Researchers have noted a severe impact caused many eating disorders. While very little is known about the prevalence of eating disorders in men, findings from other studies have revealed a significant difference in symptoms of ED in both males and females.1 In the article “Eating Disorders in Males: An 8-Year Population-Based Observational Study,” Jaworski et al.2 aimed to evaluate the effect of eating disorders among Polish men that had sought treatment through the National Health Fund (NFZ). Although the study produced significant results by demonstrating a higher prevalence of Anorexia Nervosa (AN) than Bulimia Nervosa (BN), the findings faced notable shortcomings related to the reliance on the National Health Fund (NFZ) database as the only sample source and failure to consider men who refused to seek medication.
Jaworski et al. conducted an observational study with data being collected from the National Health Information database. The participants were Polish males diagnosed with ED from 2010 to 2017. The researchers assessed four types of ED: AN, atypical anorexia nervosa, BN, and atypical bulimia nervosa. The researchers then divided the participants into nine groups according to age and analyzed the data via descriptive statistics. The results revealed that AN was higher in males between age 11 to 30, while the numbers decreased after the age of 40. On the other hand, males between 11 and 60 years had been diagnosed with BN, but it was more common in younger males aged between 11 and 30 years. However, it was noted that there was no incidence of BN in males from the age of 71 and above. Additionally, the researchers observed that the RR of occurrence of ED in men is 95%-96% lower than that in women. This study contributed to a deeper understanding of ED among males since it has always been assumed that it is only prevalent in females. The researchers stated that previous studies have suggested males may also be diagnosed with AN, but it is more common in females.
Although this study obtained a high prevalence of eating disorders in Polish men, the findings faced two critical limitations. First, the researchers obtained data from the National Health Fund (NFZ) database only. Although the database contained medical information on eating disorders in men across the nation, significant exclusions were notable. For instance, the NFZ database contains information on patients who visit public hospitals only. Therefore, medical information concerning eating disorders in males who visited private hospitals was lacking. According to Mitchison et al.3, a significant number of males with poor eating habits prefer visiting private hospitals for diagnosis and treatment. As such, the exclusion of private hospital data limited the generalization of findings to the entire Polish men population. Secondly, Jaworski et al.2 did not assess the prevalence of eating disorders in males who deliberately refused to seek medication. Only those patients seeking treatment were included in the database. Hence, Jaworski et al.2 did not consider the patients who had not sought medical attention. As such, their results could not be generalized to the entire men population. On the other hand, other researchers may have contrary views on the NFZ database and the exclusion of males with eating disorders but refused to seek medical attention. For instance, some may argue that the researchers used a database that collects the worldwide information of the patients; hence it provided a large sample for assessment, increasing the generalization power.4 However, Jaworski et al.’s article acknowledged the gaps of patients who do not seek medical treatment, and thus their information was not captured in the database. This limited the number of patients assessed using the database. As argued by Faber and Fonseca5, sample size influences the outcome of the study. Therefore, the researcher should consider a larger sample size to produce significant results.
In conclusion, the researchers established that AN was more common than BN in polish men. Nevertheless, the findings had limitations due to the exclusion in the NFZ database and failure to assess the ED prevalence in men who had not visited any health center for diagnosis or treatment. Even though the NFZ contains nationwide medical data, the database only stores information on patients who seek medication from public hospitals. Besides, the possibility that a significant number of males with eating disorders deliberately refuse to seek medical attention hindered the actual statistics on male ED prevalence in Poland. Therefore, more studies should focus on assessing the prevalence of male eating disorders in people who have no hospital record. In addition, treatment guidelines should be formulated to increase the effects of therapy on males with ED.
- Berg KC, Peterson CB, Frazier P, Crow SJ. Psychometric evaluation of the eating disorder examination and eating disorder examination questionnaire: A systematic review of the literature. International Journal of Eating Disorders. 2012 Apr;45(3):428-38. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.20931
- Jaworski M, Panczyk M, Śliwczyński A, Brzozowska M, Janaszek K, Małkowski P, Gotlib J. Eating disorders in males: an 8-Year population-based observational study. American journal of men’s health. 2019 Jul;13(4):1557988319860970. Available at : https://journals.sagepub.com/doi/abs/10.1177/1557988319860970
- Mitchison D, Hay P, Sliwa-Younan S, Mond J. The changing demographic profile of eating disorder behaviors in the community. BMC Public Health. 2014 Dec;14(1):1-9. Available at: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-943
- Magliano E, Grazioli V, Deflorio L, Leuci AI, Mattina R, Romano P, Cocuzza CE. Gender and age-dependent etiology of community-acquired urinary tract infections. The scientific world journal. 2012 Jan 1;2012. Available at: https://www.hindawi.com/journals/tswj/2012/349597/
- Faber J, Fonseca LM. How sample size influences research outcomes. Dental press journal of orthodontics. 2014 Aug;19(4):27-9.Available at: https://www.scielo.br/scielo.php?pid=S2176- 94512014000400027&script=sci_arttext&tlng=es