The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019 - PubMed (original) (raw)

The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019

Damian F Santomauro et al. Lancet Psychiatry. 2021 Apr.

Abstract

Background: Anorexia nervosa and bulimia nervosa are the only eating disorders included in the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, yet binge-eating disorder and other specified feeding or eating disorder (OSFED) are more prevalent. This study sought to estimate the prevalence and burden of binge-eating disorder and OSFED globally and present a case for their inclusion in GBD.

Methods: We sourced studies from the GBD 2019 anorexia nervosa and bulimia nervosa epidemiological databases, two systematic reviews that included studies with epidemiological estimates of binge-eating disorder and OSFED, and experts in the field. Studies, published between Jan 1, 1998, and March 1, 2019, were included if they reported non-zero prevalence of two or more eating disorders (anorexia nervosa, bulimia nervosa, binge-eating disorder, or OSFED) and diagnosed cases according to DSM-IV or DSM-5. The proportions of total eating disorder cases that met diagnostic criteria for each individual eating disorder were estimated via network meta-regression and simulation using studies reporting eating disorder prevalence. The global cases unrepresented in GBD 2019 were estimated using the proportions from the simulation and the GBD 2019 eating disorder prevalence. Disability weights for binge-eating disorder and OSFED were then estimated along with disability-adjusted life-years (DALYs). Estimates are presented with 95% uncertainty intervals (UIs).

Findings: 54 studies, of which 36 were from high-income countries, were included in the analysis. The number of global eating disorder cases in 2019 that were unrepresented in GBD 2019 was 41·9 million (95% UI 27·9-59·0), and consisted of 17·3 million (11·3-24·9) people with binge-eating disorder and 24·6 million (14·7-39·7) people with OSFED (vs 13·6 million [10·2-17·5] people with eating disorders in GBD 2019). Together, binge-eating disorder and OSFED caused 3·7 million (95% UI 2·0-6·5) DALYs globally, bringing the total eating disorder DALYs to 6·6 million (3·8-10·6) in 2019.

Interpretation: Binge-eating disorder and OSFED accounted for the majority of eating disorder cases and DALYs globally. These findings warrant the inclusion of binge-eating disorder and OSFED in future iterations of GBD, which will bring the burden experienced by people living with these disorders to the attention of policy makers with the means to target this burden.

Funding: Queensland Health, Australian National Health and Medical Research Council, and Bill & Melinda Gates Foundation.

Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

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Figures

Figure 1

Figure 1

Process of study identification GBD=Global Burden of Diseases, Injuries, and Risk Factors Study.

Figure 2

Figure 2

Global prevalence by eating disorder diagnosis, sex, and age in 2019 OSFED=other specified feeding or eating disorder. Shaded areas denote 95% uncertainty intervals.

Figure 3

Figure 3

Global DALYs by eating disorder, sex, and age in 2019 DALYs=disability-adjusted life-years. OSFED=other specified feeding or eating disorder.

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References

    1. American Psychiatric Association . 5th edn. American Psychiatric Association Publishing; Arlington, VA: 2013. Diagnostic and statistical manual of mental disorders (DSM-5)
    1. Johnson JG, Cohen P, Kasen S, Brook JS. Eating disorders during adolescence and the risk for physical and mental disorders during early adulthood. Arch Gen Psychiatry. 2002;59:545–552. - PubMed
    1. Harris EC, Barraclough B. Excess mortality of mental disorder. Br J Psychiatry. 1998;173:11–53. - PubMed
    1. Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies. Arch Gen Psychiatry. 2011;68:724–731. - PubMed
    1. Samnaliev M, Noh HL, Sonneville KR, Austin SB. The economic burden of eating disorders and related mental health comorbidities: an exploratory analysis using the U.S. Medical Expenditures Panel Survey. Prev Med Rep. 2014;2:32–34. - PMC - PubMed

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