Abstract
Background. Research on mortality and admissions for physical health problems across eating disorder diagnoses in representative settings is scarce. Inequalities in these outcomes across a range of socio-demographic characteristics have rarely been investigated.
Aims. We investigated whether people with eating disorders had greater all-cause mortality and physical health-related inpatient admissions compared to people without eating disorders and whether associations varied by sex, ethnicity, deprivation, age, and calendar year at diagnosis.
Methods. Using primary care Clinical Research Practice Datalink linked to Hospital Episode Statistics, we matched people with an incident eating disorder diagnosis (any, anorexia nervosa, bulimia nervosa, EDNOS, generic eating disorder, or a referral code) from primary care Read codes to four people without eating disorders (1:4 matching) on year of birth, sex, primary care practice, year of registration, and index date. We used univariable and multivariable Cox (mortality) and Poisson (admissions) models and fitted interactions to investigate whether associations varied by socio-demographic characteristics.
Results. We included 58,735 people (90.1% female, 91.6% white). People with any eating disorders had higher all-cause mortality (Hazard Ratio[HR]: 2.15, 95% confidence interval [CI]: 1.73 – 2.67). Anorexia nervosa had the highest mortality (HR: 3.49, 95%CI: 2.43 – 5.01). People with any eating disorders had higher rates of planned (Incidence Rate Ratio[IRR]: 1.80, 95%CI: 1.4 – 1.87) and emergency admissions for physical health problems (IRR: 2.35. 95%CI: 2.35 – 2.46) and emergency admissions for injuries, accidents and substance misuse (IRR: 5.26, 95%CI: 5.24 – 5.29). Mortality and admissions rate ratios were greater in males.
Conclusions. People with eating disorders have high rates of mortality and physical health-related admissions. Observed inequalities call for an understanding of why such inequalities exist. These findings highlight the need for prompt and effective treatment for eating disorders and for improved guidance on primary care management of people with eating disorders.
Aims. We investigated whether people with eating disorders had greater all-cause mortality and physical health-related inpatient admissions compared to people without eating disorders and whether associations varied by sex, ethnicity, deprivation, age, and calendar year at diagnosis.
Methods. Using primary care Clinical Research Practice Datalink linked to Hospital Episode Statistics, we matched people with an incident eating disorder diagnosis (any, anorexia nervosa, bulimia nervosa, EDNOS, generic eating disorder, or a referral code) from primary care Read codes to four people without eating disorders (1:4 matching) on year of birth, sex, primary care practice, year of registration, and index date. We used univariable and multivariable Cox (mortality) and Poisson (admissions) models and fitted interactions to investigate whether associations varied by socio-demographic characteristics.
Results. We included 58,735 people (90.1% female, 91.6% white). People with any eating disorders had higher all-cause mortality (Hazard Ratio[HR]: 2.15, 95% confidence interval [CI]: 1.73 – 2.67). Anorexia nervosa had the highest mortality (HR: 3.49, 95%CI: 2.43 – 5.01). People with any eating disorders had higher rates of planned (Incidence Rate Ratio[IRR]: 1.80, 95%CI: 1.4 – 1.87) and emergency admissions for physical health problems (IRR: 2.35. 95%CI: 2.35 – 2.46) and emergency admissions for injuries, accidents and substance misuse (IRR: 5.26, 95%CI: 5.24 – 5.29). Mortality and admissions rate ratios were greater in males.
Conclusions. People with eating disorders have high rates of mortality and physical health-related admissions. Observed inequalities call for an understanding of why such inequalities exist. These findings highlight the need for prompt and effective treatment for eating disorders and for improved guidance on primary care management of people with eating disorders.
| Original language | English |
|---|---|
| Number of pages | 9 |
| Journal | BJPsych International |
| Early online date | 23 Jun 2025 |
| Publication status | E-pub ahead of print - 23 Jun 2025 |