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Lower mortality was attributed to a system that coordinates diagnosis and treatment.
Mortality rates among eating disorders patients have long been a concern, particularly among anorexia nervosa patients. AN has a mortality rate that is around 12 times higher than the mortality rates from all other causes (Annual Review of Eating Disorders. CRC Press. 2018.66-76).
A recent study in Florence, Italy, has reported lower mortality rates among those with eating disorders (Acta Psychiatr Scand. 2023. 147:122). The study was conducted using data from the Eating Disorders Treatment Network (EDTN) that serves the area in and around Florence. A total of 1277 individuals with EDs were included in the authors’ study, including 368 with AN, 312 with BN, and 597 individuals with Binge Eating Disorder (BED). Twenty-two patients (1.72%) died during a median follow-up of 7.4 years. AN and BN participants were mostly females (97.6% and 97.8%, respectively), and median age was 22.5 years. Males made up 13.6% of the study group, and their median age at clinical evaluation was 43 years. The median age of onset was 17 years for AN and 17.5 years for BED. The standardized mortality ratio (SMR) was 2.49 among AN patients, and 2.07 among BN patients—(these SMR’s might suggest somewhat elevated risks but due to small sample size, these results were not statistically significantly elevated).
The mortality rates among all ED patients did not significantly differ from that of the general population of the same age and sex, with an SMR) of 1.19. Among BN patients, the mortality rate rose significantly after 10 years of clinical evaluation.
What explained the lower mortality rates?
It is of note that the sample size was small for studies of this type, and the observation period was relatively short; both factors may have influenced the results. Still, the results are encouraging.
Dr. Giovanni Castellini and fellow researchers at the University of Florence and Careggi University Hospital, Florence, attribute the lower mortality rates in their study to the establishment of the Eating Disorders Treatment Network (EDTN) that serves the area in and around Florence. The EDTN in Florence is a regional treatment referral center specializing in eating disorders. inpatient medical treatment, residential rehabilitation treatment, and day hospital care. The findings of the study may reflect in part the results of such a coordinated approach. A multidisciplinary team provides evidence-based treatment across different levels of care: outpatient, inpatient medical treatment, residential rehabilitation treatment and day hospital care. The findings of the study may reflect in part the results of such a coordinated approach.