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Anorexia nervosa epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Joseph Nasr, M.D.[2] Kiran Singh, M.D. [3]
Overview
[edit | edit source]Anorexia nervosa is an eating disorder characterized by restrictive energy intake, intense fear of weight gain, and a disturbed perception of body weight or shape. It occurs worldwide and affects individuals across all racial, ethnic, and socioeconomic groups, although prevalence varies by sex, age, and sociocultural context. The disorder most commonly begins during adolescence or young adulthood and disproportionately affects females.[1][2]
Epidemiology and Demographics
[edit | edit source]Prevalence
[edit | edit source]Epidemiologic estimates of anorexia nervosa vary by study design, diagnostic criteria, and population. Earlier estimates reported a 12-month prevalence of approximately 0.4% (400 per 100,000) among young females in Western populations.[1] More recent population-based studies suggest that the lifetime prevalence of anorexia nervosa among adults in the United States is approximately 0.6%–2.2% in females and 0.1%–0.6% in males, with point and 12-month prevalence substantially lower than lifetime prevalence.[2]
Globally, eating disorders as a group affect approximately 2%–5% of individuals during their lifetime, with anorexia nervosa representing a smaller but clinically severe proportion of cases.[3][4][5] The majority of prevalence and incidence data originate from high-income Western countries, and epidemiologic estimates may underestimate disease burden in low- and middle-income regions due to underdiagnosis and limited access to mental health services.[3][4][5]
Incidence
[edit | edit source]The incidence of anorexia nervosa peaks during adolescence, particularly in mid-to-late teenage years. Adolescents and young adults account for the highest proportion of newly diagnosed cases, with onset before age 25 in most individuals.[2][6] Incidence rates are lower in childhood and later adulthood, but cases can occur across the lifespan.
Sex and Gender Distribution
[edit | edit source]Anorexia nervosa occurs more frequently in females than males. Approximately 85%–90% of individuals diagnosed with anorexia nervosa are female, consistent with earlier clinical observations.[6] Contemporary epidemiologic studies report a female-to-male ratio of approximately 10–12:1.[2] Despite this disparity, anorexia nervosa is increasingly recognized in males, who may be underdiagnosed due to sex-based stereotypes and differences in symptom presentation.
Sexual and gender minority individuals have a higher prevalence of eating disorder diagnoses compared with heterosexual and cisgender populations, suggesting that psychosocial stressors and minority stress may contribute to increased risk.[7]
Age Distribution
[edit | edit source]The disorder most commonly presents during adolescence, with females aged 15–19 years historically accounting for a large proportion of cases.[6] However, anorexia nervosa can occur in preadolescent children and in adults, and delayed diagnosis is common, particularly in populations with atypical presentations or normal-weight restrictive eating patterns.[8][9]
Race, Ethnicity, and Geographic Distribution
[edit | edit source]Anorexia nervosa has been documented across diverse racial and ethnic groups. While early studies suggested higher prevalence among White populations in Western countries, more recent data indicate that eating disorders occur across racial and ethnic backgrounds, with disparities in diagnosis and treatment access rather than true absence of disease accounting for observed differences.[2][3][4][5]
References
[edit | edit source]- ↑ 1.0 1.1 Diagnostic and statistical manual of mental disorders : DSM-5. Washington, D.C: American Psychiatric Association. 2013. ISBN 0890425558.
- ↑ 2.0 2.1 2.2 2.3 2.4 Udo T, Grilo CM. Prevalence and correlates of DSM-5–defined eating disorders in a nationally representative sample of US adults. Biol Psychiatry. 2018;84(5):345-354. doi:10.1016/j.biopsych.2018.03. 014
- ↑ 3.0 3.1 3.2 Lai CM, Mak KK, Pang JS, Fong SS, Ho RC, Guldan GS. The associations of sociocultural attitudes towards appearance with body dissatisfaction and eating behaviors in Hong Kong adolescents. Eat Behav. 2013;14(3):320-324. doi:10.1016/j.eatbeh. 2013.05.004
- ↑ 4.0 4.1 4.2 SabryW, ElMahlawy N, Essawy H, Al-Saleet G, Saad M, MorsyM. Occurrence, sociodemographic, and clinical correlates of eating disorders among a sample of secondary school students in Egypt. Published November 25, 2020. Accessed May 21, 2024. https://mecp.springeropen.com/articles/10. 1186/s43045-020-00073-6
- ↑ 5.0 5.1 5.2 Uchôa FNM, Uchôa NM, Daniele TMD, et al. Influence of the mass media and body dissatisfaction on the risk in adolescents of developing eating disorders. Int J Environ Res Public Health. 2019;16(9):1508. doi:10.3390/ ijerph16091508
- ↑ 6.0 6.1 6.2 Lask B, and Bryant-Waugh, R (eds) (2000) Anorexia Nervosa and Related Eating Disorders in Childhood and Adolescence. Hove: Psychology Press. ISBN 0-86377-804-6.
- ↑ Kamody RC, Grilo CM, Udo T. Disparities in DSM-5 defined eating disorders by sexual orientation among US adults. Int J Eat Disord. 2020; 53(2):278-287. doi:10.1002/eat.23193
- ↑ Walsh BT, Hagan KE, Lockwood C. A systematic review comparing atypical anorexia nervosa and anorexia nervosa. Int J Eat Disord. 2023;56(4):798- 820. doi:10.1002/eat.23856
- ↑ Harrop EN, Mensinger JL, Moore M, Lindhorst T. Restrictive eating disorders in higher weight persons: a systematic review of atypical anorexia nervosa prevalence and consecutive admission literature. Int J Eat Disord. 2021;54(8): 1328-1357. doi:10.1002/eat.23519
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