Feb. 4, 2007 The first national survey of individuals with eating disorders shows that binge eating disorder is more prevalent than either anorexia nervosa or bulimia nervosa. The study, conducted by researchers at Harvard-affiliated McLean Hospital, also calls binge eating disorder a "major public health burden" because of its direct link to severe obesity and other serious health effects.
"For the first time, we have nationally representative data on eating disorders. These data clearly show that binge eating disorder is the most common eating disorder," says lead author James I. Hudson, MD, ScD, director of the Psychiatric Epidemiology Research Program at McLean Hospital and professor of psychiatry at Harvard Medical School.
The study (abstract), published in the current issue of Biological Psychiatry, is based on data obtained over two years in the National Comorbidity Survey Replication (NCS-R), a survey of more than 9,000 people from across the United States about their mental health. Ronald C. Kessler, PhD, principal investigator of the NCS-R, and Eva Hiripi, of Harvard Medical School, and Harrison Pope Jr., MD, director of McLean Hospital's Biological Psychiatry Laboratory, are co-authors of the paper.
The survey found that 0.9 percent of women and 0.3 percent of men reported having anorexia nervosa at some point in their lives, and that 1.5 percent of women and 0.5 percent of men reported having bulimia nervosa. By contrast, binge eating disorder, a condition in which individuals experience frequent uncontrolled eating binges without purging, afflicts 3.5 percent of women and 2 percent of men at some point in their lives.
"Everybody knows about anorexia and bulimia; however, binge eating disorder affects more people, is often associated with severe obesity and tends to persist longer,'' Hudson says. "The consequences of binge eating disorder can be serious-including obesity, diabetes, heart disease, high blood pressure and stroke. It is imperative that health experts take notice of these findings."
The survey also found that the average lifetime duration of anorexia was 1.7 years, compared to 8.3 years for bulimia and 8.1 years for binge eating disorder. "Contrary to what people may believe, anorexia is not necessarily a chronic illness; in many cases, it runs its course and people get better without seeking treatment. So our survey suggests that for every one severe case [of anorexia], there may be many other milder cases."
The survey calls for further study of why some individuals with anorexia are able to recover more quickly and why others are crippled by the illness, say Hudson and Pope. "If we identified the factors that allowed people to recover from eating disorders quicker than others, then we might be better able to prevent the chronic, severe cases."
The findings, say Hudson and Pope, offer additional scientific support for including the diagnosis of binge eating disorder as an official psychiatric diagnosis in the next edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders."
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