Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden

Summary & key facts

This review found that eating disorders cause a large health and social burden. In 2017 eating disorders accounted for more than 3.3 million healthy years lost worldwide. Anorexia nervosa and bulimia nervosa show rising disability, higher death rates (especially after inpatient treatment for anorexia), lower quality of life, higher costs, and problems with work and childbearing. The authors note important limits in the data and say the numbers should be interpreted with caution.

Key facts:

• In 2017, eating disorders were estimated to cause over 3.3 million healthy life years lost worldwide (years lived with disability, YLD).
• Age-standardized YLD rates in 2017 were 9.4 per 100,000 for anorexia nervosa and 33.8 per 100,000 for bulimia nervosa.
• From 2007 to 2017, YLD rates increased by 6% for anorexia nervosa and by 10% for bulimia nervosa, while overall YLD rates for mental disorders stayed the same or fell slightly.
• People with anorexia nervosa who received inpatient treatment had more than five times the mortality risk compared with the general population (for example, SMR 5.2, 95% CI 3.8–7.0 in secondary care; hazard ratio 6.5, 95% CI 3.5–12.3 in ter
• Mortality risks for bulimia nervosa, and for anorexia nervosa treated outside hospital, were reported to be about twice those of people without an eating disorder.
• Yearly healthcare costs for people with an eating disorder were about 48% higher than for the general population.
• When people with an eating disorder also had other mental health conditions, yearly earnings were on average 48% lower than for people without those comorbidities.
• Long-term (10–20 year) follow-ups of people who had inpatient treatment found that 64% of former anorexia nervosa cases, 53% of former bulimia nervosa cases, and 30% of former binge-eating disorder (BED) cases still met full diagnostic crit
• The review cautions that global burden estimates are limited because only anorexia nervosa and bulimia nervosa were included in the Global Burden of Disease figures, and the available prevalence data have poor coverage and large uncertainty

Abstract

People with a current or former eating disorder are at risk of increased mortality, high YLD rates, a reduced quality of life, increased costs, and problems with childbearing.

Topics

Eating Disorders and Behaviors Obesity, Physical Activity, Diet Obsessive-Compulsive Spectrum Disorders

Categories

Clinical Psychology Psychology Social Sciences

Tags

Anorexia nervosa Bulimia nervosa Comorbidity Eating disorders Environmental health Medicine Nursing Pediatrics Population Psychiatry Quality of life (healthcare)