Dying to be thin: Death rate among people with eating disorders
At some point in their lives, more than 20 million women and 10 million men in the U.S. have an eating disorder, including anorexia nervosa, bulimia nervosa, binge eating disorder or eating disorder not otherwise specified (EDNOS). Despite the significant number of people living with eating disorders, only 1 in 10 receive treatment. Only 35 percent of those who do receive treatment go to a specialized facility for eating disorders.
Early identification and treatment of eating disorders
“Eating disorders have the highest mortality rate of any mental illness diagnosis,” said Janet Whitney, director of Sovereign Health’s eating disorder program in San Clemente, California. “Yet the treatment, awareness and financial resources directed toward this disorder are more limited than any other mental illness diagnosis.Since this disorder often affects the younger population, it is heartbreaking that more is not being done to combat this disease.”
Anorexia nervosa is considered to have the highest mortality rate of any other mental disorder. In a meta-analysis of 36 studies examining the morbidity (i.e., illness) and mortality rates in patients with eating disorders, Jon Arcelus, Ph.D., and his colleagues reported the highest mortality rates for anorexia nervosa.
Patients with anorexia nervosaessentially starve themselves, resulting in extremely low body weight. By restricting their food intake and denying their bodies essential nutrients they need to function normally and survive, their bodies begin to shut down to conserve energy. Serious health consequences resulting from starvation lead to death in about 5 to 20 percent of people with anorexia nervosa.
Bulimia nervosa is characterized by recurrent binging episodes and behaviors to compensate for overeating. During a binge episode, individuals have difficulty controlling how much they eat, often eating until they are uncomfortably full. After binge eating, people with bulimia may engage in purging (e.g., self-induced vomiting, misusing laxatives or diuretics) or other non-purging behaviors (e.g., excessively exercising, taking diet pills) to compensate for overeating.
Compensatory behaviors to control weight can lead to problems with major organ functions, including inflammation and possible rupture of the esophagus, digestive problems, peptic ulcers and pancreatitis. Individuals with bulimia may also experience electrolyte imbalances from dehydration due to repeated purging behaviors, which can lead to irregular heart rate, heart failure and death.
According to a study published in the American Journal of Psychiatry in 2009, bulimia nervosa has a crude mortality rate of 3.9 percent. In addition, bulimia nervosa is associated with an increased risk of suicidal thoughts and attempts, which can also increase the risk of death. In 2011,Kathleen R. Merikangas, Ph.D., from the Genetic Epidemiology Research Branch of the National Institute of Mental Health (NIMH), and her colleagues reported that more than a third of adolescents with bulimia nervosa reported they had attempted suicide.
Binge eating disorder
Binge eating disorder is the most common eating disorder in the U.S. It is characterized by episodes of binge eating that are not followed by purging or other non-purging behaviors to compensate for overeating. Individuals with binge eating disorder may be more likely to binge eat when they are stressed or upset and often experience difficulty sleeping, depression and weight gain.
The National Institutes of Health (NIH)estimated that 2 in 3 people with binge eating disorder are obese, although not all people with binge eating disorder are obese. However, the excess weight often seen in patients with binge eating disorder contributes substantially to high blood pressure and high cholesterol levels, heart disease due to elevated triglycerides, liver and kidney disease, Type 2 diabetes mellitus and gallbladder disease, all of which can increase the risk of death among people with binge eating disorder.
Because eating disorders often emerge during the teen years and in young adulthood, it is essential to instill in adolescents a healthy body image and self-esteem. Early prevention and recognition of eating disordersare also necessary to help reduce the high mortality rates seen among individuals with these disorders.Identifying those at risk for developing eating disorders as early as possible enables more people to receive effective treatment before their eating disorder progresses. The earlier these individuals are reached and seek professional help, the more likely they are to fully recover from aneating disorder.
The Sovereign Health Group offers behavioral treatment programs for eating disorders, substance abuse, mental illness and co-occurring disorders. At Sovereign Health of California, San Clemente, patients with eating disorders receive evidence-based, individualizedtreatment plans based on their specific needs. For more information about eating disorders or the programs offered at Sovereign Health, please contact our 24/7 helpline to speak to a member of our team.
Written by Amanda Habermann, M.S. clinical psychology, Sovereign Health Group writer