Atypical eating disorder in a male patient.

In the literature there is evidence that a substantial proportion of patients with bulimia nervosa can be helped by cognitive behavioural self-help manuals. As there are no specific recommendations or strategies for the treatment of males with eating disorders we were therefore especially interested in the way a man might deal with such a self-help manual. In this case the book Getting better bit(e) by bit(e) by Treasure and Schmidt (also available in German translation) was given to a young man with an atypical eating disorder (atypical anorexia nervosa according to ICD-10). The patient was offered a maximum of 16 short visits and was seen by a first-year psychiatry resident. Treatment with this self-help manual was effective and the patient succeeded in changing his former eating behaviour. The case report provides preliminary evidence that a self-help manual may be a useful addition to the range of possible interventions in the treatment of eating disorders in men. Self-help manuals are less intensive and less costly than other forms of treatment and might be the lowest-step intervention in a stepped-care approach to treatment.