Health impacts of eating disorders complex and long-lasting, researchers find
Eating disorders, such as anorexia, bulimia, and binge eating, can lead to a variety of complex and long-lasting physical and mental health impacts, according to a new study led by the universities of Keele and Manchester.
The findings, published in the journal BMJ Medicine, report the risk of serious conditions like diabetes, renal and liver failure, fractures, and premature death, were particularly raised within the first 12 months of being diagnosed with an eating disorder.
They also highlight that these elevated risks can persist for years, even after the person is thought to have recovered from their eating disorder, with the researchers saying that timely interventions from multiple different health services are needed to improve patient outcomes.
The research team, led by Dr Cathy Morgan from Manchester with input from Professor Carolyn Chew-Graham OBE from Keele, were funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC).
Using the Clinical Practice Research Datalink, the researchers studied anonymised electronic health records spanning from 1998 to 2018, linked to Hospital Episode Statistics data, and linked death records across England.
Their data covered over 24,000 patients with a diagnosed eating disorder which were each matched for age, sex, and GP practice, with up to 20 others who had not been diagnosed with an eating disorder (493,001 in total). They investigated the patients’ mental and physical health over 10 years using the data to learn more about their health following initial diagnosis.
Their analysis showed that patients diagnosed with eating disorders were at a much higher risk of poor physical and mental health, and premature death. The greatest risks were within a year of diagnosis, but the researchers found that these risks persisted for years afterwards.
People with eating disorders were six times more likely to develop renal failure and nearly seven times more likely to develop liver disease within the first year of being diagnosed, as well as being at significantly heightened risks of osteoporosis, heart failure, and diabetes.
The risks of poor mental health were also higher within the first 12 months of diagnosis, with rates of depression and self harm being significantly higher during this period, with these heightened risks persisting after five years, albeit lowered.
The risk of death from any cause was also higher within the first 12 months and once again, these risks persisted for up to 10 years afterwards, although at a lower rate.
Dr Cathy Morgan from the University of Manchester, said: “This study highlights the substantial long-term effects of eating disorders. Raising awareness among healthcare providers about the lasting effects of eating disorders and the need for ongoing support in managing current symptoms and recovery is essential.”
Professor Carolyn Chew-Graham OBE from Keele University, added: “Integration is needed across primary and specialist care – both mental and physical health services including nephrology, cardiology, and endocrinology. This is particularly important at the time of diagnosis of an eating disorder and whilst a person is under specialist mental health services.
“Our work highlights that monitoring a person’s health is vital even when management of the eating disorder has been completed and the person is thought to have recovered. This monitoring should take place in primary care (general practice) – so we highlight the need for education and training of primary care clinicians, but also the need for this work to be commissioned in primary care going forwards.”
