Increased mortality in bulimia nervosa and other eating disorders.
Abstract
OBJECTIVE: Anorexia nervosa has been consistently associated with increased mortality, but whether this is true for other types of eating disorders is unclear. The goal of this study was to determine whether anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified are associated with increased all-cause mortality or suicide mortality. METHOD: Using computerized record linkage to the National Death Index, the authors conducted a longitudinal assessment of mortality over 8 to 25 years in 1,885 individuals with anorexia nervosa (N=177), bulimia nervosa (N=906), or eating disorder not otherwise specified (N=802) who presented for treatment at a specialized eating disorders clinic in an academic medical center. RESULTS: Crude mortality rates were 4.0% for anorexia nervosa, 3.9% for bulimia nervosa, and 5.2% for eating disorder not otherwise specified. All-cause standardized mortality ratios were significantly elevated for bulimia nervosa and eating disorder not otherwise specified; suicide standardized mortality ratios were elevated for bulimia nervosa and eating disorder not otherwise specified. CONCLUSIONS: Individuals with eating disorder not otherwise specified, which is sometimes viewed as a "less severe" eating disorder, had elevated mortality risks, similar to those found in anorexia nervosa. This study also demonstrated an increased risk of suicide across eating disorder diagnoses.
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Suicidality was more common among adolescents with bulimia nervosa compared with those with anorexia nervosa.
“Likewise, suicidality was more common among adolescents with BN compared with those with AN, corroborating findings from previous community surveys43 and some clinical studies.12–14”
From Prevalence and Correlates of Eating Disorders in Adolescents: Results From the National Comorbidity Survey Replication Adolescent Supplement (2011) · cites this paper as [12]
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Self-citation
- Authors
- Crow, S. J., Peterson, C. B., Swanson, S. A., Raymond, N. C., Specker, S., Eckert, E. D., & Mitchell, J. E.
- Affiliations
- University of Minnesota (US)
- Venue
- American Journal of Psychiatry
- Published
- 2009-12
- Volume
- 166
- Issue
- 12
- Pages
- 1342-1346
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2115175496
- Cited by
- 633
- References
- 23
- Citations by year
- 2026: 9 · 2025: 26 · 2024: 18 · 2023: 34 · 2022: 32 · 2021: 74 · 2020: 28 · 2019: 33 · 2018: 41 · 2017: 30 · 2016: 44 · 2015: 44 · 2014: 54 · 2013: 63 · 2012: 44
- FWCI
- 35.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (K02MH065919)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30 DK60456)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- bulimia nervosa, anorexia nervosa, eating disorder not otherwise specified, eating disorders, mortality, suicide, standardized mortality ratio, all-cause mortality, long-term outcomes
- MeSH terms
- Adult, Age Factors, Anorexia Nervosa, Feeding and Eating Disorders, Cause of Death, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Mortality, Prognosis, Risk Factors, Suicide, United States, Body Mass Index, Age Distribution, Bulimia Nervosa
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