An Upswing in Eating Disorders Is Noted In Great Britain

Some important implications for provision of health care.

Thus far, very few studies have investigated the incidence of eating disorders in Great Britain.. In a study from Great Britain conducted between 2000 and 2009, Dr. Nadia Micali and fellow researchers in London and Massachusetts found that the increase in the incidence of eating disorders varied by gender and type. Eating disorders not otherwise specified (EDNOS) was the most common eating disorder in males and females, and there was a significant increase in the incidence of eating disorders in both males and females (BMJ Open. 2013;3:e002646) during that decade.

The researchers used data from the General Practice Research Database (GPRD), a large anonymous medical general practice database. This database contains information from 400 general practices, and represents about 5% of the general population. It also includes about 40 million person-years of follow-up. The authors identified all subjects from 10 to 49 years of age who had a first-time diagnosis of anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS). The authors identified 9,120 patients with first-time diagnoses of AN, BN, or EDNOS from 2000-2009. Rates of eating disorders among females increased between 2000 to 2009, from 51.8 per 100,000 population to 62.6 per 100,000; this increase was accounted for by increases in the incidence of EDNOS cases. For example, in 2000 the incidence of EDNOS was 17.7 per 100,000 population compared to 28.4 per 100,000 in 2009. Incidence among males also increased, from 5.6 per 100,000 to 7.1 per 100,000 during 2000 to 2009. As in the female group, EDNOS was the most common diagnosis in males during the study period; the incidence was 3.4 per 100,000 in 2000 and 4.2 per 100,000 in 2009 (a 24% increase).

As one would expect, incidence was age-specific, and the incidence of AN, BN, and EDNOS was highest in girls aged 15 to 19 years. In this group, the incidence rate for all diagnosed eating disorders was 164.5 per 100,000 population; in nearly a fourth of these girls, the onset of AN occurred between 15 and 19 years of age The authors estimated that in Great Britain, 2 of 1,000 girls between 15 and 19 years of age were likely to be newly diagnosed with an eating disorder.

Among females 10 to 49 years of age, EDNOS was the most common diagnosis, reaching 28.4 per 100,000 in 2009. Incidence rates were lower for males than females ( 10 vs. 7.1 per 100,000, respectively) and the peak years of incidence were 15 and 19 years of age for females and males, respectively. As in the female groups, EDNOs was the most common diagnosis. New diagnoses of AN and BN remained stable across the study period, but the overall increase was due to a higher number of new EDNOS diagnoses in the last third of the decade.

Was the increase in incidence a reflection of a true increase in the community or merely the result of better methods of detection? The authors suggest that future research should help answer this question, and that the answer will have important implications for public health, provision of health care, and understanding of the development of eating disorders