Eating Disorders Occur Across All Age, Ethnic and Gender Groups Interview with:

Tomoko Udo, PhD Assistant Professor Department of Health Policy, Management, and Behavior School of Public Health University at Albany, State University of New York

Dr. Tomoko Udo

Tomoko Udo, PhD
Assistant Professor
Department of Health Policy, Management, and Behavior
School of Public Health
University at Albany, State University of New York What is the background for this study?  

Response: The National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC III) was the largest epidemiological study on psychiatric disorders in US non-institutionalized adults that was conducted by the National Institution on Alcohol Abuse and Alcoholism, and the first one sinceDSM-5 came out. The last population-based study with US adults that examined eating disorders was the National Comorbidity Survey-Replication Study conducted by Hudson and his colleagues and published in 2007.

We felt that it was important to obtain new prevalence estimates in a larger and representative sample especially because the DSM-5 included several changes to the criteria for eating disorders from the earlier DSM-IV. Thus, we thought it was important to provide updated and new prevalence estimates for eating disorders as well as how they are distributed across sex, ethnicity/race, and age.  Many  researchers and clinicians expected higher estimates than earlier studies as a result of “loosening” of diagnostic criteria for eating disorders. What are the main findings?

Response: We found that the estimated lifetime prevalence of anorexia nervosa, bulimia nervosa, and binge eating disorder is 0.80%, 0.28%, and 0.85%, respectively. We also found that eating disorders occur in both men and women, across ethnic/racial groups, and throughout the lifespan. All eating disorders are associated with impairments in psychosocial functioning. What should readers take away from your report?

Response: Our findings show that eating disorders represent an important public health problem and demonstrate the importance of screening for eating disorders across all sociodemographic groups. Binge eating disorder, a new ‘formal’ diagnosis in the DSM-5, is especially important to screen for and identify, as it is associated with substantially increased risk for obesity, a leading preventable cause of mortality in the US, yet binge eating disorder often goes unrecognized. What recommendations do you have for future research as a result of this work?

Response: In terms of prevalence, these numbers do not suggest that loosening of diagnostic criteria resulted in increased prevalence of eating disorders in US adults. As we outline in our paper, we emphasize that there are many possible reasons for these unexpected findings, and there needs to be more large-scale epidemiological studies on prevalence of eating disorders to better understand the impact of changes in diagnostic criteria. Is there anything else you would like to add?

Response: Because specialty treatment for eating disorders is not as easily accessible as for other psychiatric and medical conditions in many communities, improving access to care is also an important priority for healthcare systems.


Prevalence and Correlates of DSM-5–Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults

Udo, Tomoko et al.
Biological Psychiatry , Volume 0 , Issue 0

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Last Updated on June 4, 2018 by Marie Benz MD FAAD