The paper examines the issues of epidemiology, conditions, and treatment of eating disorders in men which are not widely recognised in either Polish and other International research. The aim of this paper is to provide an narrative overview of published research to date on the epidemiology, determinants and treatment of eating disorders in males, to discuss some of the differences reported in studies of self-identified gender disparities, and differences in comparison to the literature on female eating disorders. The prevalence and extent of the issue is underestimated by those affected and by clinicians. Consequently, men suffering from eating disorders (EDs) are less likely to be recognised or to receive appropriated timely help. This paper is based on a narrative review analysis of research reports on EDs. The authors discuss the issue of EDs in the context of gender, indicating how self-identified gender can affect clinical presentation (including somatic self- -perception, and the methods employed and motives in striving for a ‘perfect’ figure) and how these relate. Both the methods used in collecting data on eating disorders and the precision of diagnostic criteria for recognising eating disorders (mainly anorexia nervosa and bulimia nervosa) (both on the DSM and ICD systems) are based largely on research conducted in female clinical populations. Analysis of the empirical material to date leads us to assume that symptoms of EDs in men are more often (than in the case of women) related to (self)stigmatisation, difficulties in obtaining a correct diagnosis, coexistent body dysmorphic disorders, substance addictions, and greater physical activity.’

Eating disorders are a heterogeneous group of diseases affecting mainly young people in devel-oped countries. Among them, anorexia nervosa (AN) is the one with the highest mortality, up to five times higher compared to healthy individuals. The etiology of this medical condition is complex and still un-certain. However, disturbances of the autonomic nervous system (ANS) and increased lipolysis resulting in a decrease of the adipose tissue volume are common findings among AN patients. Since ANS is directly connected to adipocyte tissue, thus significantly affecting the body’s metabolic homeostasis, we suspect that this relationship may be a potential pathophysiological underpinning for the development of AN. In this narrative review, we have analyzed scientific reports on ANS activity in AN considering different phases of the disease in humans as well as animal models. Due to the different effects of the disease itself on the ANS as well as specific variations within animal models, the common feature seems to be dysre-gulation of its function without the identification of one universal pattern. Nonetheless, higher norepi-nephrine concentrations have been reported in adipocyte tissue, suggesting local dominance of the sym-pathetic nervous system. Further studies should explore in depth the modulation of sympathetic in adipose tissue factor and help answer key questions that arise during this brief narrative review.

Anorexia nervosa (AN) is an eating disorder characterized by distinct etiopathogenetic concepts that are gradually being linked together to unravel the dominant pathophysiological pathways underlying the disease. Excessive food restrictions, often accompanied by over-exercise and undertaken to lose weight, lead to the development of numerous complications. The biological concept of neurohormonal dysfunc-tion in AN seems incomplete without demonstrating or excluding the role of the enteric nervous system (ENS). Using an animal model of activity-based anorexia (ABA), we conducted the preliminary assess-ment of the ENS structure. Here we show, in preparations stained by immunohistochemistry with anti- ChAT, anti-NOS, anti-PGP 9.5, anti-c-fos, and anti-TH antibodies, a lower density of cholinergic and nitrergic nerve fibers as well as reduced neuronal activity in myenteric plexus. Such structural and functional damage to the ENS may be responsible for a number of gastrointestinal symptoms that worsen the course of the disease. In addition, we expanded the study to address the unresolved issue of mechanical and thermal pain sensitivity in AN. The Von Frey and hot plate tests revealed, that in ABA animals, the pain threshold for mechanical stimulus decreases while for thermal increases. In this way, we have sig-nificantly supplemented the background of AN with potentially observable nervous system changes which may influence the evolution of the therapeutic approach in the future.