Prevalence, incidence, and natural course of anorexia and bulimia nervosa among adolescents and young adults

Abstract

We aimed to assess the prevalence, incidence, age-of-onset and diagnostic stability of threshold and subthreshold anorexia nervosa (AN) and bulimia nervosa (BN) in the community. Data come from a prospective-longitudinal community study of 3021 subjects aged 14-24 at baseline, who were followed up at three assessment waves over 10 years. Eating disorder (ED) symptomatology was assessed with the DSM-IV/M-CIDI at each wave. Diagnostic stability was defined as the proportion of individuals still affected with at least symptomatic eating disorders (EDs) at follow-ups. Baseline lifetime prevalence for any threshold ED were 2.9 % among females and 0.1 % among males. For any subthreshold ED lifetime prevalence were 2.2 % for females and 0.7 % for males. Symptomatic expressions of EDs (including core symptoms of the respective disorder) were most common with a lifetime prevalence of 11.5 % among females and 1.8 % among males. Symptomatic AN showed the earliest onset with a considerable proportion of cases emerging in childhood. 47 % of initial threshold AN cases and 42 % of initial threshold BN cases showed at least symptomatic expressions of any ED at any follow-up assessment. Stability for subthreshold EDs and symptomatic expressions was 14-36 %. While threshold EDs are rare, ED symptomatology is common particularly in female adolescents and young women. Especially threshold EDs are associated with a substantial risk for stability. A considerable degree of symptom fluctuation is characteristic especially for subthreshold EDs.

Explaining the pathway from familial and peer social support to disordered eating: Is body dissatisfaction the link for male and female adolescents?

“…Overwhelmingly affecting adolescent and emerging adult women, eating disorders can have lasting complications including increased risk for depression, obesity, substance use, and health problems (Wilson, Becker, & Heffernan, 2003). The transition to college and young adulthood might be an especially vulnerable period in the development of pathological eating behaviors (Delinsky & Wilson, 2008;Nagl et al, 2016;Sassaroli & Ruggiero, 2005). The college environment involves heightened competition and stressors that increase the risk of multiple forms of psychopathology, particularly in the first year (Conley, Kirsch, Dickson, & Bryant, 2014;Dusselier, Dunn, Wang, Shelley, & Whalen, 2005).…”

Universal prevention efforts should address eating disorder pathology across the weight spectrum: Implications for screening and intervention on college campuses

“…EDs most typically onset between adolescence and young adulthood (Hudson, Hiripi, Pope, & Kessler, 2007; Nagl et al, 2016; Stice, Marti, Shaw, & Jaconis, 2009), and the college years are associated with a significant reduction in students’ healthy lifestyle behaviors, which has implications for cardiovascular health and individuals’ weight gain trajectories (Arts, Fernandez, & Lofgren, 2014; Nelson, Larson, Barr-Anderson, Neumark-Sztainer, & Story, 2009; Nelson, Story, Larson, Neumark-Sztainer, & Lytle, 2008; Spring et al, 2014). Indeed, research has indicated that adults aged 18–29 years are more likely to develop obesity than individuals of older ages (Mokdad et al, 1999).…”

Emotions mediate the relationship between autistic traits and disordered eating: A new autistic-emotional model for eating pathology

“…The current study therefore assessed the overlap between eating pathology and a range of autistic traits in a large sample of university students, and also assessed whether emotions mediate this relationship by exploring a new autistic-emotional model of eating pathology. Although the official ED prevalence rate is around 0.5-3%, depending on the specific ED diagnosis, ED symptoms in the general population have been found to be as high as 12%, suggesting that it is meaningful to explore risk factors, such as ASD traits, in general population samples (Nagl et al, 2016).…”