Individuals with an eating disorder, such as anorexia or bulimia have a significantly higher risk of dying prematurely, compared to other people, UK researchers reported in Archives of General Psychiatry.
Somebody with anorexia has a 5.8-times greater risk of dying early, compared to healthy individuals with no eating disorders. Bulimia doubles the risk of premature death.
Patients diagnosed with anorexia in their 20s have 18 times the risk of death compared to healthy individuals of the same age.
Why people with eating disorders may die early is not always clear, the authors stressed. We know that approximately 20% of all deaths among people with anorexia is from suicide. In the majority of cases, higher mortality rates are due to the effects the eating disorder has on the body over the long term. Lead author, John Arcelus said that eating disorders have "serious physical consequences".
Even though experts do not yet know exactly why people die, the researchers are sure that the main causes are physical problems caused by the illness.
Arcelus and team examined 36 studies on eating disorders between January 1, 1966, and September 30, 2010, involving 17,000 individuals, all with an eating disorders - 755 of them died.
The authors found that 0.5% of those with anorexia died annually, a mortality rate five times that of comparable individuals without an eating disorder. Bulimia and other eating disorders had double the risk of death.
Although patients with anorexia have two problems - a medical and a psychiatric one - most treatment centers tend to concentrate just on the psychiatric aspects of their illness.
A considerable proportion of anorexia sufferers also develop OCD (obsessive compulsive disorder), depression and anxiety.
For a patient to get better, the authors say, they need to be treated for all their physical and mental problems - and not just the anorexia.
Patients with anorexia tend to be very malnourished.
Patients with anorexia often become bulimic, and if they do so their risk of relapsing into anorexia is high, resulting in an even greater risk of death.
The authors concluded:
"Individuals with eating disorders have significantly elevated mortality rates, with the highest rates occurring in those with AN (anorexia nervosa). The mortality rates for BN (bulimia nervosa) and EDNOS (eating disorder not otherwise specified) are similar. The study found age at assessment to be a significant predictor of mortality for patients with AN. Further research is needed to identify predictors of mortality in patients with BN and EDNOS."
"Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders - A Meta-analysis of 36 Studies"
Jon Arcelus, LMS, MSc, FRCPsych, PhD; Alex J. Mitchell, MRCPsych; Jackie Wales, BA; Søren Nielsen, MD
Arch Gen Psychiatry. 2011;68(7):724-731. doi:10.1001/archgenpsychiatry.2011.74
Written by Christian Nordqvist