We have blogged before about how misunderstood eating disorders are. Lack of appreciation for the seriousness of anorexia and bulimia has caused countless families to be denied medical coverage for treatment, even as a wealth of recent findings has detailed the strong genetic underpinnings of this group of biologically based mental disorders.
By now, however, many know that mortality rates for anorexia are very high, and that the suicide rate among anorexics is higher than that of any other mental illness. Mortality statistics for bulimia and Eating Disorders Not Otherwise Specified (EDNOS), though, have been harder to come by.
That is until just recently, when the results of a longitudinal study done between 1979 and 1997 at the outpatient eating disorders clinic of the University of Minnesota were published in the December 2009 issue the American Journal of Psychiatry. The study looked at 1,885 people suffering from anorexia, bulimia and EDNOS (disorders serious enough to impair a person’s functioning, but which fall short of meeting the clinical definition of anorexia, bulimia or binge-eating disorder) over a period of 8 to 25 years.
The estimable eating disorders expert Dr. Walter Kaye called the study “outstanding” and reliable, in part because of its use of a computerized link to the National Death Index, which records causes of death.
This study marks the first time that reliable mortality rates have been published for bulimia and EDNOS, and they are shockingly high: The research shows that mortality from all possible causes, including suicide, is significantly elevated for bulimia and EDNOS: 3.9 percent for bulimia and 5.2 percent for EDNOS (the most commonly made eating disorders diagnosis). This is startling news because until these findings, the death rate, particularly deaths caused by suicide, in both bulimia and EDNOS were thought to be close to zero.
The study found a 4.0 mortality rate for anorexia, lower than other studies, which have found mortality rates as high as 5.3 percent. The authors of the study explain that unlike other studies, they classified patients according to their current eating disorder, not their lifetime diagnosis. In most studies, if a patient is first diagnosed with anorexia, he or she is considered anorexic. Since often patients start as anorexics and then become bulimic, bulimia has been underrepresented in studies.
These new findings should serve as a wakeup call to parents and loved ones of those suffering from eating disorders, and add more weight to the growing consensus that places eating disorders among the mental disorders that deserve to be treated exactly the same as physical illnesses. They are sobering statistics, but perhaps not a surprise to the many clinicians who have seen close up how disruptive and devastating even a subclinical eating disorder can be to the life of a child, adolescent or adult.
Take care,
Marcia and Nancy
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