Eating disorders (EDs) are complex, brain-based illnesses that have one of the highest mortality rates of any mental illness. They impact a significant portion of the global population, though, like many illnesses, they often go unnoticed and underdiagnosed. In fact, more than 70% of those struggling will never receive access to the eating disorder treatment they need and deserve.
Before we get into the data on eating disorders, let’s dispel a pervasive myth. Popular culture, patriarchy, and white supremacy have created the misconception that the typical eating disorder patients are thin, white, adolescent girls. This couldn’t be further from the truth, and is, unfortunately, often reflected in research studies. Eating disorders can affect anyone, regardless of age, gender, sexual orientation, race, or ethnicity – to name a few. Thus, much of the research may not be applicable for those who hold marginalized identities.
With these issues in mind, there is still valuable research that attempts to expand our understanding of the prevalence of eating disorders. Here, we offer some insight from some of the most current data on EDs. We highlight general information about eating disorders and put it into the context of how other factors contribute to the rate of diagnosis and treatment.
General Eating Disorder Statistics
Let’s start with the big picture: eating disorders in general. The more well-known eating disorder diagnoses include: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant/Restrictive Food Intake Disorder (ARFID), and Other Specified Feeding or Eating Disorder (OSFED). While each of these disorders may present with different symptoms, they all impact a person’s relationship with food and eating behaviors.
Global and National Prevalence
According to the World Health Organization’s 2019 estimates, approximately 14 million individuals worldwide, including 3 million children and adolescents, grapple with eating disorders. A review article from 2023 indicates that up to 22% of children and adolescents struggle with disordered eating. It’s important to note that while eating disorders are a mental health diagnosis, disordered eating describes a type of behavior such as restriction, bingeing, or excessive exercise.
Within the United States, the rates are substantially higher than the global average. A 2020 Harvard report on the economic costs of eating disorders suggests that approximately 9% of the U.S. population will experience an eating disorder within their lifetimes, underscoring the magnitude of the issue. However, differences in rates could stem from disproportional data collection.
Though eating disorders can affect people of all ages, there is a higher prevalence observed among young adults. By early adulthood, between 5.5% and 17.9% of young women and 0.6% to 2.4% of young men will have been diagnosed with a clinically-significant eating disorder, reflecting the acute vulnerability of this demographic.
Eating disorders affect people of all body weights and shapes. Only 6% of those diagnosed with EDs are medically underweight. This statistic touches on both the assumptions that both the public and healthcare professionals hold about eating disorders and the misleading and misguided use of BMI (body mass index) to reflect health.
Rates of Specific Eating Disorders
As we mentioned, there are five types of eating disorders listed in the DSM-5. Each is characterized by a unique set of criteria and symptoms, though all can have significant consequences for one’s long-term health.
Anorexia Nervosa (AN)
Anorexia Nervosa is characterized by an obsessive fear of gaining weight, which often leads to distorted body image and difficulty maintaining healthy body weight. Anorexia Nervosa carries a lifetime prevalence of up to 4% among females and 0.3% among males. Alarmingly, AN rates have increased among children under 15 in recent years, highlighting the urgency of early intervention and prevention efforts.
Learn more about the signs and symptoms of Anorexia Nervosa.
Bulimia Nervosa (BN)
Bulimia nervosa manifests as recurrent episodes of binge eating followed by compensatory behaviors, affecting up to 3% of females and over 1% of males over their lifetimes. The cycle of bingeing and purging can have a profound toll on both physical and mental well-being, necessitating comprehensive treatment approaches.
Learn more about the signs and symptoms of Bulimia Nervosa.
Binge Eating Disorder (BED)
Binge Eating Disorder affects an estimated 3.5% of women and 2% of men, and affects 30-40% of those seeking weight loss treatment. Characterized by recurring episodes of overeating in a short period, BED is the most common eating disorder among U.S. adults, affecting three times the number of those diagnosed with Anorexia Nervosa and Bulimia Nervosa combined.
Learn more about the signs and symptoms of Binge Eating Disorder.
Avoidant/Restrictive Food Intake Disorder (ARFID)
Also known as “selective eating disorder,” ARFID is characterized by an eating or feeding disturbance, such as an apparent lack of interest in eating or food, avoidance based on the sensory characteristics of food, and/or concern about aversive consequences of eating.
Despite limited research, ARFID’s prevalence ranges from 0.3% to 15.5% in non-clinical studies, with rates varying widely among children and adolescents. As a relatively recent addition to the DSM-5, ARFID warrants further investigation to elucidate its impact and inform targeted interventions.
Learn more about the signs and symptoms of ARFID.
Other Specified Feeding and Eating Disorders (OSFED)
OSFED encompasses a spectrum of eating disorders that fall outside the criteria for AN, BN, or BED, yet still have significant health ramifications that can be just as severe as other ED diagnoses. This category includes “Atypical” Anorexia Nervosa, Purging Disorder, Bulimia Nervosa and Binge Eating Disorder (of low frequency or duration), and Night Eating Syndrome.
It’s a bit of a “catchall” diagnosis and was only added to the DSM in the latest edition. However, there is a lack of research on the rates of OSFED. For example, a review of the literature on “Atypical” Anorexia Nervosa found a wide variety in prevalence rates and rarely included male, gender-diverse, or non-white participants.
Learn more about the signs and symptoms of OSFED.
Eating Disorders & Identity
As we mentioned above, eating disorders can affect anybody, regardless of gender, sexuality, race, or other demographics. However, the experiences of marginalized individuals can increase the risk of developing an eating disorder. Furthermore, those same systems of oppression have created disparities in treatment access. Here, we look at eating disorder statistics from the perspective of marginalized communities.
Toxic Masculinity and ED Misdiagnosis in Men
We start with gender. A pervasive bias–both in popular culture and research–perpetuates the myth that eating disorders predominantly affect young females, overshadowing the experiences of men, non-binary individuals, and transgender individuals.
Though men aren’t the underserved community, the empowered patriarchy does them a disservice. Anyone with an eating disorder already faces intense stigmatization, but toxic masculinity can make it even more challenging for men to get diagnosed and treated. This trend makes it difficult to decipher studies on eating disorders in men. For example, a 2005 study suggested that men constituted a mere 10% of cases of anorexia nervosa (AN) and bulimia nervosa (BN). However, subsequent research in 2007 noted that men accounted for 25% of diagnosed cases, underscoring the pressing need to broaden our understanding of eating disorders beyond traditional gender norms. A 2023 review noted the rates of eating disorders in men ranged from 0.74 to 2.2%.
Eating Disorders in Queer and Trans Communities
While eating disorders may be underreported in men, there’s evidence to suggest that the stress on members of the LGBTQ+ community may increase the risk of developing an eating disorder. Self-reported lifetime prevalence rates among transgender men and women in the United States stand at 10.5% and 8.1%, respectively, highlighting the urgent need for tailored interventions and inclusive support systems for all gender identities and sexual orientations. In general LGBTQ+ individuals show higher rates of eating disorders and disordered eating compared to their heterosexual and cis-gendered counterparts.
By acknowledging the diverse experiences and unique challenges faced by individuals of all genders, we can foster a culture of empathy and more effectively advocate for inclusive treatment.
Eating Disorders & Race
Though studies (like this 2014 one and this 2020 one) have found similar rates of eating disorders across various racial and ethnic groups, this field also leaves room for further research. Most studies on EDs do not include people of color, so rates on the prevalence of specific eating disorders in black, Hispanic, and native communities aren’t clear. In fact, BIPOC individuals with eating disorders are half as likely to be diagnosed, receive treatment, or even be asked about their eating disorder.
Access to Covered Treatment and Racial Inequities
Not only is the stereotype of eating disorders as a ‘white woman’s issue’ false, but it also creates barriers to diagnosis and treatment for individuals outside this demographic. A 2023 review from the Journal of Eating Disorders noted the connection between insurance type, race, and treatment. In our current healthcare system, those on government-subsidized health insurance often have fewer options for medical treatment. Folks on public health insurance only receive the recommended treatment for eating disorders ⅓ of the time as those on private insurance. Additionally, there is a racial disparity in access to health insurance. Compared to white Americans, marginalized communities are about twice as likely to have Medicaid or other public health insurance and between two or three times more likely to be uninsured.
Eating Disorders & Athletes
Eating disorders are caused by a mix of internal and external factors, including one’s genetics, experiences, and social environment. The athletic arena seems to increase the risk of developing eating disorders compared to the general population, with estimates suggesting up to 45% of female athletes and 19% of male athletes struggle with eating disorders. This heightened susceptibility is fueled by the pressure to meet physical standards and excel in competition.
From aesthetic-focused sports like gymnastics to weight-class-based disciplines like wrestling, athletes across various sports grapple with these illnesses. Unfortunately, disordered eating habits like overtraining or obsessing over nutrition can be disguised as discipline and are often overlooked.
Learn more about eating disorders in athletes.
Comorbidities of Eating Disorders
Eating disorders co-occur with other mental illnesses more often than they occur in isolation. The existence and specification of comorbidity can impact appropriate treatment options. Most commonly the co-occurring disorders include mood disorders, substance use disorders, or anxiety disorders.
The frequencies of co-occurrences bring into question the efficacy of treatment. The presence of more than one mental illness can impede effective treatment, lead to therapist drift, and be frustrating for both the patient and their loved ones. Can medical providers expect the treatment of one issue to resolve the other? Are they connected or isolated?
Find Tailored Eating Disorder Treatment with The Alliance
Every year, we are not only learning more about eating disorders, but we are also learning the best ways to treat them. Access to care is a necessity and should not be a luxury. Here, at The Alliance, one of our goals is to help connect those struggling with the treatment they need and deserve.
Eating disorder treatment often encompasses various therapeutic modalities, nutritional counseling, and medical and psychiatric support. Cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and family-based therapy (FBT) are among the most widely utilized therapeutic interventions for eating disorders. These approaches aim to address underlying psychological factors, reduce maladaptive behaviors, and foster healthier coping mechanisms. They may be used in various different treatment settings, from inpatient to outpatient, and can be applied alongside nutritional counseling, support groups, and other treatment interventions.
Just as eating disorders don’t have one exact cause, treatment is often multifaceted. A 2023 study highlighted the limitations of standardized treatment approaches and proposed a shift toward personalized treatment. Findings indicate that personalized treatment decreases eating disorder symptom severity along with the symptoms of comorbid mental illnesses. No one should have to navigate eating disorder recovery alone. If you or a loved one is struggling, please reach out to our free, therapist-staffed helpline at +1 (866) 662-1235. Help is available and recovery is possible.
