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Course and Prevalence of Eating Disorders

According to concervative estimates, about 0.3% of all women in the general population will suffer from Anorexia Nervosa in their lifetimes, another 1% will suffer from Bulimia Nervosa, and still another 1% will be diagnosed with Binge-Eating Disorder [ref]. When broader clinical criteria are used, it is estimated that close to one in ten women in America will experience some form of an Eating Disorder in their lifetimes [ref, ref]. One study found that as many as 16% of adolescents ages 14-20 may suffer from an Eating Disorder [ref].

These disorders are thought to be 6 to 10 times more prevalent in women than in men [ref], though one study found that in adolescents, males account for 25% of cases [ref].

Eating Disorders tend to start in adolescence, and for a substantial number of individuals the condition will persist for many years well into adulthood. In Anorexia Nervosa, the process of recovery is a slow one, with a third of patients recovering within 4 years of starting treatment, half recovering within 4-10 years, and three quarters recovering after more than 10 years of treatment [ref]. This means that about a quarter of patients with Anorexia Nervosa continue to suffer from symptoms for many years after first being diagnosed, with close to 15% not showing any improvement at all after more than 10 years [ref].

Anorexia Nervosa has the highest mortality rate of all psychiatric disorders. It is estimated that with each decade of suffering from this condition, over 5% of individuals will die [ref]. This is due to the medical complications of being severely underweight, and also to suicide [ref].

Even among those individuals who do overcome their symptoms of Anorexia Nervosa, many will continue to suffer from other psychiatric disorders [ref] and will continue to be preoccupied to some extent by their weight and eating habits [ref]. The earlier that Anorexia Nervosa is diagnosed and treated, the better the chances that the individual will recover [ref].

Individuals with Bulimia Nervosa seem to recover more quickly and in higher numbers than those with Anorexia Nervosa [ref]. However, after 10 years of being diagnosed with Bulimia Nervosa and receiving treatment, close to a third of individuals will continue to have some symptoms of an Eating Disorder [ref]. Being diagnosed at a younger age increases one's chances of recovering from Bulimia Nervosa [ref].

The course of Binge-Eating Disorder has been less rigorously studied, but the available data suggest that many of these individuals improve even without any treatment, especially if the disorder occurs in adolescence or early twenties [ref]. With treatment, about two thirds of individuals no longer have any symptoms after five years [ref].

Many individuals with Eating Disorders will be found to have different types of Eating Disorders at different points in time. More than half of those who are initially diagnosed with Anorexia Nervosa Restricting Type eventually develop symptoms of the Binge-Eating/Purging Type within several years, and only slightly more than 10% never report any binge-eating or purging behaviors at all [ref]. Anywhere from 20-50% of individuals with Anorexia Nervosa will eventually be diagnosed with Bulimia Nervosa, and about 10% of those with Bulimia Nervosa will eventually be diagnosed with Anorexia Nervosa [ref].

 

Psychological Factors

Associated Conditions (Comorbidity)