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The prevalence and epidemic of the disease bulimia

  • The prevalence and correlates of eating disorders in the national comorbidity survey replication;
  • Journal of Adolescent Health, 57 2 , 144-149;
  • Archives of General Psychiatry, 68 7 , 724-731;
  • Epidemiology of eating disorders:

This article has been cited by other articles in PMC. Abstract Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality the prevalence and epidemic of the disease bulimia of eating disorders. Anorexia nervosa is relatively common among young women. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset.

The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking.

Compared with the other eating disorders, binge eating disorder is more common among males and older individuals. Epidemiology, Incidence, Prevalence, Mortality, Eating disorders, Anorexia nervosa, Bulimia nervosa, Eating disorder not otherwise specified, Binge eating disorder Introduction Epidemiological studies provide information about the occurrence of disorders and trends in the frequency of disorders over time. For epidemiological studies on eating disorders there are some methodological issues.

Eating disorders are relatively rare among the general population and patients tend to deny or conceal their illness and avoid professional help. This makes community studies costly and ineffective. Therefore, many epidemiological studies use psychiatric case registers or medical records from hospitals in a circumscribed area. This type of study will underestimate the occurrence of eating disorders in the general population, because not all patients will be detected by their general practitioner or referred to the hospital or mental health care.

Furthermore, differences in rates over time could be due to improved case detection, increased public awareness leading to earlier detection and wider availability of treatment services, instead of a true increase in occurrence [ 12 ].

A comprehensive meta-analysis of 125 studies suggests that EDNOS is associated with substantial psychological and physiological morbidity, comparable with the specified eating disorders [ 8 ]. In 2013 the fifth edition of the DSM is scheduled to appear, including a thoroughly revised eating disorder section. The decision to make BED a separate diagnosis is partly informed by epidemiological data supporting the construct validity of BED.

BED differs from AN and BN in terms of age at onset, gender and racial distribution, psychiatric comorbidity and association with obesity. BED is often seen in obese individuals, but is distinct from obesity per se regarding levels of psychopathology, weight- and shape concerns and quality of life [ 11 ]. BED aggregates strongly in families independently of obesity, which may reflect genetic influences [ 1213 ].

The proposed changes in DSM-5 diagnostic criteria will alter the coverage of the diagnostic categories and thus their disease frequencies as well. In a Finnish study of female twins, the 5-year clinical recovery rates of AN and broad AN were almost the same; i.

Definitions of each epidemiological measure are provided at the respective paragraphs. This article is based on research publications on the epidemiology of eating disorders and updates our previous reviews, with special emphasis on studies published in the last three years [ 217 — 19 ].

The reference lists of the articles found were checked for any additional articles missed by the database search. This review is limited to articles published in English, describing the basic epidemiological parameters incidence, prevalence and mortality rates.

The eating disorder "epidemic": more apparent than real?

Incidence The incidence rate is the number of new cases of a disorder in the population over a specified period. The incidence rate of eating disorders is commonly expressed in terms of per 100 000 persons per year person-years. The study of new cases provides clues to etiology.

Anorexia Nervosa Community studies assessing the incidence of eating disorders are scarce. The incidence rate of broad AN was 490 per 100 000 person-years in the same group [ 14 ]. Community rates are much higher than incidence rates derived from primary care and medical records [ 121 ], reflecting the selection filters that form the pathway to psychiatric care [ 22 ].

Incidence rates derived from general practices represent eating disorders at the earliest stage of detection by the health care system.

Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates

Currin and colleagues [ 23 ] searched the General Practice Research Database in the UK for new cases of AN between 1994 and 2000 and compared their data with the findings of a similar study for 1988—1993 [ 24 ]. The age-adjusted and sex-adjusted incidence rate of AN remained stable over the two study periods: In 2000 it was 4.

In the Netherlands the overall incidence rate of AN ascertained by general practitioners in a large representative sample of the Dutch population remained stable as well. In 1995—1999 it was 7. The incidence of AN among males was less than 1 per 100 000 person-years in general practices in the Netherlands and the UK [ 123 ]. In Canada, the incidence rate of early-onset restrictive eating disorders diagnosed by pediatricians was 2.

In British pediatric and psychiatric care an overall incidence rate of 1.


Among middle aged and elderly women AN is relatively rare as well [ 28 — 30 ]. It is unknown whether this reflects late detection or late age at onset. The question of whether the incidence of AN is on the rise has been under debate. Longterm epidemiological studies are sensitive to minor changes in the absolute incidence numbers and in the methods used, for example, variations in registration policy, demographic differences between the populations, faulty inclusion of readmissions, the specific methods of detection used or the availability of services [ 1832 ].

Until the 1970s, there was an increase of the registered incidence of AN in Europe. Since 1970, the incidence of AN in Europe seems to have been rather stable [ 1183334 ].

In Switzerland the incidence of severe AN in females was studied in a geographically defined region using the same methodology from 1956 to 1995. The incidence of severe AN requiring hospital admission rose significantly during the 1960s and 1970s and reached a plateau of around 1.

  • What we have learned about the causes of eating disorders — a synthesis of sociocultural, psychological, and biological research;
  • Until the 1970s, there was an increase of the registered incidence of AN in Europe;
  • In a longitudinal study, diabulimia increased mortality risk threefold.