ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1595390
Global, regional, and national burdens of eating disorders from 1990 to 2021 and projection to 2035
Provisionally accepted
- 1the First Medical Center of the Chinese People′s Liberation Army General Hospital, Beijing, China
- 2People’s Liberation Army Postgraduate Medical School, Beijing, China
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Background:Eating disorders severely impact the physical and mental health and challenge global healthcare. This study examined global trends in incidence, mortality, and disability-adjusted life years (DALYs) related to eating disorders from 1990 to 2021 and projected the burden to 2035.Methods:Data from Global Burden of Disease (GBD) 2021 were used to calculate mortality, incidence, and DALYs rates. Analyses were stratified by age, sex, disorder type, and region. Frontier analysis quantified the gap between current and minimum achievable burdens. Decomposition analysis assessed population growth, aging, and epidemiological transitions. Health inequalities were studied using inequality indices. Future trends were predicted using Bayesian Age-Period-Cohort (BAPC) modeling.Results:The age-standardized DALYs rate for eating disorders increased from 37.33 (95% UI: 22.67–58.60) to 43.36 per 100,000 (95% UI: 26.35–68.45), and the age-standardized incidence rate (ASIR) rose from 106.78 (95% UI: 74.30–150.89) to 124.4 per 100,000 (95% UI: 86.48–175.74). The age-standardized DALYs rate (EAPC = 0.67) and ASIR (EAPC = 0.55) increased at faster annual rates for bulimia nervosa than for anorexia nervosa. In 2021, the highest age-standardized death rate (ASDR) were recorded in Central Europe, the largest age-standardized DALYs rate were documented in Western Europe, and the greatest ASIR were reported in Andean Latin America. High sociodemographic index (SDI) regions bore the greatest burden.We also found that Females, particularly aged 15-24, experienced higher burdens. Decomposition analysis underscored the variations in the drivers of disease burden across different SDI regions. Analysis of health inequality showed that the disparity in disease burden attributable to economic factors has further widened. BAPC modeling predicted continued burden growth.Conclusions:The disease burden imposed by eating disorders is gradually increasing, especially impacting women, youth, and young adults, and more so in regions with a high SDI index. Projections indicate that by 2035, this burden will still be substantial. Health inequalities due to the wealth gap have become more severe. These findings can guide targeted strategies for prevention and control.
Keywords: Eating Disorder, Anorexia Nervosa, Bulimia Nervosa, Incidence, Mortality, Disability-adjusted life years, Global burden of disease
Received: 18 Mar 2025; Accepted: 23 Jun 2025.
Copyright: © 2025 Liu, Liu, Yu, Yang, Liu, Yu, Qin and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yinghua Liu, the First Medical Center of the Chinese People′s Liberation Army General Hospital, Beijing, China
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