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      Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa

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          Purpose of review

          To review the recent literature on the epidemiology of anorexia nervosa and bulimia nervosa in terms of incidence, prevalence and mortality.

          Recent findings

          Although the overall incidence rate of anorexia nervosa is considerably stable over the past decades, the incidence among younger persons (aged <15 years) has increased. It is unclear whether this reflects earlier detection or earlier age of onset. Nevertheless, it has implications for future research into risk factors and for prevention programs. For bulimia nervosa, there has been a decline in overall incidence rate over time. The lifetime prevalence rates of anorexia nervosa might be up to 4% among females and 0.3% among males. Regarding bulimia nervosa, up to 3% of females and more than 1% of males suffer from this disorder during their lifetime. While epidemiological studies in the past mainly focused on young females from Western countries, anorexia nervosa and bulimia nervosa are reported worldwide among males and females from all ages. Both eating disorders may carry a five or more times increased mortality risk.

          Summary

          Anorexia nervosa and bulimia nervosa occur worldwide among females and males of all age groups and are associated with an increased mortality risk.

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          Most cited references58

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          Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.

          Morbidity and mortality rates in patients with eating disorders are thought to be high, but exact rates remain to be clarified. To systematically compile and analyze the mortality rates in individuals with anorexia nervosa (AN), bulimia nervosa (BN), and eating disorder not otherwise specified (EDNOS). A systematic literature search, appraisal, and meta-analysis were conducted of the MEDLINE/PubMed, PsycINFO, and Embase databases and 4 full-text collections (ie, ScienceDirect, Ingenta Select, Ovid, and Wiley-Blackwell Interscience). English-language, peer-reviewed articles published between January 1, 1966, and September 30, 2010, that reported mortality rates in patients with eating disorders. Primary data were extracted as raw numbers or confidence intervals and corrected for years of observation and sample size (ie, person-years of observation). Weighted proportion meta-analysis was used to adjust for study size using the DerSimonian-Laird model to allow for heterogeneity inclusion in the analysis. From 143 potentially relevant articles, we found 36 quantitative studies with sufficient data for extraction. The studies reported outcomes of AN during 166 642 person-years, BN during 32 798 person-years, and EDNOS during 22 644 person-years. The weighted mortality rates (ie, deaths per 1000 person-years) were 5.1 for AN, 1.7 for BN, and 3.3 for EDNOS. The standardized mortality ratios were 5.86 for AN, 1.93 for BN, and 1.92 for EDNOS. One in 5 individuals with AN who died had committed suicide. Individuals with eating disorders have significantly elevated mortality rates, with the highest rates occurring in those with AN. The mortality rates for BN and EDNOS are similar. The study found age at assessment to be a significant predictor of mortality for patients with AN. Further research is needed to identify predictors of mortality in patients with BN and EDNOS.
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            Prevalence of eating disorders over the 2000–2018 period: a systematic literature review

            Eating disorders (EDs) lead to multiple psychiatric and somatic complications and thus constitute a major public health concern.
              • Record: found
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              Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates

              Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15–19 year old girls. 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.

                Author and article information

                Journal
                Curr Opin Psychiatry
                Curr Opin Psychiatry
                COIP
                Current Opinion in Psychiatry
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0951-7367
                1473-6578
                November 2021
                16 September 2021
                : 34
                : 6
                : 515-524
                Affiliations
                [a ]Parnassia Psychiatric Institute, The Hague, The Netherlands
                [b ]University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
                [c ]Columbia University, Mailman School of Public Health, Department of Epidemiology, New York, New York, USA
                Author notes
                Correspondence to Annelies E. van Eeden, Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH The Hague, The Netherlands. Tel: +31883570322; e-mail: annelies.vaneeden@ 123456parnassiagroep.nl
                Article
                YCO340611 00002
                10.1097/YCO.0000000000000739
                8500372
                34419970
                03e70637-fe5c-4d7a-8b78-ff3b7dc59edc
                Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                Categories
                EATING DISORDERS: Edited by Hans W. Hoek and Anna Keski-Rahkonen
                Custom metadata
                TRUE

                anorexia nervosa,bulimia nervosa,epidemiology,mortality
                anorexia nervosa, bulimia nervosa, epidemiology, mortality

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