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Prevalence, Onset and Course of Eating Disorders

Bridget Engel, Psy.D., edited by Kathryn Patricelli, MA

Eating disorders are not as common as more familiar conditions like depression or anxiety, but they are not rare either. The World Health Organization (WHO) estimates that worldwide 70 million people have an eating disorder. Lifetime prevalence statistics suggest that about 0.4% of women and 0.04% of men will meet criteria for anorexia during their lifetimes. Between 1% and 5% of women will meet the criteria for bulimia during their lifetimes (as will between .01% and .05% of men). The prevalence rate for binge eating disorder is 1.6% in females and 0.8% in males. Binge-eating disorder shows much less of a difference between females and males, compared to the other two conditions.

Only about 10% of those diagnosed with anorexia or bulimia are male: (for every 10 females diagnosed, only 1 male is diagnosed). However, studies suggest that this may be because males are more likely to deny having eating problems and are less likely to seek help than women if they do have a disorder. Research also suggests that the number of males with eating disorders is increasing. Even though both genders experience eating disorders, the average age when the condition starts is lower for women than it is for men. Despite these important differences in frequency and starting age, there is agreement within the scientific community that eating disorders in male patients are very similar to those in females in terms of symptoms and effects.

Eating disorders typically begin in adolescence or early adulthood. Anorexia and Bulimia rarely begin before the age of puberty or after age 40. 90% of cases are diagnosed before age twenty, while fewer than 10% of all cases occur before age ten. Clearly, the stressful events of adolescence, including self-consciousness, puberty, and peer pressure, can play a big role in triggering these conditions. The start of an eating disorder is often associated with a stressful life event. This might be exposure to violence, family conflicts, stress at school, or loss. It does not seem to be associated with what race someone is or their socioeconomic status (whether one is rich or poor). Instead, these disorders are problems affecting people from all different backgrounds.

Experts believe that approximately 75%-80% suffer with these disorders for one to fifteen years. Between 6% and 20% of people with an eating disorder will die as a result of their disease. Some men and women, especially those who do not seek treatment, suffer for their entire lives. However, there is hope! A majority of those who seek treatment do recover to some degree. Data suggests that eating disorders which begin during the early teen years may be associated with a better outcome and recovery than those that begin later in life.

Young athletes are especially vulnerable to developing eating disorders. This is especially true for gymnasts, runners, body builders, rowers, wrestlers, jockeys, dancers, and swimmers. These individuals tend to be very competitive. Their sports also often require the practice of weight restriction. Because of this, disordered eating can be reinforced or rewarded. Developed eating disorders may go undetected in athletes because they tend to look healthier for longer than would otherwise be the case, and because specific and/or strict dieting is typically expected behavior.

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