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New Delhi: A new study, drawing from the 2019 Global Burden of Disease (GBD) report in the Lancet, has found that 41.9 million cases of binge-eating and other specified feeding or eating disorders (OSFED) went unrepresented that year.

The GBD is a worldwide, observational and epidemiological study tracking the prevalence of various diseases. Traditionally, the GBD has only focussed on two eating disorders — anorexia nervosa and bulimia nervosa.

The new study, also published in the Lancet on 3 March, sought to identify the prevalence of binge-eating and OSFED, which make up a majority of eating disorders globally. OSFED includes purging disorder, “subthreshold bulimia nervosa”, subthreshold binge-eating disorder, and atypical anorexia nervosa.

Anorexia is a eating disorder characterised by an abnormally low body weight and an intense fear of gaining weight. Bulimia, meanwhile, is a serious eating disorder marked by bingeing, and followed by methods to avoid weight gain. Purging disorder is characterised by purging behaviours that are not in response to a binge-eating episode.

The study noted that binge-eating disorder is defined by “recurrent episodes of compulsive overeating that lead to distress, without attempts to compensate for weight gain”. Meanwhile, OSFED “incorporates several distinct syndromes and is characterised by subclinical (example, lesser frequency or duration) or atypical symptoms of eating disorders without meeting full criteria for any of the other eating disorders”.

“GBD 2019 estimated that 13·6 million people had anorexia nervosa or bulimia nervosa in 2019, equivalent to 176.2 per 100 000 people. We estimated an additional 41·9 million prevalent cases of binge-eating disorder and OSFED globally in 2019, equivalent to 541.1 per 100 000 people,” the study noted.


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What the study says

To determine the number of cases unrepresented by the GBD, researchers selected 54 studies from various health databases, 36 of which were from high income countries.

“The network meta-regression of the prevalence ratios showed that prevalence of anorexia nervosa was lower than the prevalence of bulimia nervosa, and the prevalences of binge-eating disorder and OSFED were higher than that of bulimia nervosa,” the study found.

Of the 41.9 million cases identified in the study, there were “17·3 million people with binge-eating disorder and 24·6 million people with OSFED”. In addition, people with these two disorders caused 3.7 million disability-adjusted life-years (DALY). According to the study, “one DALY equates to one lost year of healthy life due to either mortality or disability”.

The study also found that the “burden was higher among females than males, and the burden of eating disorders peaked at 25–29 years for females and 30–34 years for males”.

Prevalence of eating disorders

The new report also said, “The inclusion of binge-eating disorder and OSFED increases the prevalence of eating disorders to 0.7 per cent in our study, in line with drug use disorders, and higher than bipolar disorder, autism spectrum disorder, and conduct disorder.”

Researchers also called for the inclusion of these eating disorders in future iterations of the GBD reports “which will bring the burden experienced by people living with these disorders to the attention of policy makers with the means to target this burden”.


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