Summary: Researchers have revised outdated estimates of the prevalence of eating disorders in the US. The study estimates 0.80% of people will suffer from anorexia during their life time, while 0.28% will be affected by bulimia and 0.85% of people will suffer from binge eating disorders.
Biological Psychiatry has published a new study revising the outdated estimates of the prevalence of eating disorders in the United States (US). The new estimates were based on a nationally-representative sample of 36,309 adults–the largest national sample of US adults ever studied. The findings estimate that 0.80 percent of US adults will be affected by anorexia nervosa in their lifetime; 0.28 percent will be affected by bulimia nervosa; and 0.85 percent will be affected by binge eating disorder.
Importantly, the study provides the first prevalence estimates using the current definitions of eating disorders. Although the diagnostic criteria for several common eating disorders were changed with the 2013 publication of the “Diagnostic and Statistical Manual of Mental Disorders (DSM)-5”, the rates of eating disorders hadn’t been studied since 2007.
“Our study confirms that eating disorders are common, are found in both men and women and across ethnic/racial groups, occur throughout the lifespan, and are associated with impairments in psychosocial functioning,” said first author Tomoko Udo, PhD, of University at Albany, New York. Dr. Udo conducted the study alongside Carlos Grilo, PhD, of Yale University School of Medicine.
“The prevalence and impact of eating disorders continues to be underestimated in society. This definitive study should guide both research and policy development,” said John Krystal, Editor of Biological Psychiatry.
The data analyzed in the study were from the 2012-2013 National Epidemiologic Survey Alcohol and Related Conditions (NESARC-III). In addition to lifetime estimates, the study found that 12-month estimates for anorexia nervosa, bulimia nervosa, and binge eating disorder were 0.05 percent, 0.14 percent, and 0.44 percent, respectively. The rates of anorexia nervosa were similar to previous estimates, but the researchers were surprised to find the rates of bulimia nervosa and binge eating disorder were lower than previous estimates.
“Many researchers and clinicians expected higher estimates than earlier studies as a result of ‘loosening’ of diagnostic criteria for eating disorders,” said Dr. Udo, referring to the changes made to criteria in the DSM-5. She added that more large-scale epidemiological studies will be needed to explain the reason for these unexpected findings and to better understand the impact of changes in diagnostic criteria.
The disorders occurred across different ages and were persistent, lasting for years. The study also reported that the eating disorders included in analysis often interfere with normal daily activities and social relationships. According to Dr. Udo, the findings show that eating disorders represent an important public health problem and demonstrate the importance of screening for eating disorders across all socio-demographic groups. “Binge eating disorder, a new ‘formal’ diagnosis in the DSM-5, is especially important to screen for and identify, as it is associated with substantially increased risk for obesity yet often goes unrecognized,” she said.
“In many communities, specialty treatment for eating disorders is not as easily accessible as for other psychiatric and medical conditions, and thus improving access to care is an important priority for healthcare systems,” said Dr. Udo.
Source: Rhiannon Bugno – Elsevier
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Original Research: Abstract for “Prevalence and Correlates of DSM-5–Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults” by Tomoko Udo and Carlos M. Grilo in Biological Psychiatry. Published April 16 2018.
Prevalence and Correlates of DSM-5–Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults
Few population-based data on the prevalence of eating disorders exist, and such data are especially needed because of changes to diagnoses in the DSM-5. This study aimed to provide lifetime and 12-month prevalence estimates of DSM-5–defined anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions.
A national sample of 36,306 U.S. adults completed structured diagnostic interviews (Alcohol Use Disorder and Associated Disabilities Interview Schedule-5).
Prevalence estimates of lifetime AN, BN, and BED were 0.80% (SE 0.07%), 0.28% (SE 0.03%), and 0.85% (SE 0.05%), respectively. Twelve-month estimates for AN, BN, and BED were 0.05% (SE 0.02%), 0.14% (SE 0.02%), and 0.44% (SE 0.04%). The odds of lifetime and 12-month diagnoses of all three eating disorders were significantly greater for women than for men after adjusting for age, race and/or ethnicity, education, and income. Adjusted odds ratios (AORs) of lifetime AN diagnosis were significantly lower for non-Hispanic black and Hispanic respondents than for white respondents. AORs of lifetime and 12-month BN diagnoses did not differ significantly by race and/or ethnicity. The AOR of lifetime, but not 12-month, BED diagnosis was significantly lower for non-Hispanic black respondents relative to that of non-Hispanic white respondents; AORs of BED for Hispanic and non-Hispanic white respondents did not differ significantly. AN, BN, and BED were characterized by significant differences in age of onset, persistence and duration of episodes, and rates of current obesity and psychosocial impairment.
These findings for DSM-5–defined eating disorders, based on the largest national sample of U.S. adults studied to date, indicate some important similarities to and differences from earlier, smaller nationally representative studies.