Hostname: page-component-6bf8c574d5-t27h7 Total loading time: 0 Render date: 2025-02-16T05:21:24.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Anorexia Nervosa

No Evidence of an Increase

Published online by Cambridge University Press:  02 January 2018

Eric Fombonne
Eric Fombonne*
Affiliation:
Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

This paper examines the evidence that rates of anorexia nervosa have increased over time.

Method

Epidemiological studies that have provided time trends in incidence rates in specific countries or psychiatric registers and prevalence surveys were reviewed to assess whether or not prevalence estimates are higher in the most recent studies.

Results

Estimated trends in incidence rates showed an increase but no study ruled out plausible alternative explanations. Studies showing no upward trend were as numerous and were generally based on larger samples. Analysis of 29 cross-sectional surveys conducted over the last 25 years indicated that the median prevalence rate was 1.3 per 1000 females. There was no indication that more recent surveys yielded higher prevalence rates.

Conclusion

Anorexia nervosa remains a rare disorder and there is no evidence of a secular increase in its incidence.

Type
Papers
Information
The British Journal of Psychiatry , Volume 166 , Issue 4 , April 1995 , pp. 462 - 471
Copyright
Copyright © Royal College of Psychiatrists, 1995 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1960) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Armitage, P. & Berry, G. (1987) Statistical Methods in Medical Research (2nd edn). Oxford: Blackwell Scientific Publications.Google Scholar
Beglin, S. J. & Fairburn, C. G. (1992) Women who choose not to participate in surveys on eating disorders. International Journal of Eating Disorders, 12, 113–116.Google Scholar
Ben-Tovim, D. I. & Morton, J. (1990) The epidemiology of anorexia nervosa in South Australia. Australian and New Zealand Journal of Psychiatry, 24, 182–186.Google Scholar
Bland, R. C., Orn, H. & Newman, S. C. (1988) Lifetime prevalence of psychiatric disorders in Edmonton. Acta Psychiatrica Scandinavica, 77 (suppl. 338), 24–32.Google Scholar
Childress, A. C., Brewerton, T. D., Hodges, E. L., et al (1993) The Kid's Eating Disorders Survey (KEDS): a study of middle school students. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 843–850.Google Scholar
Crisp, A. H., Palmer, R. L. & Kalucy, R. S. (1976) How common is anorexia nervosa? A prevalence study. British Journal of Psychiatry, 128, 549–554.CrossRefGoogle ScholarPubMed
Cullberg, J. & Engström-Lindberg, M. (1988) Prevalence and incidence of eating disorders in a suburban area. Acta Psychiatrica Scandinavica, 78, 314–319.CrossRefGoogle Scholar
de Azevedo, M. H. P. & Ferreira, C. P. (1992) Anorexia nervosa and bulimia: a prevalence study. Acta Psychiatrica Scandinavica, 86, 432–436.Google Scholar
Fairburn, C. G. & Beglin, S. J. (1990) Studies of the epidemiology of bulimia nervosa. American Journal of Psychiatry, 147, 401–408.Google ScholarPubMed
Garfinkel, P. E. & Garner, D. M. (1982) Anorexia Nervosa: a Multidimensional Perspective. New York: Brunner-Mazel.Google Scholar
Garner, D. M., Olmsted, M. P. & Garfinkel, P. E. (1985) Similarities among bulimic groups selected by different weights and weight histories. Journal of Psychiatric Research, 19, 129–134.Google Scholar
Garner, D. M., & Fairburn, C. G. (1988) Relationship between anorexia nervosa and bulimia nervosa: diagnostic implications. In Diagnostic Issues in Anorexia Nervosa and Bulimia Nervosa (eds D. M. Garner & P. E. Garfinkel), pp. 56–79. New York: Brunner-Mazel.Google Scholar
Götestam, K. G. & Agras, W. S. (1995) A population based epidemiological study of eating disorders in Norway. International Journal of Eating Disorders (in press).Google Scholar
Hall, A. & Hay, P. J. (1991) Eating disorder patient referrals from a population region 1977–1986. Psychological Medicine, 21, 697–701.CrossRefGoogle ScholarPubMed
Halmi, K. A., Casper, R., Eckert, E., et al (1979) Unique features associated with age of onset of anorexia nervosa. Psychiatry Research, 1, 209–215.Google Scholar
Hoek, H. W. (1991) The incidence and prevalence of anorexia nervosa and bulimia nervosa in primary care. Psychological Medicine, 21, 455–460.Google Scholar
Hoek, H. W. & Brook, F. G. (1985) Patterns of care of anorexia nervosa. Journal of Psychiatric Research, 19, 155–160.Google Scholar
Hsu, L. K. G. (1990) Eating Disorders. New York: Guilford Press.Google Scholar
Hwu, H.G., Yeh, E.-K. & Chang, L.-Y. (1989) Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule. Acta Psychiatrica Scandinavica, 79, 136–147.Google Scholar
Joergensen, J. (1992) The epidemiology of eating disorders in Fyn County, Denmark, 1977–1986. Acta Psychiatrica Scandinavica, 85, 30–34.CrossRefGoogle ScholarPubMed
Johnson-Sabine, E., Wood, K., Patton, G., et al (1988) Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: factors associated with abnormal response on screening questionnaires. Psychological Medicine, 18, 615–622.CrossRefGoogle ScholarPubMed
Jones, D. J., Fox, M. M., Babigian, H. M., et al (1980) Epidemiology of anorexia nervosa in Monroe county, New York: 1960–1976. Psychosomatic Medicine, 42, 551–558.Google Scholar
Kendell, R. E., Hall, D. J., Hailey, A., et al (1973) The epidemiology of anorexia nervosa. Psychological Medicine, 3, 200–203.CrossRefGoogle ScholarPubMed
King, M. B. & Bhugra, D. (1989) Eating disorders: lessons from a cross-cultural study. Psychological Medicine, 19, 955–958.CrossRefGoogle ScholarPubMed
Lee, C. K., Kwak, Y. S., Rhee, H., et al (1987) The nationwide epidemiological study of mental disorders in Korea. Journal of Korean Medical Sciences, 2, 19–34.Google Scholar
Lewinsohn, P. M., Hops, H., Roberts, R. E., et al (1993) Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM–III–R disorders in high school students. Journal of Abnormal Psychology, 102, 133–144.Google Scholar
Lucas, A. R., Beard, C. M., O'Fallon, W. M., et al (1988) Anorexia nervosa in Rochester, Minnesota: a 45-year study. Mayo Clinic Proceedings, 63, 433–442.Google Scholar
Lucas, A. R., Beard, C. M., O'Fallon, W. M., et al (1991) 50-year trends in the incidence of anorexia nervosa in Rochester, Minn.: a population-based study. American Journal of Psychiatry, 148, 917–922.Google Scholar
Mann, A. H., Wakeling, A., Wood, K., et al (1983) Screening for abnormal eating attitudes and psychiatric morbidity in an unselected population of 15-year-old schoolgirls. Psychological Medicine, 13, 573–580.Google Scholar
Moller-Madsen, S. & Nystrup, J. (1992) Incidence of anorexia nervosa in Denmark. Acta Psychiatrica Scandinavica, 86, 197–200.Google Scholar
Nielsen, S. (1990) The epidemiology of anorexia nervosa in Denmark from 1973 to 1987: a nationwide register study of psychiatric admission. Acta Psychiatrica Scandinavica, 81, 507–514.CrossRefGoogle ScholarPubMed
Patton, G. C., Johnson-Sabine, E., Wood, K., et al (1990) Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: outcome at twelve month follow-up. Psychological Medicine, 20, 383–394.Google Scholar
Rastam, M., Gillberg, C. & Garton, M. (1989) Anorexia nervosa in a Swedish urban region: a population-based study. British Journal of Psychiatry, 155, 642–646.Google Scholar
Rastam, M., Gillberg, C. & Gillberg, C. (1992) Background factors in anorexia nervosa: a controlled study of 51 teenage cases including a population sample. European Child and Adolescent Psychiatry, 1, 54–65.Google Scholar
Rathner, G. & Messner, K. (1993) Detection of eating disorders in a small rural town: an epidemiological study. Psychological Medicine, 23, 175–184.CrossRefGoogle Scholar
Robins, L. N., Helzer, J. E., Weissman, M. M., et al (1984) Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry, 41, 949–958.Google Scholar
Robins, L. N. & Regier, D. A. (eds) (1991) Psychiatric Disorders in America: the Epidemiologic Catchment Area Study. New York: The Free Press.Google Scholar
Roghmann, K. J., Babigian, H. M., Goldberg, I. D., et al (1982) The increasing number of children using psychiatric services: analysis of a cumulative psychiatric case register. Pediatrics, 70, 790–801.Google Scholar
Scheinberg, Z., Bleich, A., Koslovsky, M., et al (1992) Prevalence of eating disorders among female Israel defence force recruits. Harefuah, 123, 73–78.Google Scholar
Steinhausen, H.-Ch., Rauss-Mason, C. & Seidel, R. (1991) Follow-up studies of anorexia nervosa: a review of four decades of outcome research. Psychological Medicine, 21, 447–454.Google Scholar
Strober, M., Lampert, C., Morrell, W., et al (1990) A controlled family study of anorexia nervosa: evidence of familial aggregation and lack of shared transmission with affective disorders. International Journal of Eating Disorders, 9, 239–253.Google Scholar
Suzuki, M., Morita, H. & Kamoshita, S. (1990) Epidemiological survey of psychiatric disorders in Japanese school children. Part III: Prevalence of psychiatric disorders in junior high school children. Nippon Koshu Eisei Zasshi, 37, 991–1000.Google Scholar
Szmukler, G. I. (1983) Weight and food preoccupation in a population of English schoolgirls. In Understanding Anorexia Nervosa and Bulimia (ed. Bargman, G. J.), pp. 21–27. Columbus, Ohio: Ross Laboratories.Google Scholar
Szmukler, G. I., McCance, C., McCrone, L., et al (1986) Anorexia nervosa: a psychiatric case register study from Aberdeen. Psychological Medicine, 16, 49–58.CrossRefGoogle ScholarPubMed
Theander, S. (1970) Anorexia nervosa: a psychiatric investigation of 94 female patients. Acta Psychiatrica Scandinavica, supplement 214, 1–194.Google Scholar
Treasure, J. L. & Holland, A. J. (1991) Genes and the aetiology of eating disorders. In The New Genetics of Mental Illness (eds P. McGuffin & R. Murray), pp. 198–211. Oxford: Butterworth-Heinemann.Google Scholar
Wells, J. E., Bushnell, J. A., Hornblow, A. R., et al (1989) Christchurch psychiatric epidemiology study, part I: Methodology and lifetime prevalence for specific psychiatric disorders. Australian and New Zealand Journal of Psychiatry, 23, 315–326.CrossRefGoogle ScholarPubMed
Whitaker, A., Johnson, J., Shaffer, D., et al (1990) Uncommon troubles in young people: prevalence estimates of selected psychiatric disorders in a nonreferred adolescent population. Archives of General Psychiatry, 47, 487–496.CrossRefGoogle Scholar
Whitehouse, A. M. & Button, E. J. (1988) The prevalence of eating disorders in a U.K. college population: a reclassification of an earlier study. International Journal of Eating Disorders, 7, 393–397.Google Scholar
Whitehouse, A. M., Cooper, P. J., Vize, C. V., et al (1992) Prevalence of eating disorders in three Cambridge general practices: hidden and conspicuous morbidity. British Journal of Medical Practice, 42, 57–60.Google ScholarPubMed
Willi, J. & Grossman, S. (1983) Epidemiology of anxorexia nervosa in a defined region of Switzerland. American Journal of Psychiatry, 140, 564–567.Google Scholar
Willi, J., Giacometti, G. & Limacher, B. (1990) Update on the epidemiology of anorexia nervosa in a defined region of Switzerland. American Journal of Psychiatry, 147, 1514–1517.Google Scholar
Williams, P. & King, M. (1987) The ‘epidemic’ of anorexia nervosa: another medical myth? Lancet, i, 205–207.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.