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New studies and the latest literature review on the prevalence of eating disorders

A definitive debunking of eating disorders statistics presented by Naomi Wolf was posted earlier.  A newer literature review and two new studies on the prevalence of eating disorders are presented below. Trends are discussed, and data on the prevalence of eating disorders that do not fall into standard diagnostic categories are presented.

Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry. 2006 Jul;19(4):389-94. (zip)

PURPOSE OF REVIEW: The purpose of this review is to evaluate the recent literature on the incidence and prevalence of and mortality associated with eating disorders. RECENT FINDINGS: General-practice studies show that the overall incidence rates of anorexia nervosa remained stable during the 1990s, compared with the 1980s. Some evidence suggests that the occurrence of bulimia nervosa is decreasing. Anorexia nervosa is a common disorder among young white females, but is extremely rare among black females. Recent studies confirm previous findings of the high mortality rate within the anorexia nervosa population. SUMMARY: The incidence of anorexia nervosa is around eight per 100,000 persons per year. An upward trend has been observed in the incidence of anorexia nervosa in the past century till the 1970s. The most substantial increase was among females aged 15-24 years, for whom a significant increase was observed from 1935 to 1999. The average prevalence rates for anorexia nervosa and bulimia nervosa among young females are 0.3 and 1%, respectively. Only a minority of people with eating disorders, especially with bulimia nervosa, are treated in mental healthcare.

Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biol Psychiatry. 2007 Feb 1;61(3):348-58. Epub 2006 Jul 3. (zip)

BACKGROUND: Little population-based data exist on the prevalence or correlates of eating disorders. METHODS: Prevalence and correlates of eating disorders from the National Comorbidity Replication, a nationally representative face-to-face household survey (n = 9282), conducted in 2001-2003, were assessed using the WHO Composite International Diagnostic Interview. RESULTS: Lifetime prevalence estimates of DSM-IV anorexia nervosa, bulimia nervosa, and binge eating disorder are .9%, 1.5%, and 3.5% among women, and .3% .5%, and 2.0% among men. Survival analysis based on retrospective age-of-onset reports suggests that risk of bulimia nervosa and binge eating disorder increased with successive birth cohorts. All 3 disorders are significantly comorbid with many other DSM-IV disorders. Lifetime anorexia nervosa is significantly associated with low current weight (body-mass index <18.5), whereas lifetime binge eating disorder is associated with current severe obesity (body-mass index >/=40). Although most respondents with 12-month bulimia nervosa and binge eating disorder report some role impairment (data unavailable for anorexia nervosa since no respondents met criteria for 12-month prevalence), only a minority of cases ever sought treatment. CONCLUSIONS: Eating disorders, although relatively uncommon, represent a public health concern because they are frequently associated with other psychopathology and role impairment, and are frequently under-treated.

Machado PP, Machado BC, Goncalves S, Hoek HW. The prevalence of eating disorders not otherwise specified. Int J Eat Disord. 2006 Dec 15;40(3):212-217 [Epub ahead of print] (zip)

OBJECTIVE:: Eating Disorders Not Otherwise Specified (EDNOS) represent the most common eating disorder diagnosed in specialized treatment settings. The purpose of the current study is to assess the prevalence of EDNOS in a nationwide community sample. METHOD:: Participants were 2,028 female students, aged 12-23, attending public schools in the 9th to 12th grades in Portugal. Participants completed the Eating Disorder Examination Questionnaire in Stage 1 of the study. In Stage 2, we selected all the participants who met any of these criteria: (1) BMI </=17.5, (2) scores >/=4 on any of the four EDE-Q Subscales, (3) a total EDE-Q score >/=4, or (4) the presence of dysfunctional eating behaviors. In Stage 2, eating disorder experts interviewed 901 participants using the Eating Disorder Examination. RESULTS:: The prevalence of all eating disorders was 3.06% among young females. Prevalence for anorexia nervosa was 0.39%, for bulimia nervosa 0.30%, EDNOS 2.37%. CONCLUSION:: EDNOS is a very common eating disorder and accounts for three-quarters of all community cases with eating disorders.

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