Prevalence of Eating Disorders Among Adults ... The Newest Study and the Numbers Say ...

If we knew what it was we were doing, it would not be called research, would it?

            Albert Einstein

I believe in innovation and that the way you get innovation is you fund research and you learn the basic facts.

            Bill Gates

The most recent edition of the Journal of Biological Psychiatry just published the most comprehensive research study ever conducted on eating disorders. It is significant that the research findings took into  account the most recent version of the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition which was published in 2013. The DSM-V varied the definitions of eating disorders and was more authoritative and inclusive of the symptomology.

The research study was based on extensive interviews of 36,309 adults which was by far the most broad, far reaching study ever conducted with regard to eating disorders. The methodology and measurement techniques were designed to eliminate as many false variables as possible. For each Eating Disorder diagnosis, weighted means, medians, and frequencies were computed for age, BMI, age of onset, years with episode, persistence of ED, and ED-related impairment; analysis of covariance was used to examine whether current age, current BMI, age of onset, and years with episodes differed between AN, BN, and BED after adjusting for sociodemographic variables.

The analysis of the raw statistics, findings and results support the belief and speculation held by most experienced practitioners in the ED field.

General Findings

The general findings of the study estimate that 0.80 percent of US adults will be affected by anorexia nervosa in their lifetime; 0.28 percent will be affected by bulimia nervosa; and 0.85 percent will be affected by binge eating disorder. To translate these percentages to raw numbers, using the estimated current US population of 325,000,000 reveals the following:

1.    2,600,000 US adults will suffer from anorexia nervosa;

2.   910,000 US adults will suffer from bulimia nervosa;

3.   2,762,500 US adults will suffer from binge eating disorders.

It is unknown to what extent the numbers for bulimia and binge eating disorders overlap. But, the two most important conclusions that can be drawn from this report are:

1. Eating disorders are far more prevalent than earlier estimates, especially when one considers the second point;

2.  This study only involved adults 18 years old and older. It did not take into account our children who, every study has shown suffer from this disease on a higher percentage than adults.

Tomoko Udo, PhD, of University at Albany, New York who conducted the study alongside Carlos Grilo, PhD, of Yale University School of Medicine stated: "Our study confirms that eating disorders are common, are found in both men and women and across ethnic/racial groups, occur throughout the lifespan, and are associated with impairments in psychosocial functioning."

John Krystal, Editor of Biological Psychiatry, stated: "The prevalence and impact of eating disorders continues to be underestimated in society. This definitive study should guide both research and policy development."

Findings Taking Into Account Various Factors

The study also took into account various factors and drew conclusions based upon those factors. The study indicated:

“Adjusting for age, race and/or ethnicity, education, and income categories, odds of lifetime and 12-month diagnoses of all three EDs were significantly greater for women than men, particularly for AN and BN.”

“We also found that:

1) the risk of lifetime AN diagnosis was significantly lower for Hispanic and non-Hispanic black respondents than for non-Hispanic white respondents;

2) the risks of lifetime and 12-month BN diagnoses did not differ significantly by race and/or ethnicity;

3) the risk of lifetime BED but not 12-month BED diagnosis was significantly lower for non-Hispanic black than non-Hispanic white respondents;

4) the risks of lifetime and 12-month BED diagnoses for Hispanic and non-Hispanic white respondents did not differ significantly; and

5) the risk of lifetime AN diagnosis was associated with higher income.”

“Overall, it is important to recognize that EDs occur across all ethnic/racial groups and that the rates for some diagnoses (e.g., BN and BED to a lesser extent) are comparable across groups. However, 12-month AN diagnosis was most prevalent among non-Hispanic white respondents, women, and respondents 18 to 29 years of age. The findings are broadly consistent with previous DSM-IV–defined EDs in their analysis of 24,124 adult respondents from the World Health Organization World Mental Health Survey, reported roughly comparable prevalence estimates for BN and BED diagnoses across 14 countries.”

“Collectively, such findings highlight the importance of actively considering all forms of diversity across prevention and intervention clinical and/or research work, which to date appears to be at odds with our findings.”

“Findings regarding the mean ages of onset for AN, BN, and BED were  ages 19.3, 20.0, and 24.5 years, respectively.”

“The chronic nature of EDs was suggested by long illness durations and rates of 12-month persistence, which highlight the importance of early recognition and intervention.”

The Study’s Conclusions

“Our findings for DSM-5–defined EDs, based on the largest national sample of U.S. adults studied to date, indicate these are prevalent disorders distributed across age groups, across both men and women, and across different ethnic and/or racial groups. Although substantial differences between EDs exist, overall, they appear to be persistent and associated with substantial rates of impairment in psychosocial functioning. EDs show differential associations with obesity, and our findings highlight substantial associations between BED and extreme obesity. Thus, our findings indicate that DSM-5– defined EDs represent an important public health problem.”

Post Script

Ordinarily, at this point in most of the articles I have written, I would end with a pithy remark, a challenge to some group or an outpouring of emotion.

In this case, the very disturbing findings and conclusions of this study stand alone.

And as our loved ones continue to be treated as mere corporate commodities,  to be disposed of and discarded in the name of profits and skewed EBITDA numbers, one cannot help but wonder when the "carousel of death" fueled by private equity firms and insurance entities will slow down.