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• An estimated 9% of the U.S. population , or 28.8 million Americans, will have an eating disorder in their lifetime. 2
• 15% of women will suffer from an eating disorder by their 40s or 50s, but only 27% receive any treatment for it. 64
• Fewer than 6% of people with eating disorders are medically diagnosed as “underweight.” 7, 16 . In fact,  people in larger bodies are at the highest risk  of having developed an eating disorder in their lives, and among people in larger bodies,  the higher the BMI, the higher the risk . 60, 59
• In a sample from an American emergency room,  16% of adult patients screened positive for an eating disorder . 37
• Anorexia has the highest case mortality rate and second-highest crude mortality rate of any mental illness. 2
• 10,200 deaths each year are the direct result of an eating disorder—that’s one death every 52 minutes. 2
• Eating disorder sufferers with the highest symptom severity are  11 times more likely to attempt suicide than their peers without eating disorder symptoms, and even those with sub-threshold symptoms are 2 times more likely. 60   Patients with anorexia have a risk of suicide 18 times higher  than those without an eating disorder. 120
• The economic cost of eating disorders is $64.7 billion every year. 2

BIPOC* Eating Disorder Statistics

• While  BIPOC people are affected by eating disorders at similar rates  overall as their white peers,  they are about half as likely to be diagnosed . 63, 93
• BIPOC patients with eating and weight concerns are  significantly less likely to be asked about eating disorder symptoms by their doctors  than are non-minority patients.  3
• When therapists were presented with descriptions of a fictional patient—identical except for race—they were  less likely to recognize eating disorder symptoms in the Black and Hispanic patient  compared to the white patient.  66
• In a study of adolescents age 11 to 25 who were suffering malnutrition from an eating disorder,  only 40% received the recommended treatment , and patients who  used public insurance   were   only one third as likely to receive the recommended mental health treatment  for their eating disorders as youth with private insurance. Latinx patients were about  half as likely to receive the necessary treatment  as their white peers.  30
• Asian American college students report higher rates of restriction  compared with their white peers and higher rates of purging, muscle building, and cognitive restraint than their white or non-Asian BIPOC peers.  5
• Asian American college students report higher levels of body dissatisfaction  and negative attitudes toward obesity than their non-Asian BIPOC peers.  5
• Members of the LGBTQ+ community are at a  higher risk of having an eating disorder  than heterosexual people. Overall,  LGBTQ+ youth are three times more likely to have an eating disorder  when compared to their straight peers with homosexual and bisexual girls at 2.5 times and homosexual and bisexual boys at 6 times higher rates. 69, 71, 72
• About  1 in 3 sexual minority teenagers say they engaged in dangerous weight control behaviors  within the past month.  Gay and bisexual boys are four times more likely , and  lesbian and bisexual girls are twice as likely , to do so than their heterosexual peers.  70
• About  75% of transgender college students with eating disorders attempt suicide .  56
• Transgender college students are diagnosed with eating disorders at four times the rate  of their cisgender classmates.  73
• 32% of transgender people report using their eating disorder to modify their body  without hormones, such as to reduce curves or halt menstruation. Even so, 56% of transgender people with eating disorders  believe their disorder is not related to their physical body .  8

People with Co-Occurring Conditions Eating Disorder Statistics

• Over 70% of people with eating disorders also have other conditions , most commonly anxiety and mood disorders.  74
• People with disabilities  may have body image concerns related to their disability  that lead to developing and sustaining an eating disorder.  77
• Women with certain physical disabilities may be more likely to have  eating disorder behavior.  75
• People with diet-related chronic conditions —like diabetes and irritable bowel disease— may be at a higher risk of disordered eating.  112
• In a study, girls with type 1 diabetes aged 9-13 were evaluated for 14 years, and  by the time they were in their 20s, 40.8% met criteria for a full- or sub-threshold eating disorder , and 59.2% took part in dangerous disordered eating behavior.  113
• Eating disorders in people with type I diabetes are associated with a significantly higher risk of severe medical complications , including more frequent and longer hospitalizations, and a greater risk of ketoacidosis and retinopathy.  124
• People with eating disorders typically have between one and four other psychiatric disorders . Indeed, the majority of adolescents with eating disorders have at least one other psychiatric disorder, ranging from a low of 55% for anorexia to a high of 88% for bulimia.  21, 35
• Between  13 to 58% of ARFID patients also have Autism Spectrum Disorder . In a study of children with ASD and severe food limitations,  78% ate a diet that put them at risk for five or more nutritional deficiencies.  79, 80, 81, 82
• Between 6 and 17%  of eating disorder patients  also have ADHD.  86-87
• Girls with ADHD are 3.6 times more likely to have an eating disorder  in general and 5.6 times more likely to have bulimia in particular.  88
• Between  10 and 35% of patients with eating disorders have OCD  unrelated to the eating disorder.  118
• In a study of college and university students,  just 2% of those who met criteria for eating disorders were “underweight.”  93
• For the overall populace, the figure is usually  estimated to be less than 6% .  60
• People in larger bodies  are at higher risk of using unhealthy weight control behaviors.  21, 52, 98
• About  40% of “overweight“ girls and 20% of “overweight“ boys use disordered eating behaviors.   99
• Patients meeting the standard diagnostic criteria for anorexia were 14 times more likely to receive the recommended treatment  than those with  atypical anorexia . 30
• Among those who experience weight stigma,  two-thirds were stigmatized by doctors , leading many to avoid seeking healthcare.  102
• People who experience weight discrimination  are 60% more likely to die.  94
• Athletes report higher rates of excessive exercise  than non‐athletes.  14
• Female athletes are twice as likely to engage in eating disorder behavior than male athletes; however,  both men (77%) and women (80%) participating in weight-dependent sports report using compensatory behaviors.  43
• Eating disorders may be particularly hard to detect among athletes  due in part to secretiveness, stigma, and symptom presentation.  47
• Athletes may be less likely to seek treatment  for an eating disorder due to stigma, accessibility, and sport‐specific barriers.  14
• Certain aspects of military life are thought to contribute to developing or exacerbating eating disorders,  including weight and fitness requirements, the stress of combat exposure, and sexual trauma.  62
• Body dysmorphic disorder affects   13.0% of male military members and 21.7% of female military members , more than  five times the rates for the overall population .  107
• One-third of overweight military personnel engage in unhealthy weight loss behavior to “make weight”  while in the service, and  they are more likely to suffer from eating disorder behavior later in life  as veterans.  39
• Over 16% of female military personnel and veterans have suffered from an eating disorder , with associations between the eating disorder and sexual trauma and PTSD.  108
• In the five years studied—from 2017 to 2021– the incidence rates of eating disorders among active service  members increased by 79% .  61
• In a study of military personnel from Iraq and Afghanistan, an estimated  32.8% of female and 18.8% of male veterans showed signs of probable eating disorders , highest being atypical anorexia nervosa (13.6% of women and 4.9% of men), bulimia nervosa (6.1% of women and 3.5% of men), and binge-eating disorder (4.4% of women and 2.9% of men).  109
• At age 6 to 10, girls start to worry about their weight, and by 14,  60 to 70% are trying to lose weight .  35
• A survey found that  77% of children and adolescents as young as 12 dislike their bodies , and  45% say they are regularly bullied about how they look .  128
• Weight-related teasing is  a primary way kids are bullied , and  kids in bigger bodies are significantly more likely to be bullied  than their smaller-bodied classmates. 103, 104
• Girls who were teased about their weight were  two times more likely to be “overweight,”  1.5 times more likely to binge eat, and 1.5 times more likely to use extreme methods of weight control five years later.  99
• 22% of children and adolescents have unhealthy eating behaviors  that could lead to or indicate an eating disorder.  89
• A study found  8% of 15-year-old girls diet at a severe level , and their risk of developing an eating disorder was  18 times greater  than her non-dieting peers. 90
• About  12% of adolescent girls have some form of eating disorder .  126
• Just  20% of adolescents with eating disorders disorders seek treatment .  38
• Men represent up to 25% of people with eating disorders .  45
• Even so,  women are up to five times more likely to be diagnosed  and 1.5 times more likely to be treated for an eating disorder than men are.  93
• Men with eating disorders tend not to recognize their symptoms as problematic , in part due to the stereotype of eating disorders as being a “woman’s problem.”  110
• By the time men with eating disorder symptoms present in healthcare settings, their cases tend to be more severe , in part due to their denial of symptoms, anticipated or encountered prejudice, and even denial of treatment because of their gender.  44
• Healthcare professionals tend to minimize the symptoms of men with eating disorders.  46

Older Adults Eating Disorder Statistics

• While most older adults with eating disorders have had symptoms since adolescence,  life transitions and stressors common in older adulthood —such as children leaving the home and menopause— can make eating disorders much worse .  70
• Among women age 50 and over,  71.2% say they are currently trying to lose weight , and 79.1% said their weight or shape had a “moderate” effect on or was “the most important” part of their self-esteem.  125
• 41% of women over 50 have current or previous core eating disorder symptoms , divided into 13.3% who have current and 27.7% with past symptoms.  125
• Compare to other patients, eating disorder patients who receive mentorship  report significant improvement in 7 of 12 areas related to quality of life, and greater psychological, emotional, and physical well-being. 129
• Patients in eating disorder treatment are  119% more likely to attend appointments  with their providers when they also receive mentorship. 129
• Eating disorder patients who receive mentorship from peers who have recovered from an eating disorder  see greater reduction in body dissatisfaction and anxiety  than those who received support from people without lived experience. 130
• Parents and families  supporting someone with an eating disorder got  significant value out of connecting with a mentor . They benefited greatly from the support, information, and compassion received. 131
• Research suggests that using trained mentors to deliver mental health care  could increase the number of youth receiving evidence-based mental health care.   132

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• Duplicate of 21 
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Eating Disorders

What are eating disorders.

There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

What are the signs and symptoms of eating disorders?

Anorexia nervosa.

Anorexia nervosa is a condition where people avoid food, severely restrict food, or eat very small quantities of only certain foods. They also may weigh themselves repeatedly. Even when dangerously underweight, they may see themselves as overweight.

There are two subtypes of anorexia nervosa: a "restrictive "  subtype and a "binge-purge " subtype.

• In the restrictive subtype of anorexia nervosa, people severely limit the amount and type of food they consume.
• In the binge-purge  subtype of anorexia nervosa, people also greatly restrict the amount and type of food they consume. In addition, they may have binge-eating and purging episodes—eating large amounts of food in a short time followed by vomiting or using laxatives or diuretics to get rid of what was consumed.

Anorexia nervosa can be fatal. It has an extremely high death (mortality) rate compared with other mental disorders. People with anorexia are at risk of dying from medical complications associated with starvation. Suicide is the second leading cause of death for people diagnosed with anorexia nervosa.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline   at 988 or chat at 988lifeline.org   . In life-threatening situations, call 911.

Symptoms include:

• Extremely restricted eating
• Extreme thinness (emaciation)
• A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
• Intense fear of gaining weight
• Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight

Other symptoms may develop over time, including:

• Thinning of the bones (osteopenia or osteoporosis)
• Mild anemia and muscle wasting and weakness
• Brittle hair and nails
• Dry and yellowish skin
• Growth of fine hair all over the body (lanugo)
• Severe constipation
• Low blood pressure
• Slowed breathing and pulse
• Damage to the structure and function of the heart
• Brain damage
• Multiorgan failure
• Drop in internal body temperature, causing a person to feel cold all the time
• Lethargy, sluggishness, or feeling tired all the time
• Infertility

Bulimia nervosa

Bulimia nervosa is a condition where people have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or over overweight.

• Chronically inflamed and sore throat
• Swollen salivary glands in the neck and jaw area
• Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
• Acid reflux disorder and other gastrointestinal problems
• Intestinal distress and irritation from laxative abuse
• Severe dehydration from purging of fluids
• Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack

Binge-eating disorder

Binge-eating disorder is a condition where people lose control over their eating and have reoccurring episodes of eating unusually large amounts of food. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.

• Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
• Eating even when you're full or not hungry
• Eating fast during binge episodes
• Eating until you're uncomfortably full
• Eating alone or in secret to avoid embarrassment
• Feeling distressed, ashamed, or guilty about your eating
• Frequently dieting, possibly without weight loss

Avoidant restrictive food intake disorder

Avoidant restrictive food intake disorder (ARFID), previously known as selective eating disorder, is a condition where people limit the amount or type of food eaten. Unlike anorexia nervosa, people with ARFID do not have a distorted body image or extreme fear of gaining weight. ARFID is most common in middle childhood and usually has an earlier onset than other eating disorders. Many children go through phases of picky eating, but a child with ARFID does not eat enough calories to grow and develop properly, and an adult with ARFID does not eat enough calories to maintain basic body function.

• Dramatic restriction of types or amount of food eaten
• Lack of appetite or interest in food
• Dramatic weight loss
• Upset stomach, abdominal pain, or other gastrointestinal issues with no other known cause
• Limited range of preferred foods that becomes even more limited (“picky eating” that gets progressively worse)

What are the risk factors for eating disorders?

Eating disorders can affect people of all ages, racial/ethnic backgrounds, body weights, and genders. Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life.

Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Researchers are using the latest technology and science to better understand eating disorders.

One approach involves the study of human genes. Eating disorders run in families. Researchers are working to identify DNA variations that are linked to the increased risk of developing eating disorders.

Brain imaging studies are also providing a better understanding of eating disorders. For example, researchers have found differences in patterns of brain activity in women with eating disorders in comparison with healthy women. This kind of research can help guide the development of new means of diagnosis and treatment of eating disorders.

How are eating disorders treated?

It is important to seek treatment early for eating disorders. People with eating disorders are at higher risk for suicide and medical complications. People with eating disorders can often have other mental disorders (such as depression or anxiety) or problems with substance use. Complete recovery is possible.

Treatment plans are tailored to individual needs and may include one or more of the following:

• Individual, group, and/or family psychotherapy
• Medical care and monitoring
• Nutritional counseling
• Medications

Psychotherapies

Family-based therapy, a type of psychotherapy where parents of adolescents with anorexia nervosa assume responsibility for feeding their child, appears to be very effective in helping people gain weight and improve eating habits and moods.

To reduce or eliminate binge-eating and purging behaviors, people may undergo cognitive behavioral therapy (CBT), which is another type of psychotherapy that helps a person learn how to identify distorted or unhelpful thinking patterns and recognize and change inaccurate beliefs.

Evidence also suggests that medications such as antidepressants, antipsychotics, or mood stabilizers may also be helpful for treating eating disorders and other co-occurring illnesses such as anxiety or depression. The Food and Drug Administration’s (FDA) website  has the latest information on medication approvals, warnings, and patient information guides.

How can I find a clinical trial for an eating disorder?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago. Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you.

To learn more or find a study, visit:

• NIMH’s Clinical Trials webpage : Information about participating in clinical trials
• Clinicaltrials.gov: Current Studies on Eating Disorders  : List of clinical trials funded by the National Institutes of Health (NIH) being conducted across the country

Where can I learn more about eating disorders?

Free brochures and shareable resources.

• Eating Disorders: About More Than Food : A brochure about the common eating disorders anorexia nervosa, bulimia nervosa, and binge-eating disorder, and various approaches to treatment. Also available en español .
• Let’s Talk About Eating Disorders : An infographic with facts that can help shape conversations around eating disorders. Also available in en español .
• Shareable Resources on Eating Disorders : Help support eating disorders awareness and education in your community. Use these digital resources, including graphics and messages, to spread the word about eating disorders.
• Mental Health Minute: Eating Disorders : Take a mental health minute to watch this video on eating disorders.
• Let’s Talk About Eating Disorders with NIMH Grantee Dr. Cynthia Bulik : Learn about the signs, symptoms, treatments, and the latest research on eating disorders.

Research and statistics

• NIMH Eating Disorders Research Program : This program supports research on the etiology, core features, longitudinal course, and assessment of eating disorders.
• Journal Articles   : References and abstracts from MEDLINE/PubMed (National Library of Medicine).
• Statistics: Eating Disorders

Last Reviewed: January 2024

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Eating Disorder Facts and Statistics: What You Need to Know

Eating disorders overview.

• By Ethnicity
• By Age and Gender
• Mortality Rates

Frequently Asked Questions

• Next in Eating Disorders Guide Types of Eating Disorders

Eating disorders are mental health conditions that involve disturbed patterns of thinking and behavior related to food, weight, and body shape.  

Around 30 million people in the U.S. (including an estimated 20 million women and 10 million men) will meet the criteria for at least one eating disorder during their lifetime. Research suggests that eating disorders are on the rise. Eating disorder prevalence rates increased from about 3.5% from 2000 to 2006 to 7.8% from 2013 to 2018.

This article will discuss eating disorders, including key facts, statistics, mortality rates, and causes.

tommaso79 / Getty Images

Eating disorders are serious, potentially life-threatening mental illnesses that involve disturbed eating behaviors. Many people with eating disorders eat too little or too much. They may also have a distorted body image , a fixation on their weight, and/or low self-esteem.

There are several different types of eating disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition ( DSM-5 ), including:

• Anorexia nervosa (AN) : Involves severely restricting food intake for the purpose of achieving extreme thinness.
• Bulimia nervosa (BN) : Involves episodes of binging (eating a lot of food in a short amount of time) and purging (“compensating” for binging by using laxatives, vomiting, or exercising excessively).
• Binge eating disorder (BED) : Involves repeated binging episodes and feeling out of control while overeating.
• Avoidant restrictive food intake disorder (ARFID) : Involves being very selective about food intake for reasons unrelated to weight or appearance.

If left untreated, eating disorders can have serious medical consequences, such as dehydration , electrolyte imbalances , malnutrition , and organ damage. In some cases, they may be fatal. 

Treatment for eating disorders typically involves psychotherapy and/or medication. Residential treatment may be necessary in severe cases.

How Common Are Eating Disorders?

Eating disorders affect millions of people in the U.S. every year. The following statistics offer a snapshot of how widespread eating disorders are:

• About 30 million American adults will have an eating disorder at some point in their lifetime.  
• An estimated 1 in 5 U.S. women will experience an eating disorder before the age of 40.
• About 1 in 7 American men develop an eating disorder before turning 40.  

Some eating disorders are more common than others. A 2018 study found the following lifetime and 12-month prevalence rates of anorexia , bulimia , and binge eating disorder among U.S. adults:

ARFID prevalence rates are less well-known. However, some studies suggest that around 5% to 14% of children and youth in inpatient eating disorder programs and about 22.5% of children and teens in day treatment programs for eating disorders meet the diagnostic criteria for ARFID.

Eating disorders appear to have become more common in recent years. One review of worldwide data found that eating disorder diagnoses more than doubled from 2000 to 2018. This trend was consistent across different regions, age groups, and genders.

Amid the COVID-19 pandemic, healthcare providers noticed a particularly significant uptick in the number of people seeking treatment for eating disorders.

For example, the overall incidence of eating disorders among teen girls and young women rose by 15.3% in 2020 in comparison to previous years. According to a 2021 study, the number of people entering inpatient treatment for an eating disorder doubled between 2018 and 2020.

Eating Disorders by Ethnicity

Researchers have noted that eating disorder rates vary somewhat by ethnicity. These differences may be due in part to differences in risk factors, cultural influences, and socioeconomic status. 

However, access to healthcare also likely plays a role. People of color report that they are significantly less likely to be asked about eating disorder symptoms by healthcare providers.  

A 2018 study found that the overall prevalence of eating disorders was similar across different racial and ethnic groups. However, the likelihood of developing a particular eating disorder varied by ethnicity, as follows:

Other important facts and statistics to know about racial disparities in eating disorder rates include:

• Black teenagers are approximately 50% more likely to display symptoms of bulimia , such as binging and purging, than their White peers.
• In comparison to White college students, Asian-American college students are about 1.5 times likelier to restrict their food intake, 1.2 times likelier to report dissatisfaction with their body, and 2.2 times likelier to exhibit purging behaviors.
• Binge eating disorder and bulimia nervosa are the most common eating disorders among Hispanics/Latinos in the U.S.

Eating Disorders by Age and Gender

Regardless of their age, gender, weight, appearance, or socioeconomic status , anyone can develop an eating disorder. Still, anorexia and other eating disorders are especially common among younger people and women.

An estimated 1 in 4 people with an eating disorder is male. Women are about four times likelier than men to develop anorexia and three times likelier to be diagnosed with binge eating disorder.

People whose gender identity does not match the sex assigned at birth have a higher risk of being diagnosed with an eating disorder or reporting that they engage in disordered eating. Because this is a highly varied group, research is ongoing into which individuals may be more at risk.

Researchers believe that this disparity is due in part to social pressures that disproportionately affect women. In addition, many men report that they feel too ashamed to seek treatment for an eating disorder due to mental health stigma .  

Adolescents and young adults are particularly vulnerable to eating disorders. Estimated annual rates of eating disorder diagnoses rise steadily throughout the teen years among Americans. The highest average annual prevalence rate is age 21 in men (7.4%) and women (10.3%). Approximately 95% of first-time eating disorder cases are diagnosed before age 25.  

Among young people, teen girls and college-aged women are disproportionately likely to develop eating disorders. Some estimates suggest that between 1 in 50 and 1 in 100 adolescent girls will develop anorexia.

Meanwhile, approximately half of teenage girls and one-third of teenage boys in the U.S. resort to unhealthy weight loss methods, such as extremely restrictive dieting, abusing laxatives , and exercising excessively.

Eating Disorders in Children and Teens

Eating disorders are common among children and teens. In fact, nearly 1 in 5 youth aged 11 to 17 exhibit symptoms of disordered eating patterns.

Causes of Eating Disorders and Risk Factors

Researchers haven’t identified one unifying cause for eating disorders . Instead, the interaction between a combination of factors—such as genetics, environment, and trauma—increases the likelihood of developing an eating disorder.

Risk factors for eating disorders include:

• Family history : Some eating disorders may be passed down in families due to a combination of genetics , early childhood experiences, and/or learned behavior. Up to 50% of the estimated eating disorder risk can be attributed to genetic factors.
• Environment : Research indicates that cultural and social factors—such as peer pressure, certain careers, and media beauty standards—play a role in the prevalence of eating disorders.
• Personality : High rates of certain personality traits, such as perfectionism , have been noted among people with eating disorders.
• Comorbid mental health conditions : Many people with eating disorders have other mental health conditions at the same time, such as major depressive disorder (MDD), generalized anxiety disorder (GAD), and substance use disorder (SUD). Around 25% to 35% of people with bulimia and 10% to 20% of people with anorexia attempt suicide at least once during their lifetime.  
• Trauma : Around 50% of people with eating disorders have a history of childhood trauma, such as sexual abuse .

Eating Disorders and Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a particularly common mental health condition among people with eating disorders. Estimates suggest that between 20% to 60% of people with an eating disorder have met the criteria for OCD at some time during their life.

What Are the Mortality Rates for Eating Disorders?

Due to associated risks such as malnutrition, heart disease , and suicide, eating disorders have some of the highest mortality rates of any mental health condition. An estimated 10,200 people die each year in the U.S. as a direct result of an eating disorder.

If left untreated, anorexia is associated with a particularly heightened risk of fatal complications. People with anorexia nervosa are about 5 to 6 times likelier to die than members of the general population.

Relative to other young adults, people with anorexia between the ages of 16 and 24 have approximately 10 times the risk of death. Meanwhile, people with bulimia or BED are about twice as likely to die in a given year in comparison to their same-aged peers.

However, treatment works to prevent many potential deaths related to eating disorder symptoms. If you or someone you know has an eating disorder, it’s important to seek treatment as soon as possible. 

One study found that current eating disorder treatments prevent about 42 deaths per 100,000 people under 40 in the U.S. The same review estimated that increasing treatment access to more people with eating disorders could prevent around 70.5 deaths for every 100,000 people before the age of 40.

Eating disorders are mental health conditions that involve disturbed patterns in how someone eats and thinks about their food intake, weight, body shape, and/or appearance. Common eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant restrictive food intake disorder. 

About 30 million Americans, including approximately 1 in 5 women and 1 in 7 men, will experience an eating disorder during their lifetime. Eating disorders appear to be on the rise, with global rates more than doubling between 2000 and 2018.

While anyone can develop eating disorders, they are especially common among teen girls and young women. Over 9 in 10 first-time eating disorder cases are diagnosed in people under 25. 

Eating disorders are also some of the deadliest mental health diagnoses. Anorexia is associated with particularly high mortality rates . People with anorexia nervosa are about 5 to 6 times more likely to die than their peers in the general population.

Studies link using social media platforms like Instagram regularly to an increased risk of eating disorders among adolescents and young adults.

One 2021 study found that participants who frequently compared their appearance to their social media followers were more likely to struggle with unhealthy eating patterns and low self-esteem. Young adults who said they “always” compared their appearance to others’ were 9.2 times likelier to exhibit disordered eating behaviors.

Many professional dancers, especially ballet dancers, say they feel immense pressure to be extremely thin and restrict their food intake. One systemic review and meta-analysis found that 16.4% of ballet dancers had at least one eating disorder. Four percent of ballet dancers met the diagnostic criteria for anorexia nervosa.

Research suggests that professional and student athletes are more likely to develop eating disorders. Estimated eating disorder prevalence rates among athletes are up to 19%. Meanwhile, up to 45% of adolescent and adult female athletes meet the criteria for an eating disorder at some point.

MedlinePlus. Eating disorders .

National Eating Disorders Association. What are eating disorders?

Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000-2018 period: a systematic literature review .  Am J Clin Nutr . 2019;109(5):1402-1413. doi:10.1093/ajcn/nqy342

National Institute of Mental Health. Eating disorders: about more than food .

Ward ZJ, Rodriguez P, Wright DR, Austin SB, Long MW. Estimation of eating disorders prevalence by age and associations with mortality in a simulated nationally representative US cohort .  JAMA Netw Open . 2019;2(10):e1912925. doi:10.1001/jamanetworkopen.2019.12925

Udo T, Grilo CM. Prevalence and correlates of DSM-5-defined eating disorders in a nationally representative sample of U.S. adults .  Biol Psychiatry . 2018;84(5):345-354. doi:10.1016/j.biopsych.2018.03.014

Norris ML, Spettigue WJ, Katzman DK. Update on eating disorders: current perspectives on avoidant/restrictive food intake disorder in children and youth .  Neuropsychiatr Dis Treat . 2016;12:213-218. doi:10.2147/NDT.S82538

Zipfel S, Schmidt U, Giel KE. The hidden burden of eating disorders during the COVID-19 pandemic .  Lancet Psychiatry . 2022;9(1):9-11. doi:10.1016/S2215-0366(21)00435-1

Asch DA, Buresh J, Allison KC, et al. Trends in US patients receiving care for eating disorders and other common behavioral health conditions before and during the COVID-19 pandemic .  JAMA Netw Open . 2021;4(11):e2134913. doi:10.1001/jamanetworkopen.2021.34913

National Association of Anorexia Nervosa and Associated Disorders. Eating disorder statistics .

Cheng ZH, Perko VL, Fuller-Marashi L, Gau JM, Stice E. Ethnic differences in eating disorder prevalence, risk factors, and predictive effects of risk factors among young women .  Eat Behav . 2019;32:23-30. doi:10.1016/j.eatbeh.2018.11.004

Uri RC, Wu YK, Baker JH, Munn-Chernoff MA. Eating disorder symptoms in Asian American college students .  Eat Behav . 2021;40:101458. doi:10.1016/j.eatbeh.2020.101458

Perez M, Ohrt TK, Hoek HW. Prevalence and treatment of eating disorders among Hispanics/Latino Americans in the United States .  Curr Opin Psychiatry . 2016;29(6):378-382. doi:10.1097/YCO.0000000000000277

Schaumberg K, Welch E, Breithaupt L, et al. The science behind the Academy for Eating Disorders' nine truths about eating disorders .  Eur Eat Disord Rev . 2017;25(6):432-450. doi:10.1002/erv.2553

Diemer EW, White Hughto JM, Gordon AR, Guss C, Austin SB, Reisner SL. Beyond the binary: differences in eating disorder prevalence by gender identity in a transgender sample .  Transgend Health . 2018;3(1):17-23. doi:10.1089/trgh.2017.0043

Sangha S, Oliffe JL, Kelly MT, McCuaig F. Eating disorders in males: how primary care providers can improve recognition, diagnosis, and treatment .  Am J Mens Health . 2019;13(3):1557988319857424. doi:10.1177/1557988319857424

National Eating Disorders Association. Eating disorder statistics & research .

Hilbert A. Childhood eating and feeding disturbances .  Nutrients . 2020;12(4):972. doi:10.3390/nu12040972

Rikani AA, Choudhry Z, Choudhry AM, et al. A critique of the literature on etiology of eating disorders .  Ann Neurosci . 2013;20(4):157-161. doi:10.5214/ans.0972.7531.200409

Groth T, Hilsenroth M, Boccio D, Gold J. Relationship between trauma history and eating disorders in adolescents .  J Child Adolesc Trauma . 2019;13(4):443-453. doi:10.1007/s40653-019-00275-z

Bang L, Kristensen UB, Wisting L, et al. Presence of eating disorder symptoms in patients with obsessive-compulsive disorder .  BMC Psychiatry . 2020;20(1):36. doi:10.1186/s12888-020-2457-0

van Hoeken D, Hoek HW. Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden .  Curr Opin Psychiatry . 2020;33(6):521-527. doi:10.1097/YCO.0000000000000641

Jiotsa B, Naccache B, Duval M, Rocher B, Grall-Bronnec M. Social media use and body image disorders: association between frequency of comparing one's own physical appearance to that of people being followed on social media and body dissatisfaction and drive for thinness .  Int J Environ Res Public Health . 2021;18(6):2880. doi:10.3390/ijerph18062880

Arcelus J, Witcomb GL, Mitchell A. Prevalence of eating disorders amongst dancers: a systemic review and meta-analysis .  Eur Eat Disord Rev . 2014;22(2):92-101. doi:10.1002/erv.2271

Bratland-Sanda S, Sundgot-Borgen J. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment .  Eur J Sport Sci . 2013;13(5):499-508. doi:10.1080/17461391.2012.740504

By Laura Dorwart Dr. Dorwart has a Ph.D. from UC San Diego and is a health journalist interested in mental health, pregnancy, and disability rights.

• Introduction
• Conclusions
• Article Information

SCOFF indicates Sick, Control, One, Fat, Food.

a Data from KiGGS baseline, 2003-2006. 34

b Data from KiGGS wave 2, 2014-2017. 34

eTable 1. Electronic search strategy

eTable 2. Excluded studies and reasons for exclusion

eTable 3. Results of the quality assessment checklist for prevalence studies

eFigure. Doi plot and Luis Furuya-Kanamori index determining the publication bias of the studies analyzed for proportion of disordered eating

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López-Gil JF , García-Hermoso A , Smith L, et al. Global Proportion of Disordered Eating in Children and Adolescents : A Systematic Review and Meta-analysis . JAMA Pediatr. 2023;177(4):363–372. doi:10.1001/jamapediatrics.2022.5848

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Global Proportion of Disordered Eating in Children and Adolescents : A Systematic Review and Meta-analysis

• 1 Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
• 2 Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
• 3 Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
• 4 Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, United Kingdom
• 5 Division of Psychology and Mental Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
• 6 Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
• 7 Centre for Public Health, Queen’s University, Belfast, United Kingdom
• 8 Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
• 9 Escuela de Fisioterapia, Universidad de las Américas, Quito, Ecuador
• 10 Faculty of Nursing, Universidad de Castilla-La Mancha, Albacete, Spain
• 11 Faculty of Health Sciences, San Antonio Catholic University of Murcia, Murcia, Spain

Question   What is the global proportion of disordered eating in children and adolescents?

Findings   In this systematic review and meta-analysis of 32 studies including 63 181 participants from 16 countries, 22% reported that children and adolescents showed disordered eating. The proportion was further elevated among girls, older adolescents, and those with higher body mass index.

Meaning   Identifying the magnitude of disordered eating and its distribution in at-risk populations is crucial for planning and executing actions aimed at preventing, detecting, and dealing with them.

Importance   The 5-item Sick, Control, One, Fat, Food (SCOFF) questionnaire is the most widely used screening measure for eating disorders. However, no previous systematic review and meta-analysis determined the proportion of disordered eating among children and adolescents.

Objective   To establish the proportion among children and adolescents of disordered eating as assessed with the SCOFF tool.

Data Sources   Four databases were systematically searched (PubMed, Scopus, Web of Science, and the Cochrane Library) with date limits from January 1999 to November 2022.

Study Selection   Studies were required to meet the following criteria: (1) participants: studies of community samples of children and adolescents aged 6 to 18 years and (2) outcome: disordered eating assessed by the SCOFF questionnaire. The exclusion criteria included (1) studies conducted with young people who had a diagnosis of physical or mental disorders; (2) studies that were published before 1999 because the SCOFF questionnaire was designed in that year; (3) studies in which data were collected during COVID-19 because they could introduce selection bias; (4) studies based on data from the same surveys/studies to avoid duplication; and (5) systematic reviews and/or meta-analyses and qualitative and case studies.

Data Extraction and Synthesis   A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.

Main Outcomes and Measures   Proportion of disordered eating among children and adolescents assessed with the SCOFF tool.

Results   Thirty-two studies, including 63 181 participants, from 16 countries were included in this systematic review and meta-analysis. The overall proportion of children and adolescents with disordered eating was 22.36% (95% CI, 18.84%-26.09%; P  < .001; n = 63 181) ( I 2  = 98.58%). Girls were significantly more likely to report disordered eating (30.03%; 95% CI, 25.61%-34.65%; n = 27 548) than boys (16.98%; 95% CI, 13.46%-20.81%; n = 26 170) ( P  < .001). Disordered eating became more elevated with increasing age ( B , 0.03; 95% CI, 0-0.06; P  = .049) and body mass index ( B , 0.03; 95% CI, 0.01-0.05; P  < .001).

Conclusions and Relevance   In this systematic review and meta-analysis, the available evidence from 32 studies comprising large samples from 16 countries showed that 22% of children and adolescents showed disordered eating according to the SCOFF tool. Proportion of disordered eating was further elevated among girls, as well as with increasing age and body mass index. These high figures are concerning from a public health perspective and highlight the need to implement strategies for preventing eating disorders.

Eating disorders are psychiatric disorders characterized by abnormal eating or weight control behaviors, which can lead to serious health problems. 1 These disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder–not otherwise specified. 2 , 3 They are defined according to individual signs and symptoms and with degrees of severity detailed in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) ( DSM-5 ), 2 as well as in the World Health Organization International Classification of Diseases, 11th Revision (ICD-11) . 3 Similarly, they are recognized within the mental disorders included in the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 4 and are currently a public health concern in most mid- and high-income countries because their prevalence in young people has markedly increased over the past 50 years. 1 Furthermore, eating disorders are among the most life-threatening of all mental health conditions 5 and accounted for 17 361.5 years of life lost (between 1990 and 2019) and caused 318.3 deaths worldwide in 2019. 4

The etiology of eating disorders is very complex and, similar to other psychiatric disorders such as depression and anxiety, arises from the intersection of many risk factors. 6 Although the prevalence varies according to study populations and definitions used, 7 it is recognized that eating disorders are common in adolescents and even more common in young adults. 8 Based on the DSM-5 , the prevalence of eating disorders in children and adolescents (aged 11-19 years) has been stated to be between 1.2% (boys) and 5.7% (girls), with increasing incidence over recent decades. 7 Considering that mid to late adolescence is a peak period of eating disorders and their symptoms, knowing and understanding the proportion of disordered eating among youths is a crucial issue. 9

Because some children and adolescents with eating disorders may hide the core symptoms of the illness and delay seeking specialized care due to feelings of shame or stigmatization, 10 it is reasonable to consider that eating disorders are underdiagnosed and undertreated. 11 In addition to diagnosed eating disorders, parents, guardians, and health care professionals should be aware of symptoms of disordered eating, which include behaviors such as weight loss dieting, binge eating, self-induced vomiting, excessive exercise, and the use of laxatives or diuretics (although not to the level to warrant a clinical diagnosis of an eating disorder). 12 Although these symptoms predict outcomes related to eating disorders and obesity in adolescents 5 years later, 13 it is important to distinguish disordered eating from eating disorders. 14 The term disordered eating is often used to describe and identify some of the different eating behaviors that do not necessarily meet the diagnostic criteria for an eating disorder and therefore cannot be classified as eating disorders per se. 15 Notwithstanding, although its impact on health is often minimized, disordered eating should be closely evaluated because it can evolve into eating disorders. 12

The Sick, Control, One, Fat, Food (SCOFF) questionnaire, developed in 1999 by Morgan et al, 16 is the most widely used screening measure for eating disorders. 17 It consists of 5 questions with dichotomic answers options (ie, yes or no) 16 : (1) Do you make yourself sick because you feel uncomfortably full? (2) Do you worry you have lost control over how much you eat? (3) Have you recently lost more than 1 stone in a 3-month period? (4) Do you believe yourself to be fat when others say you are too thin? (5) Would you say that food dominates your life? A positive screen is provided when a participant answers yes to 2 or more questions, 16 which denotes a suspicion of an existing eating disorder (ie, disordered eating). 17 Previous systematic reviews have examined the SCOFF questionnaire as a screening tool in primary care setting. 17 , 18 For instance, a recent systematic review with meta-analysis including 25 validation studies found that the validity of the cutoff point of 2 or more on the SCOFF questionnaire was high across samples with a pooled sensitivity of 86.0% and specificity of 83.0%. Another recent systematic review for populations and settings relevant to primary care in the US found that a cutoff point of 2 or more on the SCOFF questionnaire had a pooled sensitivity of 84% and pooled specificity of 80% among adults. 18 Among young people, previous studies have found that the cutoff point of 2 or more on the SCOFF questionnaire provided a sensitivity ranging from 64.1% to 81.9% and a specificity ranging from 77.7% to 87.2%. 19 - 22

Despite the above, thus far, no previous systematic review and meta-analysis determined the proportion of disordered eating among children and adolescents. From an epidemiological perspective, identifying the magnitude of disordered eating and its distribution in at-risk populations is crucial for planning and executing actions aimed at preventing, detecting, and dealing with them. 23 Therefore, the aim of the present study was to establish the proportion among children and adolescents of disordered eating as assessed with the SCOFF tool, one of the most widely used methods to study disordered eating in this population. 8

This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) ( CRD42022350837 ) and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses ( PRISMA ) reporting guideline. 24

Studies were required to meet the following criteria: (1) participants: studies of community samples of children and adolescents aged 6 to 18 years and (2) outcome: disordered eating assessed by the SCOFF questionnaire. Searching was not restricted to articles published in peer-reviewed journals of any particular language. For studies that included children/adolescents and adults, the articles were reviewed and, if reported, the child/adolescent samples were included.

The exclusion criteria included (1) studies conducted with young people who had a diagnosis of physical or mental disorders; (2) studies that were published before 1999 because the SCOFF questionnaire was designed in that year 16 ; (3) studies in which data were collected during COVID-19 because they could introduce selection bias; (4) studies based on data from the same surveys/studies to avoid duplication; and (5) systematic reviews and/or meta-analyses and qualitative and case studies.

Two researchers (J.F.L.-G. and D.V.-M.) systematically searched PubMed, Scopus, Web of Science, and the Cochrane Library with date limits from January 1999 to November 2022. Based on the participants, outcome, and study criteria, studies were identified using all possible combinations of the following groups of search terms: (1) child* OR adolescent* OR youth* OR teen* OR young* and (2) Sick, Control, One, Fat, Food OR SCOFF. The complete search strategy for each database is shown in eTable 1 in Supplement 1 . In addition, the list of references of the studies included in this review and in a previous systematic review 17 was thoroughly reviewed to ensure that no eligible studies were missed.

After identifying eligible studies, Mendeley (version for Windows 10; Elsevier) was used to remove duplicate studies. Two members of the research team (J.F.L.-G. and D.V.-M.) conducted the selection process independently and screened every title and abstract to identify potentially relevant articles to be reviewed in the full-text phase. A third researcher (A.G.-H.) participated to resolve any discrepancies.

The proportion of participants with disordered eating (ie, cutoff point ≥2 on the SCOFF questionnaire) was extracted by 1 researcher (D.V.-M.). Another researcher (J.F.L.-G.) checked the data for accuracy. In case of a discrepancy between these 2 researchers, a third researcher (A.G.-H.) reviewed the information.

Information on the authors, affiliations, date, and source of each study included in this review was hidden to avoid bias in the assessment of the methodological quality of the articles. Two researchers (D.V.-M. and J.F.L.-G.) independently assessed the risk of study bias of the included studies. This assessment was performed using a specific tool by Hoy et al 25 for prevalence studies. The tool consists of 10 items that address both the external and internal validity of prevalence studies. Each item can be classified as yes (low risk) or no (high risk), which equals 0 and 1 point, respectively. The overall risk of study bias is deemed to be at low risk of bias, moderate risk of bias, or high risk of bias if the points scored are 0 to 3, 4 to 6, or 7 to 9, respectively.

Proportion of disordered eating was computed based on the raw numerators (ie, participants who scored ≥2 on SCOFF questionnaire) and denominators (ie, total sample) found among the studies.

Using RStudio software version 2022.07.2 + 576 (R Group for Statistical Computing) with the meta package, 26 a meta-analysis of single proportions (ie, metaprop ) was pooled by applying a random-effects model that displayed the results as forest plots using the inverse variance method. The exact or Clopper-Pearson method was used to establish 95% CIs for proportion from the selected individual studies, 27 and a Freeman-Tukey double arcsine transformation was used to normalize the results before calculating the pooled proportion. 28 A continuity correction of 0.5 was used both to calculate individual study results with confidence limits and to conduct meta-analysis.

Heterogeneity between the included studies was determined by the I 2 statistic and its P value. Small study effects and publication bias were examined using the Doi plot and the Luis Furuya-Kanamori index. 29 No asymmetry, minor asymmetry, or major asymmetry were considered with values of less than −2, between −2 and −1, and more than −1, respectively. 29

Subgroup analyses were conducted by gender. Furthermore, random-effects meta-regression analyses using the method of moments were estimated to independently assess whether disordered eating differed by mean age or body mass index (BMI) (both as continuous variables).

A total of 628 records were identified through database searches ( Figure 1 ). After screening for duplicates, gray literature, and other reasons, 302 records remained. Finally, 97 records were obtained for full-text review. Of those studies, 67 were excluded for several reasons (eTable 2 in Supplement 1 ). Two studies were included via other methods (ie, citation searching). Finally, 32 studies, including 63 181 participants, were included in this systematic review, and all studies were included in the meta-analysis.

The main characteristics of the 32 included studies are summarized in the Table . Twenty-six of the studies were cross-sectional, 19 , 20 , 30 , 31 , 34 , 36 , 37 , 39 , 41 - 46 , 48 - 59 4 were longitudinal, 32 , 33 , 35 , 40 1 was a quasi-experimental study, 47 and 1 was a randomized clinical trial. 38 A total of 63 181 participants (51.8% girls) aged 7 to 18 years were included in this systematic review and meta-analysis.

According to gender, 22 studies reported the overall proportion of children and adolescents with disordered eating in both girls and boys, and 2 studies included only 1 gender (ie, only girls 44 , 55 ). The remaining 8 studies did not report proportion segmented by gender. In terms of geographical regions, 16 different countries were identified, including 21 studies in Europe, 19 , 20 , 30 , 34 - 36 , 40 - 43 , 45 , 46 , 48 - 53 , 56 , 57 , 59 5 in Asia, 33 , 37 , 47 , 55 , 58 4 in North America, 31 , 32 , 44 , 54 1 in South America, 38 and 1 in Africa. 39 All the studies were conducted with participants from only 1 country.

All studies were deemed to be at low risk of bias, presenting scores ranging between 0 and 2 points (with the exception of the study by Hicks et al, 44 which presented 3 points). The main sources of bias were associated with the representativeness of the analyzed sample. 19 , 20 , 30 , 31 , 35 - 39 , 41 , 44 , 46 , 47 , 50 , 52 , 54 , 55 A summary of the risk of bias scoring is shown in eTable 3 in Supplement 1 .

Figure 2 shows that the overall proportion of children and adolescents with disordered eating was 22.36% (95% CI, 18.84%-26.09%; P  < .001; n = 63 181) ( I 2  = 98.58%). The Luis Furuya-Kanamori index for the Doi plot showed no asymmetry, indicating no risk of publication bias (Luis Furuya-Kanamori index = −0.58) (eFigure in Supplement 1 ).

Figure 3 depicts the subgroup analysis according to gender. Girls were significantly more likely to report disordered eating (30.03%; 95% CI, 25.61%-34.65%; n = 27 548) than boys (16.98%; 95% CI, 13.46%-20.81%; n = 26 170) ( P  < .001).

The random-effects meta-regression models between proportion of disordered eating and mean age or BMI are shown in Figure 4 . Disordered eating became more elevated with increasing age ( B , 0.03; 95% CI, 0-0.06; P  = .049) ( Figure 4 A) and BMI ( B , 0.03; 95% CI, 0.01-0.05; P  < .001) ( Figure 4 B).

To our knowledge, this is the first meta-analysis that has comprehensively examined the overall proportion of children and adolescents with disordered eating in terms of gender, mean age, and BMI. The main findings of this study are as follows: (1) a total of 14 856 of 63 181 children and adolescents (22.36%) from 16 countries showed disordered eating; (2) the proportion of children and adolescents with disordered eating was significantly higher in girls than in boys; and (3) the proportion of disordered eating among children and adolescents was positively associated with mean age and BMI. These findings can inform intervention priorities for disordered eating as a global health initiative to prevent possible health problems among young people, 60 particularly in girls and young people with higher BMI.

Our findings indicate that more than 1 in 5 children and adolescents presented with disordered eating. It is noteworthy that disordered eating and eating disorders are not similar because not all children and adolescents who reported disordered eating behaviors will necessarily be diagnosed with an eating disorder. 15 However, disordered eating in childhood/adolescence may predict outcomes associated with eating disorders in early adulthood. 13 For this reason, this high proportion found is worrisome and call for urgent action to try to address this situation. In 2019, 14 million people experienced eating disorders including almost 3 million children and adolescents. 61 The behaviors related to eating disorders may lead to greater risk or damage to health, significant distress, or significant impairment of functioning. 60 Indeed, eating disorders are among the most life-threatening psychiatric problems, and people with these conditions die 10 to 20 years younger than the general population. 5

Our findings also indicated that the proportion of children and adolescents with disordered eating was higher in girls than in boys. Although sex differences in disordered eating seem to be relatively minor in adolescence, 62 it is well known that these disorders are more prevalent among girls. 63 Conventionally, studies have focused principally on the female sex, but currently this is not considered as a female-specific matter. The reasons for sex disagreement in the prevalence are not well known. 62 It has been pointed out that disordered eating is frequently unobserved among boys. 64 Boys are presumed to underreport the problem because of the societal perception that these disorders mostly affect girls 65 and because disordered eating has usually been thought by the general population to be exclusive to girls and women. 64 Additionally, it has been noted that the current diagnostic criteria of eating disorder 2 fail to detect disordered eating behaviors more commonly observed in boys than in girls, such as intensely engaging in muscle mass and weight gain with the goal of improving body image satisfaction. 64

On the other hand, the proportion of young people with disordered eating increased with increasing age. This finding is in line with the scientific literature. 66 - 68 The age at onset of eating disorders has classically been described in adolescence. 68 Adolescence represents a critical period for the onset of eating disorders. 66 Similarly, Swanson et al 67 found that the median age at onset of some eating disorders (eg, anorexia nervosa, bulimia nervosa, binge eating disorder) ranged from 12.3 to 12.6 years in a US nationally representative sample including 10 123 adolescents. As the analyzed sample in the present systematic review and meta-analysis ranged from age 7 to 18 years and only 3 studies included only children (ie, aged 7-10 years), it seems to corroborate these ages at onset.

Importantly, we found that the proportion of children and adolescents with disordered eating became more evaluated with increasing BMI. In this sense, the proportion of disordered eating is higher in young people with excess weight than in their counterparts with normal weight. 37 , 69 , 70 Young people who have excess weight may follow disordered eating behaviors while attempting to lose body weight. 71 Therefore, it has been described that young people with excess weight is the population that appears to experience symptoms of disordered eating most frequently (eg, unsupervised weight loss dieting may lead to eating disorder risk 72 ). Although most adolescents who develop an eating disorder do not report prior excess weight problems, some adolescents could misinterpret what eating healthy consists of and engage in unhealthy behaviors (eg, skipping meals to generate a caloric deficit), which could then lead to development of an eating disorder. 73

The WHO’s Comprehensive Mental Health Action Plan 2013-2030 recognizes the essential role of mental health in achieving health for all people, establishing some objectives/priorities. 60 For instance, among others, this plan tries to strengthen information systems, evidence, and research for mental health. In this sense, our systematic review and meta-analysis contributes to this aim by providing epidemiological evidence on the current situation of disordered eating that, if undetected and untreated, can lead to eating disorders with their harmful consequences for the individual, the family, and society. Similarly, the high proportion of disordered eating found in this systematic review and meta-analysis reinforce the importance of screening eating disorders in primary care setting. This is in line with the recommendations by the American Academy of Pediatrics 74 and the American Academy of Child and Adolescent Psychiatry, 75 which advise screening young people through longitudinal height and weight monitoring and looking for symptoms of disordered eating. In this sense, the SCOFF questionnaire is simple, memorable, and easy for applying and scoring, 16 which may be considered the first approach to identify the need for a more detailed and specialized evaluation. 20 However, positive results should be followed by further questioning, prior to an automatic referral to mental health professionals. 76

The present study has certain limitations that must be acknowledged. First, only studies that analyzed disordered eating using the SCOFF questionnaire were included. This decision is justified by the intention of homogenizing the proportion of global proportion of children and adolescents with disordered eating. In this sense, the SCOFF questionnaire is the most widely used screening tool for eating disorders, has been adapted and validated for its use in several languages, seems to be highly effective as a screening tool, and has been extensively used to raise the suspicion level of an eating disorder. Second, because of the cross-sectional nature of most of the included studies, a causal relationship cannot be established. Third, due to the inclusion of binge eating disorder and other specified eating disorders in the DSM-5 , there is not enough evidence to support the use of SCOFF in primary care and community-based settings for screening all the range of eating disorders. However, a meta-analysis by Kutz et al 17 concluded that the SCOFF is a useful and simple screening tool for the most prevalent eating disorders (ie, bulimia nervosa, anorexia nervosa). Fourth, we included studies based on self-report questionnaires to assess disordered eating, and consequently, both social desirability and recall bias could influence the findings.

The available evidence from 32 studies comprising large samples from 16 countries showed that approximately 22% of children and adolescents showed disordered eating according to the SCOFF tool. The proportion of disordered eating was further elevated among girls as well as with increasing age and BMI. This high proportion is worrisome from a public health perspective and highlights the need to implement strategies for preventing eating disorders. 60

Accepted for Publication: November 30, 2022.

Published Online: February 20, 2023. doi:10.1001/jamapediatrics.2022.5848

Corresponding Authors: José Francisco López-Gil, PhD, Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca 16071, Spain ( [email protected] ); Héctor Gutiérrez-Espinoza, PhD, Escuela de Fisioterapia, Universidad de las Américas, Quito 170504, Ecuador ( [email protected] ).

Author Contributions: Dr López-Gil had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: López-Gil, García-Hermoso, Mesas, Tárraga-López, Victoria-Montesinos.

Acquisition, analysis, or interpretation of data: López-Gil, Smith, Firth, Trott, Mesas, Jiménez-López, Gutiérrez-Espinoza, Tárraga-López.

Drafting of the manuscript: López-Gil, García-Hermoso, Smith, Firth.

Critical revision of the manuscript for important intellectual content: López-Gil, Victoria-Montesinos, Smith, Firth, Trott, Mesas, Jiménez-López, Gutiérrez-Espinoza, Tárraga-López.

Statistical analysis: López-Gil, Tárraga-López.

Administrative, technical, or material support: López-Gil, García-Hermoso, Victoria-Montesinos.

Supervision: Smith, Firth, Trott, Tárraga-López.

Conflict of Interest Disclosures: Dr López-Gil is a Margarita Salas Fellow (Universidad de Castilla-La Mancha; 2021-MS-20563). Dr García-Hermoso is a Miguel Servet Fellow (Instituto de Salud Carlos III; CP18/0150). No other disclosures were reported.

Data Sharing Statement: See Supplement 2 .

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Key research and statistics

On this page, overview of eating disorders today, key diagnostic statistics, eating disorders and gender, eating disorders and age, eating disorders and lgbtiqa+ communities, eating disorders and cultural and ethnic diversity, eating disorders and aboriginal and torres strait islander people, eating disorders and co-occurring conditions, eating disorder mortality and suicidality, eating disorder treatment and recovery, eating disorders and economic impact, body image, dieting and social media.

This page provides key research and statistics on issues relating to eating disorders.

Please be aware that some of these statistics relate to confronting issues regarding eating disorder risk factors, suicide/mortality rates and mental illness susceptibility.

It is important to remember that these figures provide a statistical overview only – eating disorders are highly individual and varied and not all research will be applicable to all.  

Please always attribute the statistic to the original source, not Eating Disorders Victoria.  

Eating disorders, when combined with disordered eating, are estimated to affect 16.3% of the Australian population (Hay et al., 2015).   

Latest data estimates that the number of people in Australia with an eating disorder aged over 5 years old is around 1.1 million, or approximately 4.45% of the population (Deloitte Access Economics, 2024, p.27). This number indicates that 286,069 Victorians had an eating disorder in 2023.  

A concerning trend in age distribution shows that 27% of eating disorder cases in Australia are among those aged 10-19. This is has nearly doubled since 2012, highlighting a significant increase in eating disorders among younger age groups (Deloitte Access Economics, 2024, p.10).  

According to the latest data, the most prevalent eating disorders in Australia were Unspecified Feeding and Eating Disorders and Other Specified Feeding and Eating Disorders , affecting approximately 1.5% and 1.1% of the Australian population respectively. In contrast, Anorexia Nervosa and Bulimia Nervosa each occurred in less than 0.5% of the general population (Deloitte Access Economics, 2024, p.27).   

The lifetime prevalence for eating disorders is approximately 10.46% of the Australian population. This estimates that 2,754, 446 Australians had an eating disorder at any time within their life (Deloitte Access Economics, 2024, p.30). This is an increase of 1.46% from conservative estimates in 2012 (NEDC, 2017).  

A recent review found that worldwide, lifetime prevalence of eating disorders was 8.4% (3.3-18.6%) for women and 2.2% (0.8-6.5%) for men. The results also showed that the prevalence has been increasing over time (Galmiche et.al., 2019).   

Eating disorders are serious mental illnesses.

Learn about the different types of eating disorders and signs and symptoms to look out for.

Binge Eating Disorder   

• Based on Australian data, the lifetime prevalence of Binge Eating Disorder is the second highest of all eating disorders at 2.2% (Deloitte Access Economics, 2024, p.30).  
• Binge Eating Disorder has the latest average age of onset of all eating disorders estimated to be about 25 years old (Butterfly Foundation, 2012).   

Learn more about binge eating disorder  

Anorexia Nervosa  

• The lifetime prevalence of Anorexia Nervosa in the Australian population is 1.8% (Deloitte Access Economics, 2024, p.30).  
• The average onset of Anorexia Nervosa is 16-17 years, although more and more younger children are becoming affected (Keski-Rahkonen at al., 2018).   

Learn more about anorexia nervosa  

Bulimia Nervosa    

• The lifetime prevalence of Bulimia Nervosa in the Australian population is estimated to be 1.85% (Deloitte Access Economics, 2024, p.30).  
• The average age of onset of Bulimia Nervosa is 18 years (Volpe et.al., 2016).   

Learn more about bulimia nervosa  

Eating disorders are the third most common chronic illness in young women (Yeo & Hughes, 2011).   

• 67% of people with eating disorders in Australia are female and 33% male (Deloitte Access Economics, 2024, p.28).   
• Women and girls are more likely to experience all types of eating disorders than men and boys, where Binge Eating Disorder prevalence is almost double in women compared to men, and more than doubled for Bulimia Nervosa (Deloitte Access Economics, 2024, p.28).  
• Approximately 80-85% of individuals diagnosed with Anorexia Nervosa or Bulimia Nervosa are female and 15-20% are male (Hay et al., 2008).    
• Eating disorders and disordered eating behaviours in boys and men may present differently than in girls and women, particularly with muscularity-oriented disordered eating (Nagata et al., 2020).   
• Research suggests that transgender people, whose assigned sex at birth does not match their gender identity, are more likely than cisgender people, whose assigned sex at birth matches their gender identity, to have been diagnosed with an eating disorder or to engage in disordered eating (Watson et al., 2017).   
• Research indicates that both transfeminine spectrum (TFS; those assigned male at birth and identifying as women or on the feminine spectrum) and transmasculine spectrum (TMS; those assigned female at birth and identifying as men or on the masculine spectrum) individuals had higher levels of disordered eating and body dissatisfaction than cisgender participants (Witcomb et.al., 2015).    
• An Australian study found that 23% of transgender young people have a current or previous diagnosis of an eating disorder (Strauss et.al., 2017).   

Did you know?

Research indicates that over one third of people experiencing an eating disorder are men ( Koreshe et al., 2023). Many experts believe that this number is likely to be even higher due to underreporting due to gender stereotyping and misdiagnosis.  

Eating disorders can affect people of all ages and have been diagnosed in those younger than 5 years and older than 80 years (NEDC, 2017).   

• Research shows that adolescents are at greatest risk, with the average age of onset for an eating disorder between 12 and 25 years (Volpe et al., 2016).   
• The highest prevalence is found in 15 – 19 year olds, where up to 12% of adolescents in this age bracket had an eating disorder in 2023 (Deloitte Access Economics, 2024, p.29).  
• 75% of people diagnosed with Anorexia Nervosa and 83% of people diagnosed with Bulimia Nervosa are between 12 and 25 years (Volpe et al., 2016).   
• 57% of contacts to the Butterfly Foundation National Helpline in 2018-2019 were from young people aged up to 25 years (Butterfly Foundation, 2020a).  

People who are LGBTIQA+ are at a greater risk for disordered eating behaviours (Calzo et al, 2017).  

• Gay, lesbian and bisexual teens may be at higher risk of binge eating than their heterosexual peers (Austin et al., 2009).  
• A review from the United States found that lifetime prevalence for eating disorders is higher among sexual minority adults compared with cisgender heterosexual adults however, more detailed research is required (Nagata et al., 2020).  

Eating disorders occur in all ethnicities, nationalities and cultural backgrounds (Schamberg et al., 2017).  

• A 2019 review found that at any point in time (one-time prevalence) eating disorders occur all over the world, specifically, 4.6% in America, 2.2% in Europe and 3.5% in Asia (Galmiche et al., 2019).  
• It is important to recognise unique cultural nuances and sensitivities, and varied sociocultural factors that influence an individual’s relationship with food, body image, and mental health.  

Though research is limited, it has been estimated that eating disorders incidence is much higher in Indigenous populations with estimates that up to 27% are affected (Burt, et al., 2020).    

• A recent research study found that 28% of Indigenous high school students have an eating disorder compared to 22% of other Australian teens (Burt et al., 2020).   
• Binge eating disorders are as common, if not more common, among Aboriginal and Torres Strait Islander youth (Hay & Carriage, 2012).   
• Research suggests that 30% of Aboriginal and Torres Strait Islander young people are extremely or very concerned about their body image (Hall et al., 2020).   

Eating disorders are frequently associated with other psychological and physical disorders such as depression, anxiety disorders, substance abuse and personality disorders (Hudson et.al, 2007).   

• Approximately 55- 97% of people diagnosed with an eating disorder have a mental illness comorbid condition (NEDC, 2017).   
• Approximately 45-86% of individuals diagnosed with an eating disorder have co-existing depression (O’Brien & Vincent, 2003).   
• Approximately 64% of individuals diagnosed with an eating disorder have co-existing anxiety disorder (Kaye et al., 2004).   
• Approximately 58% of individuals diagnosed with an eating disorder have co-existing personality disorder (NEDC, 2017).   
• Among adolescents, approximately 88% of individuals with Bulimia Nervosa , 84% of individuals with Binge Eating Disorder , and 55% of individuals with Anorexia Nervosa have had one or more co-existing mental illness at some point in their lives (NEDC, 2017).    
• Research indicates that anxiety disorder (especially social anxiety) can precede the onset of an eating disorder (Swinbourne & Touyz, 2007).   
• Higher rates of disordered eating have been described in chronic health conditions that require dietary modification, including Celiac disease, Cystic Fibrosis and Diabetes (Wabich et al., 2020).   
• People with Diabetes (both Type 1 and Type 2) may be two times as likely to develop disordered eating and/or an eating disorder likely due to the nature of the illness including factors such as weight-gain, obsession with food and feelings of loss of control (Pereira and Alvarenga, 2007).   
• Gastrointestinal conditions such as Irritable Bowel Syndrome (IBS) are more prevalent in those diagnosed with an eating disorder though research is unclear if symptoms are resulting from or precede the eating disorder (Marie et al., 2019).   
• Research findings suggest that patients with inflammatory bowel disease (IBD) including Crohn’s disease and Ulcerative Colitis, may struggle with maladaptive attitudes toward eating making them at higher risk for developing disordered eating and/or an eating disorder however more research specific to these conditions is required (Wabich et al., 2020).   

Eating disorders, along with substance use disorders, have the highest mortality rate of all psychiatric disorders (Chesney, Goodwin & Fazel, 2014).   

• The mortality rate of those with Anorexia Nervosa is higher than other eating disorders (Fichter & Quadflieg, 2016).   
• Cardiovascular complications is the leading cause of death among people with Anorexia Nervosa, followed by suicide (Smith, Zuromski & Dodd, 2018).   
• The rate of mortality of individuals with Bulimia Nervosa and Binge Eating Disorder is lower than those with Anorexia Nervosa, but still significantly higher than the general population (NEDC, 2017).   
• People with Anorexia Nervosa are more than 31 times more likely to attempt suicide and those with Bulimia Nervosa 7.5 times more likely to attempt suicide than the general population (Preti et.al, 2011).   
• People with Anorexia Nervosa are 18 times more likely to die by suicide and those with Bulimia Nervosa are 7 times more likely to die by suicide relative to gender and aged matched comparison groups (Smith, Zuromski & Dodd, 2018).   
• Suicidal behaviour is elevated in Binge Eating Disorder relative to the general population (Smith, Zuromski & Dodd, 2018).    
• Suicide risk is higher when eating disorders occur with other psychological conditions (Smith et.al., 2018).   

When skilled and knowledgeable health professionals deliver treatment, full recovery and good quality of life can be achieved for most people with eating disorders (Butterfly Foundation, 2016).  

• It is estimated that 75% of people with an eating disorder don’t seek professional help (Hart et.al., 2011).   
• The reasons/ barriers for not accessing treatment include stigma, shame, denial, failure to perceive the severity of the illness, cost of treatment, low motivation to change, lack of encouragement and lack of knowledge about how to access help resources (Ali et.al, 2017).    
• The most effective treatment for eating disorder is person-centred care, tailored to suit the individual’s illness, situation and needs (Hay et.al., 2014).   
• The average time taken to recover from all types of eating disorders, after seeking treatment, is 1-6 years (Deloitte Access Economics, 2015).  

Learn more about treatment for eating disorders  

Accessing professional, evidence-based treatment for an eating disorder will give you the best possible recovery outcomes.  

• The economic cost has increased by 36% in the last decade, exceeding $66.9 billion in 2023 – this equates to a cost per person of $60,654 (Deloitte Access Economics, 2024).  
• Health system costs (public and private) attributed to eating disorders in 2023 was $251.4 million. Importantly this does not account for all out-of-pocket health system expenses incurred by those impacted by eating disorders (Deloitte Access Economics, 2024).  
• Anorexia nervosa accounts for 75% of the total health system costs, also accounting for the highest per person costs ($4,859) followed by BN ($163) (Deloitte Access Economics, 202
• Body image has been listed in the top four concerns for young Australians from 2009-2018 with 30% concerned about body image (Carlisle et al, 2018).   
• Research shows that up to 80% of young teenage girls report a fear of becoming ‘fat’ (Kearney-Cooke & Tieger, 2015).   
• Nearly 23% of Australian women report a self over evaluation of weight and shape – meaning they think they are larger than they are according to BMI (Mitchison et.al., 2013).   
• It has been reported that more than 55% of Australian girls and 57% boys aged 8 to 9 years are dissatisfied with their body t (Daragnova, 2013).    
• Nearly half of Australian women and one third of Australian men are dissatisfied with their body (NEDC, 2017).   
• Weight related teasing in children is associated with disordered eating, weight gain, binge eating, and extreme weight control measures (Golden, Schneider & Wood, 2016).   
• Social media use has been linked to self-objectification, and using social media for merely 30 minutes, a day can change the way you view your own body (Fardouly & Vartanian, 2015).   
• A study of teen girls reported that social media users were significantly more likely than non-social media users to have internalized a drive for thinness and to engage in body surveillance (Fardouly et.al., 2015).    
• Weight-loss dieting is a risk factor for the development of an eating disorders and. Dieting frequently precedes the onset of an eating disorder (Butryn & Wadden, 2005).   
• Dietary restraint influences binge-eating behaviour (Andres & Saldana, 2014).   
• High frequency dieting and early onset of dieting are associated with poorer physical and mental health, more disordered eating, extreme body dissatisfaction, and more frequent general health problems (Tucci et al., 2007).   

Learn more about dieting and eating disorders

Engaging in weight-loss dieting is the a key behavioural risk factor for developing an eating disorder.

Ali, K., Farrer, L., Fassnacht, D.B., Gulliver, A., Bauer, S., & Griffiths, K.M., (2017). Perceived barriers and facilitators towards help seeking for eating disorders: A systematic review. International Journal of Eating Disorders 50(1), 9-21.   

American Psychiatric Association. (2013).  Diagnostic and statistical manual of mental disorders  (5th ed.). American Psychiatric Association.   

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Mindful Eating

What Is It?

Mindful eating stems from the broader philosophy of mindfulness, a widespread, centuries-old practice used in many religions. Mindfulness is an intentional focus on one’s thoughts, emotions, and physical sensations in the present moment. Mindfulness targets becoming more aware of, rather than reacting to, one’s situation and choices. Eating mindfully means that you are using all of your physical and emotional senses to experience and enjoy the food choices you make. This helps to increase gratitude for food, which can improve the overall eating experience. Mindful eating encourages one to make choices that will be satisfying and nourishing to the body. However, it discourages “judging” one’s eating behaviors as there are different types of eating experiences. As we become more aware of our eating habits, we may take steps towards behavior changes that will benefit ourselves and our environment.

How It Works

Mindful eating focuses on your eating experiences, body-related sensations, and thoughts and feelings about food, with heightened awareness and without judgment. Attention is paid to the foods being chosen, internal and external physical cues, and your responses to those cues. [1] The goal is to promote a more enjoyable meal experience and understanding of the eating environment. Fung and colleagues described a mindful eating model that is guided by four aspects: what to eat , why we eat what we eat , how much to eat , and how to eat . [1]

Mindful eating:

• considers the wider spectrum of the meal: where the food came from, how it was prepared, and who prepared it
• notices internal and external cues that affect how much we eat
• notices how the food looks, tastes, smells, and feels in our bodies as we eat
• acknowledges how the body feels after eating the meal
• expresses gratitude for the meal
• may use deep breathing or meditation before or after the meal
• reflects on how our food choices affect our local and global environment

Seven practices of mindful eating

• Honor the food . Acknowledge where the food was grown and who prepared the meal. Eat without distractions to help deepen the eating experience.
• Engage all senses . Notice the sounds, colors, smells, tastes, and textures of the food and how you feel when eating. Pause periodically to engage these senses.
• Serve in modest portions . This can help avoid overeating and food waste. Use a dinner plate no larger than 9 inches across and fill it only once.
• Savor small bites, and chew thoroughly . These practices can help slow down the meal and fully experience the food’s flavors.
• Eat slowly to avoid overeating . If you eat slowly, you are more likely to recognize when you are feeling satisfied, or when you are about 80% full, and can stop eating.
• Don’t skip meals . Going too long without eating increases the risk of strong hunger, which may lead to the quickest and easiest food choice, not always a healthful one. Setting meals at around the same time each day, as well as planning for enough time to enjoy a meal or snack reduces these risks.
• Eat a plant-based diet, for your health and for the planet . Consider the long-term effects of eating certain foods. Processed meat and saturated fat are associated with an increased risk of colon cancer and heart disease . Production of animal-based foods like meat and dairy takes a heavier toll on our environment than plant-based foods.

Watch: Practicing mindful eating

The Research So Far

The opposite of mindful eating, sometimes referred to as mindless or distracted eating, is associated with anxiety, overeating, and weight gain. [3] Examples of mindless eating are eating while driving, while working, or viewing a television or other screen (phone, tablet). [4] Although socializing with friends and family during a meal can enhance an eating experience, talking on the phone or taking a work call while eating can detract from it. In these scenarios, one is not fully focused on and enjoying the meal experience. Interest in mindful eating has grown as a strategy to eat with less distractions and to improve eating behaviors.

Intervention studies have shown that mindfulness approaches can be an effective tool in the treatment of unfavorable behaviors such as emotional eating and binge eating that can lead to weight gain and obesity, although weight loss as an outcome measure is not always seen. [5-7] This may be due to differences in study design in which information on diet quality or weight loss may or may not be provided. Mindfulness addresses the shame and guilt associated with these behaviors by promoting a non-judgmental attitude. Mindfulness training develops the skills needed to be aware of and accept thoughts and emotions without judgment; it also distinguishes between emotional versus physical hunger cues. These skills can improve one’s ability to cope with the psychological distress that sometimes leads to binge eating. [6]

Mindful eating is sometimes associated with a higher diet quality, such as choosing fruit instead of sweets as a snack, or opting for smaller serving sizes of calorie-dense foods. [1]

• A literature review of 68 intervention and observational studies on mindfulness and mindful eating found that these strategies improved eating behaviors such as slowing down the pace of a meal and recognizing feelings of fullness and greater control over eating. [8] Slower eating was associated with eating less food, as participants felt fuller sooner. Mindfulness and mindful eating interventions appeared most successful in reducing binge eating and emotional eating. However, the review did not show that these interventions consistently reduced body weight. Limitation of the studies included small sample sizes, limited durations of about 6 months or less, lack of focus on diet quality, and lack of follow-up so that longer-term success was not determined.
• A randomized controlled trial following 194 adults with obesity (78% were women) for 5.5 months looked at the effects of a mindfulness intervention on mindful eating, sweets consumption, and fasting glucose levels. The participants were randomly assigned to one of two groups: a diet and exercise program with mindfulness concepts (stress reduction, chair yoga, meditation, affirmations) or the same program but without mindfulness concepts. After 12 months, the mindfulness group showed a decreased intake of sweets and maintenance of fasting blood glucose, as opposed to the control group showing increased fasting blood glucose. [9] The research authors also evaluated weight loss with these participants, but did not find a significant difference in weight changes between the mindfulness group and control group. [10]
• A small controlled trial of 50 adults with type 2 diabetes were randomized to either a 3-month mindful eating intervention that was focused on reducing overeating and improving eating regulation or to a diabetes self-management education (DSME) intervention that was focused on improving food choices. Both groups showed significant improvements in measures of depression, nutrition self-efficacy, and controlling overeating behaviors. Both groups lost weight during the intervention but there was no difference in amount of weight loss between groups. [11]

It is important to note that currently there is no standard for what defines mindful eating behavior, and there is no one widely recognized standardized protocol for mindful eating. Research uses a variety of mindfulness scales and questionnaires. Study designs often vary as well, with some protocols including a weight reduction component or basic education on diet quality, while others do not. Additional research is needed to determine what behaviors constitute a mindful eating practice so that a more standardized approach can be used in future studies. [1] Standardized tools can help to determine the longer-term impact of mindful eating on health behaviors and disease risk and prevention, and determine which groups of people may most benefit from mindfulness strategies. [1]

Mindfulness is a strategy used to address unfavorable eating behaviors in adults, and there is emerging interest in applying this method in adolescents and children due to the high prevalence of unhealthy food behaviors and obesity in younger ages. More than one-third of adolescents in the U.S. have overweight or obesity. Youth who have overweight/obesity are likely to experience weight-related stigma and bullying by their peers, which in turn can negatively affect eating behaviors and lead to eating disorders. [12] Studies have found that eating disorders are developing at younger ages, with an increased number of children younger than 12 years of age presenting for treatment. [12]

• A review of 15 studies of mindfulness-based interventions in adolescents found that mindfulness techniques were associated with reduced concerns about body shape, less dietary restraint, decreased weight, and less binge eating. [12] However, interestingly, the overall acceptability of the mindfulness-related interventions was rated low by the participants, compared with general health education. It is likely that the way mindful strategies are presented to younger ages needs better understanding as it may be different than in adults. An example could be using new online technologies that are specific to their developmental age and learning ability. The review also found that mindfulness in the form of meditation and mindful breathing can have significant effects on disordered eating through better stress management and reduced overeating caused by depression and anxiety.
• Studies are still scarce in children, but novel programs are emerging. A pilot mindful eating intervention was tested in a low-income school in California involving third-through-fifth grade children including Hispanic and non-Hispanic children. [13] The goal was to foster healthy eating behaviors in the children and their parents. The program included topics such as “Master Mindless Munching,” “Getting to Know Hunger and Fullness,” and “Sensational Senses,” and provided take-home activities to do with their parents. Surveys at the end of the program showed that the children and parents liked the activities, and there was an increase in parents serving nutritious meals and practicing mindfulness during meals (e.g., recognizing when hungry vs. full).

Potential Pitfalls

• Mindful eating is not intended to replace traditional treatments for severe clinical conditions such as eating disorders . Neurochemical imbalances are a risk factor for developing eating disorders such as bulimia and anorexia nervosa, and although mindfulness may be an effective component of a treatment plan, it should not be used as a sole treatment.
• May not be effective as a weight loss strategy on its own, but rather a complement to a weight loss program. Mindful eating embraces making food choices that promote well-being and increasing enjoyment of the eating experience. Traditional weight loss regimens focus on following a structured meal plan that may not necessarily be satisfying or enjoyable. Combining mindfulness with a meal plan under the guidance of a registered dietitian may reduce the risk of emotional overeating or binge eating. [14] Research has not consistently shown that mindfulness strategies lead to weight loss, but this may be due to the study design not including education on healthy eating choices as part of the mindfulness intervention.

Bottom Line

Mindful eating is an approach to eating that can complement any eating pattern. Research has shown that mindful eating can lead to greater psychological wellbeing, increased pleasure when eating, and body satisfaction. Combining behavioral strategies such as mindfulness training with nutrition knowledge can lead to healthful food choices that reduce the risk of chronic diseases, promote more enjoyable meal experiences, and support a healthy body image. More research is needed to examine whether mindful eating is an effective strategy for weight management.

Mindful eating in context of COVID-19

In the meantime, individuals may consider incorporating any number of mindful eating strategies in their daily lives alongside other important measures to help stay healthy during COVID-19 . For example:

• If you’re working from home and find that “office” time blends into all hours of the day, schedule times in your calendar to only eat : a lunch break away from your computer, a reserved time for dinner with your family, etc.
• If you find yourself standing in your pantry or staring in your refrigerator, pause and ask yourself: “am I truly hungry, or am I just bored or stressed?” If hungry, eat. If boredom or stress is the source, reroute your attention to an activity you enjoy, call a friend, or simply spend some time breathing.
• If you have a craving for comfort foods, pause and take a few in-breaths and out-breaths to be fully present with your craving. Take a portion of the food from the container (a handful of chips, a scoop of ice cream) and put it on a plate. Eat mindfully, savoring each bite.

A note about eating disorders : The COVID-19 pandemic may raise unique challenges for individuals with experience of eating disorders. [17] In the U.S., the National Eating Disorders Association has reported a significant increase in calls and messages for help as compared to a year ago. As noted, mindful eating is not intended to replace traditional treatments for severe clinical conditions such as eating disorders. If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237, or text “NEDA” to 741-741.

A note about food insecurity : Many individuals may be facing food shortages because of unemployment or other issues related to the pandemic. If you (or someone you know) are struggling to access enough food to keep yourself or your family healthy, there are several options to help. Learn more about navigating supplemental food resources .

• Healthy Weight
• The Best Diet: Quality Counts
• Diet Reviews
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• Hanh TN, Cheung L. Savor: Mindful Eating, Mindful Life . HarperCollins Publishers. 2010.  
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• Ogden J, Coop N, Cousins C, Crump R, Field L, Hughes S, Woodger N. Distraction, the desire to eat and food intake. Towards an expanded model of mindless eating. Appetite . 2013 Mar 1;62:119-26.
• Katterman SN, Kleinman BM, Hood MM, Nackers LM, Corsica JA. Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eating behaviors . 2014 Apr 1;15(2):197-204.
• O’Reilly GA, Cook L, Spruijt‐Metz D, Black DS. Mindfulness‐based interventions for obesity‐related eating behaviours: a literature review. Obesity reviews . 2014 Jun;15(6):453-61.
• Ruffault A, Czernichow S, Hagger MS, Ferrand M, Erichot N, Carette C, Boujut E, Flahault C. The effects of mindfulness training on weight-loss and health-related behaviours in adults with overweight and obesity: A systematic review and meta-analysis. Obesity research & clinical practice . 2017 Sep 1;11(5):90-111.
• Warren JM, Smith N, Ashwell M. A structured literature review on the role of mindfulness, mindful eating and intuitive eating in changing eating behaviours: effectiveness and associated potential mechanisms. Nutrition research reviews . 2017 Dec;30(2):272-83. *Disclosure: Study  was  funded by Mondelez International.  
• Mason AE, Epel ES, Kristeller J, Moran PJ, Dallman M, Lustig RH, Acree M, Bacchetti P, Laraia BA, Hecht FM, Daubenmier J. Effects of a mindfulness-based intervention on mindful eating, sweets consumption, and fasting glucose levels in obese adults: data from the SHINE randomized controlled trial. Journal of behavioral medicine . 2016 Apr 1;39(2):201-13.
• Daubenmier J, Moran PJ, Kristeller J, Acree M, Bacchetti P, Kemeny ME, Dallman M, Lustig RH, Grunfeld C, Nixon DF, Milush JM. Effects of a mindfulness‐based weight loss intervention in adults with obesity: A randomized clinical trial. Obesity . 2016 Apr;24(4):794-804.
• Miller CK, Kristeller JL, Headings A, Nagaraja H. Comparison of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a randomized controlled trial. Health Education & Behavior . 2014 Apr;41(2):145-54.
• Omiwole M, Richardson C, Huniewicz P, Dettmer E, Paslakis G. Review of mindfulness-related interventions to modify eating behaviors in adolescents. Nutrients . 2019 Dec;11(12):2917.
• Wylie A, Pierson S, Goto K, Giampaoli J. Evaluation of a mindful eating intervention curriculum among elementary school children and their parents. Journal of nutrition education and behavior . 2018 Feb 1;50(2):206-8.
• Tapper K, Shaw C, Ilsley J, Hill AJ, Bond FW, Moore L. Exploratory randomised controlled trial of a mindfulness-based weight loss intervention for women. Appetite . 2009 Apr 1;52(2):396-404.
• Bhutani S, Cooper JA. COVID‐19 related home confinement in adults: weight gain risks and opportunities. Obesity . 2020 May 19.
• Clemmensen C, Petersen MB, Sørensen TI. Will the COVID-19 pandemic worsen the obesity epidemic?. Nature Reviews Endocrinology . 2020 Sep;16(9):469-70.
• Branley-Bell D, Talbot CV. Exploring the impact of the COVID-19 pandemic and UK lockdown on individuals with experience of eating disorders.  Journal of Eating Disorders .  2-2020 Aug;8(44).

Last reviewed September 2020

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• Eating Disorders

How Disordered Eating Becomes a Concern in the Neurodivergent

Explore the nuances of disordered eating among neurodivergent populations..

Posted April 18, 2024 | Reviewed by Ray Parker

• What Are Eating Disorders?
• Find a therapist to heal from an eating disorder
• Not all unusual eating habits in neurodivergent people are disorders.
• Standard methods for diagnosing eating disorders may not apply to neurodivergent people.
• Treatment for eating disorders in neurodivergent people should consider their neurodivergence.

Research has shown an overlap between neurodivergence and those struggling with eating disorders. Neurodivergence is a term used to describe those whose minds process information differently than what society has deemed the standard, including variations in how they interpret, experience, and absorb their surroundings.

Due to perpetuated stereotypes across media and academic institutions, eating disorder research was previously skewed to focus on Western female populations, giving a false perception of who was struggling with these disorders. However, as research continues to evolve and awareness of the presentation of neurodivergence among marginalized populations is built, we are learning how a diverse range of populations are affected by these disorders, including the neurodivergent community.

There are a multitude of reasons why neurodivergent people may be at an increased risk of developing an eating disorder. They may have increased or decreased sensory sensitivities, for example, or difficulties identifying hunger and fullness cues, or they may experience emotions more intensely.

Many of these differences are exacerbated due to the stress of having to live in a world designed primarily for neurotypical people, which could itself lead to the development of an eating disorder. However, due to differences in how they process the world around them, neurodivergent folks also commonly have their own relationship with food that may appear to a neurotypical person as disordered.

But does someone whose experience of the world is privileged to align with the neurotypical society get to make this judgment call? Is it even possible to make a sweeping definition of what disordered eating looks like in neurodivergent populations?

I’ll do my best to briefly explore the nuances of disordered eating among neurodivergent populations as well as identify some parameters for when disordered eating becomes a concern.

Is Disordered Eating in Neurodivergent Folks a Concern?

As I mentioned, many neurodivergent individuals have a unique relationship with food due to differences in how they interpret the world around them. They may stick to the same foods each day, be fearful of trying new things, struggle with hunger or fullness cues, avoid going out, or forget to eat and then eat a lot at once. But is this disordered?

Disordered is a word that suggests a disruption to a person’s overall functioning. This means for eating to be disordered, it would cause increased challenges to an area of functioning, be it physical, emotional, social, or financial.

Whether or not functioning is impaired for a neurodivergent individual should not be determined through a neurotypical lens. Instead, it should be seen in collaboration with what the individual reports and/or desires to see in their life moving forward.

For many clinicians, this involves pushing against the traditional methods for eating disorder treatment to see things from a more holistic and nuanced perspective because neurodivergence is a piece of the person, not a clinical symptom to treat as if to make it disappear.

Eating Disorder or Disordered Eating?

One distinction between an eating disorder and disordered eating lies in how impactful a person’s eating behaviors are on their overall health, functioning, and quality of life. Diagnostic criteria require that an eating disorder significantly impact a person’s functioning in one or more areas of their life. This means that disordered eating has intensified to the point where a person’s well-being is jeopardized by the illness.

Identifying an eating disorder in neurodivergent folks may be complicated because symptoms don’t always align with the perception of eating disorders that we have from the media or society. Following are some signs that are more specific to neurodivergent individuals:

• Sticking to one type of texture (e.g., soft foods, crunchy foods)
• Avoiding cold foods
• Avoiding hot foods
• Only eating foods of a certain color palette (e.g., only tan foods, only red foods)
• Avoiding foods with a certain smell
• Refusing foods if small changes are made (e.g., new packaging, new brand, new presentation)
• Taking a long time to finish a meal
• Going long periods of time without remembering to eat or feeling hungry
• Eating alone or only in a certain location
• Going long periods of time without the awareness of hunger
• Eating large quantities of food after going long periods of time without awareness of hunger
• Developing a strong fixation on one or a few types of foods for a period of time

As I mentioned, not all these behaviors have to be labeled as disordered in nature. It is more about whether these behaviors lead to impairments to an individual's well-being. For a personal look into this concept and more information on this topic, you can check out this article , where I offered some additional insights.

Reaching Out for Support

Early intervention can be an important factor in recovering from an eating disorder. However, reaching out for support when an individual is neurodivergent may feel more complicated because it can be challenging to find providers who have a background in eating disorder treatment and an understanding of neurodivergence.

For this reason, it can be helpful to schedule consultation calls with providers before committing to working with them. In these calls, you can ask about their experience with neurodivergent individuals and how they work to take a nuanced approach to treatment beyond the traditional eating disorder interventions, which weren’t developed considering neurodivergent experiences.

Adrian G-S, Victoria M-M, Luis B-F. Connecting Eating Disorders and Sensory Processing Disorder: A Sensory Eating Disorder Hypothesis. Glob J Intellect Dev Disabil. 2017; 3(4): 555617

Balasundaram, P., & Santhanam, P. (2022). Eating Disorders. In StatPearls. StatPearls Publishing.

Baron-Cohen, S., Jaffa, T., Davies, S., Auyeung, B., Allison, C., Wheelwright, S. (2013). Do girls with anorexia nervosa have elevated autistic traits? Molecular Autism, 4(24), 2-8.

Biederman, Joseph MD*†; Ball, Sarah W. SCD*; Monuteaux, Michael C. SCD*†; Surman, Craig B. MD*†; Johnson, Jessica L. BS*; Zeitlin, Sarah BA*. Are Girls with ADHD at Risk for Eating Disorders? Results from a Controlled, Five-Year Prospective Study. Journal of Developmental & Behavioral Pediatrics: August 2007 - Volume 28 - Issue 4 - p 302-307 doi: 10.1097/DBP.0b013e3180327917

Morgan Blair, M.A., LPCC , has 17 years of experience living with, studying, and treating eating disorders. She now has her own practice where she treats gender-expansive and neurodivergent individuals recovering from eating disorders.

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Eating disorders in the United Kingdom - Statistics & Facts

Eating disorders, obesity in the uk, key insights.

Detailed statistics

England: primary diagnoses of eating disorders 2021/22, by type and gender

Share of young population with eating disorder in England in 2023, by age and gender

Obesity prevalence in England 2000-2021, by gender

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Current statistics on this topic.

Mental Health & Substance Abuse

Share of the population with an eating disorder worldwide from 1990 to 2019

Share of the population with an eating disorder worldwide 1990-2019, by gender

Deaths from eating disorders worldwide from 1990 to 2019

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Hospital admissions with a diagnosis of an eating disorder in England 2019/21, by age

Number of hospital admissions with a primary or secondary diagnosis of an eating disorder in England from 2019 to 2021, by age

England: hospital admissions with an eating disorder diagnosis 2021/22, by age

Number of hospital admissions involving a diagnosis of an eating disorder in England in 2021/22, by age

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Number of hospital admissions with a primary or secondary diagnosis of an eating disorder in England in 2021, by gender and diagnosis

England: cases of anorexia nervosa 2021/22, by age

Hospital admissions involving a diagnosis of anorexia nervosa in England in 2021/22, by age

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Eating disorders among children, teens, and young adults

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Prevalence of children and young people with anorexia nervosa in England in 2023, by age and gender

Share of young population with bulimia nervosa in England in 2023, by age and gender

Prevalence of children and young people with bulimia nervosa in England in 2023, by age and gender

Percentage of children and young people with an eating disorder in England in 2023, by age and gender

Share of young people in England aged 11 to 16 years in 2017-23 by eating disorder

Prevalence of selected eating disorders among young people aged 11 to 16 years in 2017 and 2023

Share of young people in England aged 17 to 19 years in 2017-23, by eating disorder

Prevalence of selected eating disorders among young people aged 17 to 19 years in 2017 and 2023

Children with unhealthy weight in Scotland 2022, by gender and age

Share of children with unhealthy weight in Scotland in 2022, by gender and age

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England: prevalence of adults who were obese 2021, by gender and region

Prevalence of adults who were obese in England in 2021, by gender and region

Obese adults in Scotland 2020, by gender and age

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Share of individuals with a longstanding illness in England in 2021, by gender and body mass index (BMI)

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Physical Fitness Linked to Better Mental Health in Young People

A new study bolsters existing research suggesting that exercise can protect against anxiety, depression and attention challenges.

By Matt Richtel

Physical fitness among children and adolescents may protect against developing depressive symptoms, anxiety and attention deficit hyperactivity disorder, according to a study published on Monday in JAMA Pediatrics.

The study also found that better performance in cardiovascular activities, strength and muscular endurance were each associated with greater protection against such mental health conditions. The researchers deemed this linkage “dose-dependent,” suggesting that a child or adolescent who is more fit may be accordingly less likely to experience the onset of a mental health disorder.

These findings come amid a surge of mental health diagnoses among children and adolescents, in the United States and abroad, that have prompted efforts to understand and curb the problem.

The new study, conducted by researchers in Taiwan, compared data from two large data sets: the Taiwan National Student Fitness Tests, which measures student fitness performance in schools, and the National Insurance Research Databases, which records medical claims, diagnoses prescriptions and other medical information. The researchers did not have access to the students’ names but were able to use the anonymized data to compare the students’ physical fitness and mental health results.

The risk of mental health disorder was weighted against three metrics for physical fitness: cardio fitness, as measured by a student’s time in an 800-meter run; muscle endurance, indicated by the number of situps performed; and muscle power, measured by the standing broad jump.

Improved performance in each activity was linked with a lower risk of mental health disorder. For instance, a 30-second decrease in 800-meter time was associated, in girls, with a lower risk of anxiety, depression and A.D.H.D. In boys, it was associated with lower anxiety and risk of the disorder.

An increase of five situps per minute was associated with lower anxiety and risk of the disorder in boys, and with decreased risk of depression and anxiety in girls.

“These findings suggest the potential of cardiorespiratory and muscular fitness as protective factors in mitigating the onset of mental health disorders among children and adolescents,” the researchers wrote in the journal article.

Physical and mental health were already assumed to be linked , they added, but previous research had relied largely on questionnaires and self-reports, whereas the new study drew from independent assessments and objective standards.

The Big Picture

The surgeon general, Dr. Vivek H. Murthy, has called mental health “the defining public health crisis of our time,” and he has made adolescent mental health central to his mission. In 2021 he issued a rare public advisory on the topic. Statistics at the time revealed alarming trends: From 2001 to 2019, the suicide rate for Americans ages 10 to 19 rose 40 percent, and emergency visits related to self-harm rose 88 percent.

Some policymakers and researchers have blamed the sharp increase on the heavy use of social media, but research has been limited and the findings sometimes contradictory. Other experts theorize that heavy screen use has affected adolescent mental health by displacing sleep, exercise and in-person activity, all of which are considered vital to healthy development. The new study appeared to support the link between physical fitness and mental health.

“The finding underscores the need for further research into targeted physical fitness programs,” its authors concluded. Such programs, they added, “hold significant potential as primary preventative interventions against mental disorders in children and adolescents.”

Matt Richtel is a health and science reporter for The Times, based in Boulder, Colo. More about Matt Richtel

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Though meditation can be beneficial to those with A.D.H.D., sitting still and focusing on breathing can be hard for them. These tips can help .