Global, regional, and national burden of eating disorders in 204 countries and territories, 1990-2021: findings from the Global Burden of Disease Study 2021.

objectiveThe study is to examine the global, regional, and national burden of anorexia nervosa and bulimia nervosa from 1990 to 2021, and also the profile of eating disorders burden separated by the Socio-demographic Index (SDI) measurement.

methodsWe extracted age-standardized rates (ASRs) and their 95% uncertainty intervals (UIs) for the prevalence and disability-adjusted life years (DALYs) of anorexia nervosa (AN) and bulimia nervosa (BN) from the Global Burden of Disease Study 2021 (GBD 2021) through the period 1990-2021. Estimated annual percentage changes (EAPCs) were calculated to quantify secular trends of the burden of AN and BN. Cross-country inequality analysis was performed to assess absolute and relative inequalities of the burden between countries and territories.

resultsGlobally, the burden of AN and BN shows distinct geographic variations. In 2021, the age-standardized prevalence and DALYs rates of the diseases were generally higher in high-income regions such as North America, Western Europe, and Australasia, whereas Asia, Africa, and most countries across Latin America recorded relatively low levels. Although the burden was higher among females, the increase in ASRs was greater among males. In 2021, the highest ASRs of AN and BN were observed in Australasia globally, with prevalence rates of 184.36 (95% UI: 124.96-257.23) and 811.90 (95% UI: 629.68-1041.59), and DALYs rates of 39.46 (95% UI: 23.94-62.53) and 170.34 (95% UI: 106.42-262.05) per 100,000 population, respectively. However, East Asia exhibited the most significant ASRs increases. The burden estimates exhibited a positive correlation with SDI levels across most geographical regions. Furthermore, we observed that higher prevalence and DALYs rates were disproportionately concentrated in those countries with higher SDI.

conclusionSubstantial disparities exist in the burden of eating disorders across different SDI levels, regions, and countries, with marked variations in the rates of increase. Future research and interventions aimed at mitigating the burden should prioritize the development of tailored prevention and treatment strategies accounting for distinct regional and cultural contexts. Eating disorders (EDs), such as anorexia nervosa (AN) and bulimia nervosa (BN), are serious health conditions that affect millions of people around the world. Understanding their impact on different populations is crucial for organizing effective healthcare and support.In this study, we scrutinized the global burden of these disorders-meaning how common and disabling they are-across different countries and regions from 1990 to 2021. We analyzed data from over 200 countries to see how patterns have changed over time and whether they are linked to a country's level of social and economic development.What we found:Global Patterns: The burden of eating disorders is not evenly spread. In 2021, they were much more common in high-income regions like North America, Western Europe, and Australasia. In contrast, countries across Asia, Africa, and much of Latin America reported relatively lower levels. A Growing Concern for Men: While females are still more affected overall, the rate of increase in cases among males has been greater over the past three decades. Link to Development: There is a clear connection between a nation's development level and eating disorder rates. Countries with higher socioeconomic development tend to have significantly higher prevalence and health impacts from these disorders.Why this matters:Our findings show that the challenge of eating disorders varies greatly around the world. This means that a one-size-fits-all approach will not work. To reduce the global impact of these illnesses, prevention and treatment strategies must be carefully tailored to fit the specific social, economic, and cultural contexts of different regions and countries.