被忽略的男性身心健康議題：飲食異常青少年男性吃食相關經驗探究

Neglected Physical and Mental Health Issues among Males: Exploring the Experience of Adolescent Boys with Eating Disorders

男性飲食異常議題長期被忽略且影響身心健康甚鉅，建議需由學校系統早期介入以有效協助，故理解男性如何經歷飲食異常經驗，有助於推動以校園為基礎之早期預防。本研究目的有二：一、探究飲食異常青少男的吃食相關經驗；二、理解飲食異常發展中身為男性之經驗。方法：採兩階段研究設計，先招募某高中男校，以「飲食態度量表-26題」針對高一、高二男生進行第一階段篩選，回收有效問卷1714份，並邀請其中73位高危險群進行第二階段診斷性晤談，依結果招募到7位符合條件者進行深入質性訪談。結果與結論：參與者浮現六項以「吃」貫穿之經驗主題：一、「愛吃：期待又怕受傷害」；二、「恨吃：胖受嘲諷責己食」；三、「拒吃：挨餓只盼外型佳」；四、「愧吃：催吐抗吃心矛盾」；五、「困吃：提心吊膽怕復胖」；與六、「難吃：愛美中性男難為」。本研究發現青少男飲食異常吃食相關經驗之困境脈絡，由性別角度觀之，社會文化期望男孩多吃、體壯，然若被賦予追求成就的男孩，在發育時感受到受矚目外表或成就的失落，又身處外界對體型的嘲諷與規訓，或喜好為非男性主流、性別氣質不合模時，易以激烈方式與進食纏鬥，身為男性更隱諱難言，文末提出對教育、實務與政策之建議。

Purpose: The research has two purposes: (1) to explore the eating experience of adolescent boys with eating disorders; (2) to understand the experience of being a male in the development of eating disorders. Method: Adopting the hermeneutic phenomenology as the research approach, a two–stage design was conducted to look for hidden participants in the community. A total of 1, 714 valid questionnaires were obtained with EAT-26, which was administered in a male high school in Tainan, Taiwan; 73 students were identified as high risk for eating disorders. Seven diagnosed students were included as participants in this study. Result: Six themes were generated. Theme 1 to 5 showed the developmental process of eating disorders, while theme 6 reflected gender experiences of teenage boys with eating disorders: (1) “like to eat- look forward to but afraid of getting hurt”; (2) “hate to eat- decide to lose weight for getting good reputation”; (3) “refuse to eat- hope to get good shape although it might be suffering”; (4) “be ashamed to eat- vomit it out against over eating but feel ambivalence”; (5) “puzzle to eat- afraid to eat for getting fat”, and (6) “difficult to eat- the sissy boys like to dress up and make up, easily excluded by others”. Results and conclusions: This study specifically presents the painful dilemma and context encountered by adolescent boys with eating disorders , and there are further discussions and suggestions at the end of the article.