While eating disorders are especially prevalent in adolescence and young adulthood, they can also reoccur in later life, suggesting the importance of identification, prevention, and treatment across all ages, according to study results published in JAMA Network Open. The study results also suggest that increasing treatment coverage could decrease the rate of eating disorder-related deaths.
Investigators conducted an analytical study in which a virtual group of 100,000 people (50% men) were modeled from birth to age 40 years for anorexia nervosa, bulimia nervosa, binge eating disorder, and other specified feeding and eating disorders. The primary outcomes were age-specific 12-month and lifetime eating disorder prevalence and the mortality rate per 100,000 people in the general population by age 40 years.
Both men and women had the highest estimated average annual prevalence of eating disorders around age 21 years (7.4% men, 10.3% women). By age 40 years, lifetime average prevalence increased to 14.3% for men and 19.7% for women; 95% of first-time cases of eating disorders occurred by age 25 years.
Researchers noted that while the current treatment coverage could prevent 41.7 deaths per 100,000 individuals by age 40 years, increasing treatment coverage for all patients with eating disorders could prevent an average of 70.5 deaths per 100,000 people.
“Our findings support the idea that adolescence and young adulthood are critical periods for the initial development of [eating disorders]…” the investigators noted. “This finding suggests that prevention efforts may best be targeted to adolescent or younger individuals. However, given the risk of relapse and continued [eating disorder] prevalence at later ages, diagnosis and treatment of [eating disorders] at older ages should also be a priority,” they concluded.
“Further research on cost-effective strategies to increase the proportion of patients with EDs who receive treatment could help to alleviate the ED disease burden,” added the researchers.
Ward ZJ, Rodriguez P, Wright DR, Austin SB, Long MW. Estimation of eating disorders prevalence by age and associations with mortality in a simulated nationally representative US cohort. JAMA Netw Open. 2019;2(10):e1912925.