Global study significantly underestimated prevalence of certain eating disorders
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The Global Burden of Diseases, Injuries and Risk Factors Study should formally include binge-eating disorder and other specified feeding or eating disorders, according to study results published in The Lancet Psychiatry.
Doing so would have implications for government funding towards eating disorder research and health care, researchers noted.
“We sought to estimate the prevalence and burden due to binge-eating disorder and [other specified feeding or eating disorders] globally using methods that adhere to the [Global Burden of Diseases, Injuries and Risk Factors Study] (GBD) protocols and framework,” Damian F. Santomauro, PhD, of the School of Public Health at the University of Queensland in Australia, and colleagues wrote. “In doing so, we evaluated the importance and feasibility of their inclusion within future GBD studies. The availability of burden of disease estimates for binge-eating disorder and [other specified feeding or eating disorders] would provide further resources for better understanding the effects of eating disorders on population health, and in determining the best strategies for reducing these effects.”
The researchers sourced data from the anorexia nervosa and bulimia nervosa epidemiological databases of the GBD 2019, studies with epidemiological estimates of binge-eating disorder and other specified feeding and eating disorders included in two systematic reviews and from experts in the field. Specifically, they included 54 studies, of which 36 were from high-income countries, published between January 1998 and March 2019 that reported non-zero prevalence of at least two eating disorder and diagnosed cases according to DSM-IV or DSM-5 criteria. They used network meta-regression and simulation based on studies that reported eating disorder prevalence to estimate proportions of total eating disorder cases that met each individual eating disorder’s diagnostic criteria. Further, using the proportions from the simulation and the GBD 2019 eating disorder prevalence, they estimated global cases not represented in GBD 2019.
Results showed 41.9 million global eating disorder cases in 2019 were unrepresented in GBD 2019. This amount consisted of 17.3 million individuals with binge-eating disorder and 24.6 million with other specified feeding or eating disorders; these disorders caused a combined 3.7 million disability-adjusted life years (DALYs) globally for a total eating disorder DALYs of 6.6 million in 2019.
“The inclusion of binge-eating disorder and [other specified feeding and eating disorders] in GBD will bring recognition of the burden experienced by people living with these disorders to those with the means to target this burden,” Santomauro and colleagues wrote.
In a related editorial, Jennifer J. Thomas, PhD, and Kendra R. Becker, PhD, of the Eating Disorders and Clinical Research Program at Massachusetts General Hospital, provided recommendations for how the GBD can improve its future estimation of eating disorders.
“We recommend that GBD include prevalence estimates for avoidant/restrictive food intake disorder, rumination disorder and pica; and obtain direct measures of the disability associated with all DSM-5 Feeding and Eating Disorders,” Thomas and Becker wrote. “If they do, the reported global burden will be even greater, underscoring the clear need for increased funding to study, prevent and treat these debilitating illnesses.”