Most practitioners acknowledge that in order to provide the most effective treatment for a client, treatment must take into account their personal preferences, styles and characteristics.  When it comes to treatment approaches geared towards males with eating disorders, there is relatively little empirical research directed at establishing effective therapeutic guidelines.  Most of the treatment guidelines for males with eating disorders have come from clinical experience working with males, which due to the smaller percentage of clients who are male, can be hard to come by.  Cielo House has been treating males with eating disorders since our inception in 2010, and we have gained valuable experience with some of the specific treatment guidelines that work for males.  A useful framework that summarizes these recommendations can be easily remembered using the acronymT.R.E.A.T.
T -Effective therapy for males with eating disorders must tackle the maladptive Thinking of the individual.  Cognitive-Behavioral Therapyis a treatment approach we use that focuses on creating change in the maladaptive thought patterns of clients.  This is an approach that is particularly useful and important for male clients, and its structure seems to be naturally appealing to many males.
R –  Effective therapy for males with eating disorders must include emphasis on Relationships.  Interpersonal Therapy is an approach that works towards improving the relational health of an individual.  This is a particular area of importance for males, who often have significant interpersonal struggles.
E –  Effective therapy for males with eating disorders must address the Emotions of the individual.  Emotion-Focused Therapy is another approach we utilize, and it allows us to take an emotion-friendly stance while in therapy, encouraging the processing and expression of emotions and helping clients to see all of their emotions as having value.  This is particularly useful for males, who are sometimes conditioned to believe that emotions are unimportant or the expression of emotion goes against gender stereotyped norms.
A –  Effective therapy for males with eating disorders must address the Actions of the individual, and/or be action-oriented in general.  The behavioral aspects of our treatment help address this need.  Not only do we provide a supportive structure in which destructive behaviors can be contained, but we work with clients to implement alternative behaviors in their life not just while in treatment, but well beyond it.  For males it is important they see the fruits of their labor, and tend to hold more value for evidence they can concretely see.  The behavioral changes serve to show them that the things they are learning and working on in treatment actually work.
T – Effective therapy for males with eating disorder should be done Together.  Group approaches that address the eating disorder are necessary for males.  Since males are often under-represented in eating disorder treatment, having other people who can relate to and support them is critical.  Males have a greater tendency not to involve others in their problems, and as a result they miss out on an important sense of togetherness, and group therapy provides an important reminder that they are not alone.  Any treatment for males with eating disorders should emphasize a sense of togetherness.
When it comes to eating disorder treatment, there is no “one-size-fits-all” approach.  There is no magic cure and no silver bullet.  Taking into account some of the unique needs of male clients, we can offer these guidelines to anyone who seeks to provide treatment for males with eating disorders.  While it is not a prescription for how treatment should be done, incorporating these guidelines would be consistent with our extensive experience for what males find to be most effective in their treatment.
Matt Keck, MFT is Co-founder and CEO of Cielo House Comprehensive Eating Disorder Treatment programs.  As a male therapist working in the field of eating disorders, he understand the unique challenges male clients face in eating disorder treatment.