Trends in the prevalence and disability-adjusted life years of eating disorders from 1990 to 2017: results from the Global Burden of Disease Study 2017

Abstract

Aim Eating disorders have increasingly become a public health concern globally. This study aimed to reveal the burden of eating disorders at the global, regional and national levels using the Global Burden of Disease (GBD) Study 2017 data. Methods We extracted the age-standardised rates (ASRs) of prevalence and disability-adjusted life years (DALYs) and their 95% uncertainty intervals (UIs) of eating disorders, including anorexia nervosa and bulimia nervosa, between 1990 and 2017 from the GBD 2017 data. The estimated annual percentage changes (EAPCs) were calculated to quantify the secular trends of the burden of eating disorders. Results The ASRs of prevalence and the DALYs of eating disorders continuously increased worldwide from 1990 to 2017 by an average of 0.65 (95% UI: 0.59–0.71) and 0.66 (95% UI: 0.60–0.72), respectively. The burden of eating disorders was higher in females than in males, but the increment in ASRs was greater in males than in females over time. In 2017, the highest burden of eating disorders was observed in the high sociodemographic index (SDI) regions, especially Australasia (ASR of prevalence = 807.13, 95% UI: 664.20–982.30; ASR of DALYs = 170.74, 95% UI: 113.43–244.14, per 100 000 population), Western Europe and high-income North America. However, the most significant increment of the burden of eating disorders was observed in East Asia (EAPC for prevalence = 2.23, 95% UI: 2.14–2.32; EAPC for DALYs = 2.22, 95% UI: 2.13–2.31), followed by South Asia. An increasing trend in the burden of eating disorders at the national level was observed among most countries or territories. The countries with the top three highest increasing trends were Equatorial Guinea, Bosnia and Herzegovina and China. Positive associations were found between the burden estimates and the SDI levels in almost all geographic regions during the observed 28-year period. We also found that the human development indexes in 2017 were positively correlated with the EAPCs of the ASRs of prevalence (ρ = 0.222, P = 0.002) and DALYs (ρ = 0.208, P = 0.003). Conclusion The highest burden of eating disorders remains in the high-income western countries, but an increasing trend was observed globally and in all SDI-quintiles, especially in Asian regions that were highly populous. These results could help governments worldwide formulate suitable medical and health policies for the prevention and early intervention of eating disorders.

Burden of Eating Disorders in China, 1990-2019: An Updated Systematic Analysis of the Global Burden of Disease Study 2019

“…However, the prevalence and DALY rates of BN reached a peak at the age of 30-34 years. This finding is consistent with previous results (19). This may be due to the insufficient treatment of adolescent BN patients by clinical psychiatrists and the poor treatment effect.…”

“…However, given the very limited information on this issue, further studies in China are needed to explore the potential reason. The aforementioned study found that the burden of eating disorders increased with the increased SDI at regional levels and the highest burden was observed in the high SDI regions, particularly in Australasia, Western Europe, and high-income North America (19). In general, overweight and obesity are positively correlated with economic levels, globalization, and urbanization; these conditions could increase the risk of eating disorders (39).…”

“…The incidence of BN has decreased after a sharp rise in the UK (16). It is indeed that the high burden of eating disorders remains in the high-income western regions, but an increasing trend was observed worldwide, particularly in Asian regions that were highly populous (19). Historical evidence regarding the epidemic of eating disorders is commonly studied in Western countries; however, studies in China are mainly limited to Hong Kong, which is a high-income region (20,21).…”

Exploring Neural Mechanisms Related to Cognitive Control, Reward, and Affect in Eating Disorders: A Narrative Review of FMRI Studies

“…Eating disorders are serious psychiatric illnesses with a significant public health impact. 1 All eating disorders are characterized by a combination of disturbances in body image and maladaptive eating behaviors. The most well-characterized are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED).…”

Open science practices for eating disorders research

“…A major reason for under-powered studies is difficulty recruiting members of narrowly defined (and therefore small) and often hard to reach or retain populations. Although eating disorders are quite common overall (Burt et al, 2020;Kjeldbjerg & Clausen, 2021;Mitchison et al, 2020;Santomauro et al, 2021;Udo & Grilo, 2018;Wu, Liu, Li, Ma, & Wang, 2020), researchers may find it difficult to recruit specific subgroups (e.g., individuals with anorexia nervosa) within a reasonable timeframe. Any steps researchers can take to harmonize recruitment, assessment, training, or intervention protocols, and to share data will help accelerate discovery.…”