Caution: Eating Disorders Pose 4 Times Higher Health Risks

Bulimia, binge eating, and anorexia are known as eating disorders that give rise to serious health risks in both physical and mental well-being. The consequences are long-lasting and dangerous that need coordinated multidisciplinary care from specialists. The revelations were given by researchers from BMJ group, and published in BMJ Medicine. Physical complications like fractures, organ failure, and premature death are at higher level, especially within the first 12 months of diagnosis.(1^✔ ✔Trusted Source
Adverse outcomes in patients with a diagnosis of an eating disorder: primary care cohort study with linked secondary care and mortality records

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Mental conditions like psychological disorders, suicidal behavior, and self-harm may cause severe life threats, elevated for years.

Researchers reveal that urgent and comprehensive care from physical specialists such as nephrology, cardiology, hepatology and psychiatry (for mental health) with constant monitoring are the keys to improve patient outcomes.

20-Year Analysis Links Eating Disorders to Increased Physical, Mental Health Risks

To strengthen the evidence base, the researchers scrutinized anonymized medical records in the Clinical Practice Research Datalink, linked to Hospital Episode Statistics and death certification data for people across England over a 20-year period (1998 to 2018 inclusive).

Some 24,709 people, aged 10-44, with a diagnosed eating disorder, were matched for age, sex, and GP practice with up to 20 others without these disorders (493,001 in total), and their mental and physical health tracked for 10 years.

Most (89%) of the entire sample was female. And among those with eating disorders, 14.5% (3577) had anorexia; 20.5% (5085) had bulimia; 5% (1215) had a binge eating disorder; and in 60% (14,832), the eating disorder was unspecified.

Analysis of the data revealed that eating disorders were associated with substantially higher risks of poor physical and mental health, and premature death.

Health Risks and All-Cause Death Rates

The following are the risks of poor health outcomes for individuals with eating disorders compared to the general population:

Health Condition	Risk within the First 12 Months (Relative to General Population)
Renal (Kidney) Failure	6 times higher
Liver Disease	Nearly 7 times higher
Osteoporosis	6 times higher
Heart Failure	Twice as high
Depression	7 times higher
Self-Harm	More than 9 times higher

Similarly, the mental health risks within the first 12 months of diagnosis are as follows:

Condition	Increased Risk (Relative)	Additional Cases (per 10,000 people)
Depression	7 times higher	596
Self-Harm	More than 9 times higher	309

The risk of death from any cause within the first 12 months of diagnosis was also more than 4 times as high, and for unnatural deaths, including suicide, it was 5 times as high.

After 5 years, these risks were still 2 and 3 times higher, corresponding to 43/10,000 extra deaths from all causes and 184/100,000 extra deaths from unnatural causes.

And 10 years after diagnosis, the equivalent figures for additional deaths amounted to 95/10,000 and 341/100,000, respectively. The risk of suicide was nearly 14 times higher in the first year but was still nearly 3 times higher after 10 years, accounting for 169 additional deaths/100,000 people.

Researcher Conclusions and Call for Integrated Care

The researchers acknowledge that the medical records data didn’t include the severity of the eating disorder, making it impossible to link severity to worse outcomes.

But they say: “Our data describe the substantial long-term effects of eating disorders and emphasize the potential opportunity for primary care to have a greater role in offering support and long-term monitoring for individuals who are recovering from an eating disorder.”

They suggest: “A closer and more cohesive management approach in primary and specialist care may also be needed, for both physical (nephrology, cardiology, and endocrinology) and mental health services to provide this support.”

They add: “A potential gap exists in provision where patients' difficulties are too complex for low intensity brief interventions but not complex enough for specialist teams.”

And they conclude: “Raising awareness among healthcare providers about the lasting effects of eating disorders and the need for ongoing support in managing current symptoms and recovery is essential.”

The Urgency of Recognizing Consequences

In a linked editorial, Dr Jennifer Couturier and Ethan Nella of McMaster University, Ontario, Canada, point out that despite the high prevalence of eating disorders, “their consequences are under-recognized.”

They add: “Earlier studies have illustrated the limited education given during medical training on the topic of eating disorders, and the current study emphasizes the importance of disseminating this knowledge to all healthcare professionals.

“Medical education should place greater emphasis on the recognition and management of eating disorders, to equip primary care providers, specialists, and allied health professionals with the tools to identify early warning signs and monitor ongoing risks associated with eating disorders.”

They conclude: “Multiple organ systems are affected by eating disorders, which then requires an integration of care to adequately treat patients. This situation places primary care providers in an ideal position for leading and coordinating their care, and suggests that primary care settings would be apt for early and ongoing intervention.”

Reference:

1. Adverse outcomes in patients with a diagnosis of an eating disorder: primary care cohort study with linked secondary care and mortality records - (https://bmjmedicine.bmj.com/content/4/1/e001438)

Source-Eurekalert