study of body image almost exclusively focused on women and weight loss. Recently, researchers have begun to shift their attention to understanding men’s body image-related issues (e.g., Edwards et al., 2016; Tod & Edwards, 2015). This research generally suggests that men may often perceive themselves as too small and desire to build a more muscular physique (Edwards et al., 2014; Edwards et al., 2012). While muscularity is commonly associated with health and wellbeing, a growing body of research suggests that the excessive pursuit of muscle is associated with a variety of adverse consequences (e.g., Tod et al., 2016). The drive for muscle may, for example, manifest in an array of problematic eating and exercise behaviours (Cunningham et al., 2021; Edwards et al., 2014). Much of the research and policy on body image and perception disorders, compulsive exercise, and eating disorders, however, remains centred on thinness concerns (Murray et al., 2017). As such, muscle-oriented preoccupations (e.g., muscle-oriented disordered eating, muscle-oriented exercise addiction, muscle dysmorphia), and related cognitions, emotions, and impairment may not be within the cultural repertoire of clinicians (Murray et al., 2017). Muscularity-orientated issues were introduced to eating disorder quality standards and medical emergency guidelines this year (Das, 2022; MEED, 2022). Nevertheless, the current female-centric understanding of body image issues and eating disorders marginalises those with muscularity-centred issues. Such structural issues may impede the care provision for those living with muscle-oriented preoccupations. Consequently, the first main objective of this PhD is to explore:

  • possible service gaps and clinicians’ knowledge of muscle-orientated issues.

Further, it is well known across the healthcare sector that formal help-seeking among men is lower than among women. In our own research, for example, only one participant (out of 20) sought formal help for their muscle-building preoccupation (Edwards et al., 2017). This participant was unable to find a therapist via the NHS and had to seek private support. He disclosed that he only attended one therapy session because “nothing came out of it that [he] didn’t already know.” Two other participants sought medical help for anabolic steroid use injection site infections. On admission for in-patient treatment, one of the participants was taking fourteen anabolic substances a day and disclosed that doctors “preached to him" saying “you should not do steroids!”. These experiences are consistent with other reports that men are reluctant to disclose body-related preoccupations or behaviours or seek professional support because of experiences and fear of stigmatization (e.g., Hope et al., 2020). Men’s traditionalist masculine attitudes may also restrict their help-seeking through formal sources (e.g., therapists; Heath et al., 2017). Men may more often seek support from informal networks (than formal sources), such as significant others (e.g., parents) and via social forums (e.g., online networks; Robertson et al., 2015). Consequently, the second main objective of this PhD is to explore:

  • men’s formal and informal help-seeking for muscle-orientated issues

Aims and Objectives

This PhD aims to explore care provision for men with muscle-orientated issues in the UK. This aim will incorporate the following research objectives:

  1. To audit the male-specific muscularity-oriented content of the publicly available policy and documentation of London-based eating disorder, and body image-related services.
  2. To explore UK-based clinicians' knowledge of muscle-orientated issues and their provision of care for/to men living with muscle-orientated preoccupations.
  3. To explore the help-seeking attitudes, behaviours, and formal and informal care experiences of men living with muscle-orientated preoccupations.

Indicative methodology

Consistent with the research objectives, this PhD will contain the following phases:

In phase 1, an audit of London-based health care services and service providers’ (i.e., NHS and third sector) publicly available documentation will be undertaken. Documents will be put to a qualitative content analysis.

In phase 2, an online survey of clinicians working in eating disorders and related services in the UK (i.e., NHS and third sector) will be undertaken. Both quantitative and qualitative analysis methods will be used to interpret survey responses.

In phase 3, the help-seeking attitudes, behaviours, and care experiences of men with muscle-oriented preoccupations will be explored through repeated in-depth, qualitative interviews. Recorded interviews will be transcribed verbatim and subject to a thematic analysis.

Within each phase, executive summaries will be presented to First Steps ED and shared with the Quality Network for Eating Disorders at The Royal College of Psychiatrists.

Details of the studentship

The studentship is offered for a 4-year period on a full-time basis. The studentship is campus based. During the period of your studentship, you will receive the following:

  • a laptop and other IT equipment and software as appropriate to the project,
  • use of the Research School facilities,
  • throughout this PhD the student will collaborate with a leading eating disorder charity,
  • the PhD student will have the opportunity to share their findings with the Quality Network for Eating disorders at The Royal College of Psychiatrists.

Application Process

To begin the application process for this studentship please go to http://www.worcester.ac.uk/researchstudentships and click ‘apply now’ next to the project you wish to apply for. It is expected that applicants will have the following qualifications:

  • a Masters in the area of Sports and Exercise Science, Sports and Exercise Nutrition, Psychology, Sport and Exercise Psychology or equivalent professional experience,
  • a First or Upper Second Honours Degree.

It is also expected that applicants will be able to demonstrate the following:

  • a sound understanding of and interest in both the project and the wider subject area (i.e., men’s health, muscle-orientated body image, muscle dysmorphia, muscle-orientated disordered eating, muscle-oriented exercise addiction),
  • experience of relevant research methods and skills,
  • ability to contribute to the research design of the project,
  • proficiency in oral and written English,
  • proficiency in IT relevant to the project,
  • ability to organise and meet deadlines,
  • good interpersonal skills,
  • ability to work independently,
  • ability to work with/alongside collaborating organisations.

Funding Notes

The studentship is offered for a 4-year period on a full-time basis. The studentship is campus based. During the period of your studentship, you will receive the following:
a tax-free bursary of £15,609 for 3 years,
a fee-waiver for 4 years (expectation is that full time students complete in 3 years. If a student enters year 4,
the bursary stops but fees are still waived), a budget to support your direct project costs including dissemination costs,

References

Cunningham, M.L., Nagata, J.M., & Murray, S.B. (2021). Muscularity-oriented disordered eating in boys. In J. M. Nagata, T.A. Brown, Murray. S.B, & Lavender, J.M. (Eds.), Eating Disorders in Boys and Men. Springer International Publishing.
Das, A (2022). Quality Network for Eating Disorders (QED) Quality Standards for Adult Community Eating Disorder Services. The Royal College of Psychiatrists.
Edwards, C., Tod, D., Morrison, T., & Molnar, G. (2012). Drive For muscularity. In D. Tod & D. Lavallee (Eds.). Psychology of strength and conditioning: Current perspectives. (pp. 148-172). London, Routledge.
Edwards, C., Tod, D., & Molnar, G. (2014). A systematic review of the drive for muscularity research area. International Review of Sport and Exercise Psychology, 7, 18-41.
Edwards, C., Tod, D., Molnar, G. & Markland, D. (2016). Predicting muscularity-related behavior, emotions, and cognitions in men: The role of psychological need thwarting, drive for muscularity, and mesomorphic internalization. Body Image, 18, 108-112.
Edwards, C., Tod, D., Molnar, G. (2017). Searching for masculine capital: Experiences leading to high drive for muscularity in men. Psychology of Men and Masculinity, 18, 361-371.
Heath, P. J., Brenner, R. E., Vogel, D. L., Lannin, D. G., & Strass, H. A. (2017). Masculinity and barriers to seeking counselling: The buffering role of self-compassion. Journal of Counseling Psychology, 64, 94-103.
Hope, V. Leavey, C. Morgan, G. Acreman, D. Turner, D. Smith, J (2020). Facilitators and barriers to health care access amongst people using image and performance enhancing drugs in Wales: Findings & Outcomes Report. Project Report. Public Health Wales.
MEED (2022). Medical Emergencies in Eating Disorders: Guidance on Recognition and Management (College Report CR233). The Royal College of Psychiatrists.
Murray, S. B., Nagata, J. M., Griffiths, S., Calzo, J. P., Brown, T. A., Mitchison, D., Blashill, A. J., & Mond, J. M. (2017). The enigma of male eating disorders: A critical review and synthesis. Clinical psychology review, 57, 1-11.
Robertson, S. White, A. Gough, B. Robinson, M. Seims, A. Raine, G. Hanna, E. (2015). Promoting mental health and wellbeing with men and boys: What works? Centre for Men’s Health, Leeds Beckett University, Leeds.
Tod, D. & Edwards, C. (2015). A meta-analysis of the drive for muscularity’s relationships with exercise, disordered eating, and supplement consumption. International review of Sport and Exercise Psychology, 8, 185-203.
Tod, D., Edwards, C., & Cranswick, I. (2016). Muscle dysmorphia: current insights. Psychology Research and Behavior Management, 9, 179.
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