Eating disorders rose from 2018 to 2022 in US
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Key takeaways:
- Patients aged 14 to 18 years accounted for most eating disorder claims in 2022.
- Overall, 72% of patients with eating disorders were diagnosed with at least one co-occurring mental illness.
Eating disorder claims in the United States rose 65% as a percentage of all medical claims over the last 5 years, according to a report from FAIR Health, a health care claims repository.
Researchers at FAIR Health evaluated more than 43 billion private health care claims records to investigate trends in eating disorders from 2018 to 2022 based on regional and national levels, demographic and socioeconomic factors and other health conditions.
They found an increase in all eating disorders subtypes, which included:
- avoidant/restrictive food intake disorder (ARFID; 305%);
- binge-eating disorder (81%);
- anorexia (73%); and
- bulimia (3%).
Robin Gelburd, the president of FAIR Health, told Healio that the prevalence of co-occurring mental health disorders among eating disorder claims particularly stood out to her.
“Seventy-two percent of patients with eating disorders were also diagnosed with one or more co-occurring mental health conditions that were not eating disorders,” she said.
The percentage of one or more co-occurring mental health conditions ranged from 65% among patients with ARFID to 78% among patients with bulimia. The most common co-occurring conditions were:
- general anxiety disorder (41%);
- major depressive disorder (38.6%);
- adjustment disorders (11.5%); and
- ADHD (11.2%).
Additionally, more than 20% of patients with an eating disorder also had a substance use disorder.
Gelburd said the findings “somewhat confirmed” that women and girls were disproportionally reflected in the data.
“We found that in every year from 2018 to 2022, females accounted for more than 89% of eating disorder claim lines compared to less than 11% for males,” she said.
The only age group in 2022 where more males had eating disorder claims than females were those aged 0 to 9 years.
Researchers also found that telehealth use for the treatment of eating disorders increased by 10,000%, whereas office-based care fell 55%.
In 2018, patients aged 19 to 24 years accounted for the largest share of eating disorder claims (25%), followed by those aged 14 to 18 years (21%). By 2022, patients aged 14 to 18 years accounted for the largest proportion (28%), whereas those aged 19 to 24 years were the second largest group (23%). This shift comes amid an ongoing mental health crisis in youth, one the AMA has called a national emergency.
Based on the prevalence of mental illness conditions and its connections to eating disorders, Gelburd said that “primary care physicians should be particularly sensitive to that relationship in their intake questionnaires and ongoing monitoring of their patients to [ensure] that the patients’ eating disorder is not compartmentalized from other aspects of their health care.”
References:
- From 2018 to 2022, eating disorder claim lines increased 65 percent nationally as a percentage of all medical claim lines. https://www.eurekalert.org/news-releases/1007924. Published Nov. 15, 2023. Accessed Nov. 15, 2023.
- Spotlight on eating disorders: An analysis of private healthcare claims. https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/Spotlight%20on%20Eating%20Disorders%20-%20A%20FAIR%20Health%20White%20Paper.pdf. Accessed Nov. 15, 2023.
Perspective
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Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS
This report sheds light on the prevalence of eating disorders in the population. Of note, binge eating disorder was highly prevalent but was most likely not to be associated with concurrent mental health disorders. The most significant increase in diagnoses was ARFID, but there were also large increases in binge eating disorder and anorexia nervosa. Telemedicine was used to diagnose these entities, which was up over 10,000%, which speaks to the changing landscape of medicine. It should also be noted that there were regional differences in diagnosis and treatment.
PCPs should have a heightened awareness of eating disorders of all subtypes in their practices. They should use tools to screen and appropriately refer patients who need additional care to manage their disorder. The goal is to diagnose and treat early to avoid negative long-term sequelae.
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