Publications

Journal Article Ahead of print

PubMed: 42949727 DOI: 10.1001/jamapsychiatry.2026.3457

Global Burden of Anorexia Nervosa and Bulimia Nervosa, 1990 to 2023, With Forecasts to 2050: A Global Burden of Disease Study 2023 Analysis.

JAMA Psychiatry

Authors: Ruhai Bai, Wanyue Dong, Xu Wang, Aihua Zhang, Damian F Santomauro, Hasan Aalruz, Olumide Abiodun, Richard Gyan Aboagye, Khaled M Aboshanab, Lucas Guimarães Abreu, Amr Selim Abu Lila, Hana J Abukhadijah, Mohammad S Abu-Mahfouz, Nuhu Lawan Adamu, Babatope Oluwadamilare Adebiyi, Saheed Ayodeji Adekola, Miracle Ayomikun Adesina, Habeeb Omoponle Adewuyi, Amaha K Adhanu, Obed Adonteng-Kissi, Percival Delali Agordoh, Salome Wumpini Agordoh, César Agostinis Sobrinho, Abdul Momin Rizwan Ahmad, Khabir Ahmad, Ali Ahmed, Md Faisal Ahmed, Shakeel Ahmed, Kenni Wojujutari Ajele, Oluwabusayomi O Akeju, Oladipo Vincent Akinmade, Wole Akosile, Ashley E Akrami, Ahmad Al Athamneh, Salah Al Awaidy, Duaa Fayiz Al Maghaireh, Omar Al Omari, Mohammad Ahmmad Mahmoud Al Zoubi, Mohammad Khursheed Alam, Muath A Alammar, Shams M F Al-Anzi, Mohammed Albashtawy, Abdulelah Mastour Aldhahir, Bezawit Abeje Alemayehu, Baidaa Alhalabi, Fadwa Naji Alhalaiqa, Mohammad Jamil Alhawajreh, Ashraf Alhumaidi, Ahmed Naif Ali, Mohammed Usman Ali … and 454 other authors

Affiliations

  • Evidence-Based Research Center of Social Science and Health, School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China.
  • Clinical Medical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, China.
  • School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China.
  • Department of Science and Technology, Children's Hospital of Nanjing Medical University, Nanjing, China.
  • Children's Hospital of Nanjing Medical University, Nanjing, China.
  • Institute for Health Metrics and Evaluation, University of Washington, Seattle.
  • School of Public Health, The University of Queensland, Brisbane, QLD, Australia.
  • Queensland Centre for Mental Health Research, Wacol, QLD, Australia.
  • Department of Nursing, Al Zaytoonah University of Jordan, Amman, Jordan.
  • Department of Community Medicine, Babcock University, Ilishan-Remo, Nigeria.
  • Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana.
  • School of Population Health, University of New South Wales, Sydney, NSW, Australia.
  • Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.
  • Department of Pediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Department of Pharmaceutics, University of Hail, Hail, Saudi Arabia.
  • Clinical Trials Unit, Hamad Medical Corporation, Doha, Qatar.
  • Department of Nursing, Almoosa College of Health Sciences, Al-Ahsa, Saudi Arabia.
  • Department of Nursing Science, Modibbo Adama University, Yola, Nigeria.
  • Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
  • School of Public Health, University of the Western Cape, Bellville, South Africa.
  • Department of Chemical Pathology, University of Abuja, Abuja, Nigeria.
  • Centre for Health Systems Support and Development, University of Abuja, Abuja, Nigeria.
  • Slum and Rural Health Initiative Research Academy, Slum and Rural Health Initiative, Ibadan, Nigeria.
  • Department of Physiotherapy, University of Ibadan, Ibadan, Nigeria.
  • Department of Educational Counselling and Developmental Psychology, University of Ibadan, Ibadan, Nigeria.
  • Department of Educational Psychology, University of Johannesburg, Johannesburg, South Africa.
  • Nutrition & Health Innovation Research Institute, Edith Cowan University, Perth, WA, Australia.
  • School of Arts and Social Sciences, Edith Cowan University, Bunbury, WA, Australia.
  • Department of Nutrition and Dietetics, University of Health and Allied Sciences, Ho, Ghana.
  • Operations Department, World Vision, Kete Krachi, Ghana.
  • SPRINT Sport Physical Activity and Health Research & Innovation Center, Polytechnic Institute of Guarda, Guarda, Portugal.
  • Health Research and Innovation Sciences Center, Polytechnic Institute of Guarda, Klaipeda, Lithuania.
  • Department of Human Nutrition & Dietetics, National University of Sciences & Technology (NUST), Islamabad, Pakistan.
  • Department of Health Sciences, University of York, York, United Kingdom.
  • King Khaled Eye Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
  • Department of Pharmacy Practice, Riphah Institute of Pharmaceutical Sciences, Islamabad, Pakistan.
  • Division of Infectious Diseases and Global Public Health (IDGPH), University of California San Diego, San Diego, California.
  • Department of Health Sciences and Informatics, Bangladesh Institute of Innovative Health Research, Dhaka, Bangladesh.
  • Department of Applied Statistics and Data Science, Jahangirnagar University, Dhaka, Bangladesh.
  • Department of Computer Science, Jazan University, Jazan, Saudi Arabia.
  • Social Sciences, North-West University, Mafikeng, South Africa.
  • College of Integrated Health Sciences, Health Policy, Management and Behavior, University at Albany, Albany, New York.
  • University of Warwick, Coventry, United Kingdom.
  • Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia.
  • Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois.
  • Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
  • Department of Nutrition, University of Petra, Amman, Jordan.
  • Department of Communicable Diseases, Ministry of Health, Muscat, Oman.
  • Middle East, Eurasia, and Africa Influenza Stakeholders Network, Muscat, Oman.
  • College of Nursing, Sulaiman AlRajhi University, AlBukayriyah, Saudi Arabia.
  • Fundamentals and Administration Department, Sultan Qaboos University, Muscat, Oman.
  • School of Public Health, University of Texas, Houston.
  • Preventive Dentistry Department, Jouf University, Sakaka, Saudi Arabia.
  • Department of Family Medicine, Shaqra University, Shaqra, Saudi Arabia.
  • School of Nursing, University of British Columbia, Vancouver, BC, Canada.
  • Department of Community and Mental Health, Al al-Bayt University, Mafraq, Jordan.
  • Respiratory Therapy Program, Jazan University, Jazan, Saudi Arabia.
  • Department of Midwifery, Bahir Dar University, Bahir Dar, Ethiopia.
  • School of Public Health, SRM Institute of Science and Technology, Chennai, India.
  • Department of Nutrition, Homs University, Homs, Syria.
  • College of Nursing, Qatar University, Doha, Qatar.
  • School of Health Sciences, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates.
  • Faculty of Dentistry, Ibn Al-Nafis University for Medical Sciences, Sana'a, Yemen.
  • Department of Oral and Maxillofacial Surgery, Xi'an Jiaotong University, Xi'an, China.
  • Hawler Medical University, College of Nursing, Salahaddin University, Erbil, Iraq.
  • Department of Medical Rehabilitation (Physiotherapy), University of Maiduguri, Maiduguri, Nigeria.
  • Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.

Abstract

IMPORTANCE

Eating disorders are a major cause of nonfatal mental health burden, yet global evidence on their long-term trends, geographic distribution, and future trajectories remains limited.

OBJECTIVE

To estimate the global, regional, and national prevalence and disability burden of anorexia nervosa and bulimia nervosa-and mortality attributable to anorexia nervosa-from 1990 to 2023, and to forecast prevalence to 2050.

DESIGN, SETTING, AND PARTICIPANTS

Using Global Burden of Disease (GBD) 2023 methods, data were synthesized from systematic literature reviews, population surveys, and vital registration systems. Estimates were produced for 204 countries and territories from 1990 to 2023, with forecasts through 2050. These data were analyzed from October 2025 to August 2026.

EXPOSURE

Anorexia nervosa or bulimia nervosa diagnosis.

MAIN OUTCOMES AND MEASURES

Counts and age-standardized rates with 95% uncertainty intervals (UIs) for anorexia nervosa and bulimia nervosa prevalence, years lived with disability (YLDs), and disability-adjusted life-years (DALYs), and anorexia nervosa mortality, reported by age, sex, and location.

RESULTS

In 2023, an estimated 18.1 million people (95% UI, 13.9-24.0) globally were living with anorexia nervosa or bulimia nervosa, of whom 12.6 million (69.4%) were female, 5.5 million were male (30.6%), and 41.2% were aged 10 to 24 years. These cases accounted for 3.83 million DALYs (95% UI, 2.23-5.69). Since 1990, the global number of prevalent cases increased by 71.0%, while age-standardized prevalence and DALY rates rose by about 21%. Females experienced substantially higher prevalence and DALY rates than males. The highest age-standardized prevalence rates were observed in high-income regions, particularly Australasia and Western Europe, whereas the largest relative increases in age-standardized prevalence occurred in East Asia, South Asia, and Southeast Asia. Forecasts indicate continued increases in prevalent cases through 2050.

CONCLUSIONS AND RELEVANCE

This GBD 2023 analysis found that anorexia nervosa and bulimia nervosa contribute substantially to global nonfatal health loss. These findings support the integration of eating disorders into mental health surveillance, prevention, and service planning worldwide.

MeSH

Bulimia Nervosa, Anorexia, Mortality, Bulimia, Mental Disorders, Global Burden Of Disease, Prevalence, Cost Of Illness, Anorexia Nervosa, Mental Health