Lifetime and 12-month prevalence of eating disorders amongst women in mid-life: a population-based study of diagnoses and risk factors

Abstract

BackgroundEating disorders (EDs) are common amongst women; however, no research has specifically investigated the lifetime/12-month prevalence of eating disorders amongst women in mid-life (i.e., fourth and fifth decade of life) and the relevant longitudinal risk factors. We aimed to investigate the lifetime and 12-month prevalence of EDs and lifetime health service use and to identify childhood, parenting, and personality risk factors.MethodsThis is a two-phase prevalence study, nested within an existing longitudinal community-based sample of women in mid-life. A total of 5658 women from the UK Avon Longitudinal Study of Parents and Children (ALSPAC; enrolled 20 years earlier) participated. ED diagnoses were obtained using validated structured interviews. Weighted analyses were carried out accounting for the two-phase methodology to obtain prevalence figures and to carry out risk factor regression analyses.ResultsBy mid-life, 15.3% (95% confidence intervals, 13.5–17.4%) of women had met criteria for a lifetime ED. The 12-month prevalence of EDs was 3.6%. Childhood sexual abuse was prospectively associated with all binge/purge type disorders and an external locus of control was associated with binge-eating disorder. Better maternal care was protective for bulimia nervosa. Childhood life events and interpersonal sensitivity were associated with all EDs.ConclusionsBy mid-life a significant proportion of women will experience an ED, and few women accessed healthcare. Active EDs are common in mid-life, both due to new onset and chronic disorders. Increased awareness of the full spectrum of EDs in this stage of life and adequate service provision is important. This is the first study to investigate childhood and personality risk factors for full threshold and sub-threshold EDs and to identify common predictors for full and sub-threshold EDs. Further research should clarify the role of preventable risk factors on both full and sub-threshold EDs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-016-0766-4) contains supplementary material, which is available to authorized users.

Eating pathology in midlife women: Similar or different to younger counterparts?

“…Results of the study argue for continued attention to reducing barriers to accessing treatment and identifying cases as early as possible (e.g., Reas et al, ). A recent study highlighted the importance of adequate healthcare provision with regards to women in midlife (Micali et al, ), and thus the present findings serve as a continued reminder that EDs occur across the age range. Further studies might look at whether EDs in older individuals are being correctly identified, and whether current psychological therapies are sufficiently personalized to address the needs of all those presenting for ED treatment.…”

Child maltreatment and eating disorders among men and women in adulthood: Results from a nationally representative United States sample

“…Different trends were also noted for BED in the most adjusted models with physical neglect having the most robust relationship among men and sexual abuse and emotional abuse having the most robust relationships among women. These are important novel findings since other representative community studies have not examined gender differences (Garfinkel et al, ; Micali et al, ; Sachs‐Ericsson et al, ). As well, the data indicate that some child maltreatment types are more strongly associated with certain eating disorders with emotional neglect being more strongly associated with BN and BED compared to AN, and physical neglect being more strongly associated with BED compared to AN.…”

“…Previous population‐based studies examining child maltreatment and eating disorders have found that sexual abuse and physical abuse are related to an increased likelihood of experiencing eating disorders or symptoms (Garfinkel et al, ; Micali et al, ; Sachs‐Ericsson et al, ). Our findings are consistent with the current literature, but also extend knowledge.…”

Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population

“…A recent community study in the US using diagnostic specifiers reported much lower 3-month DSM-5 BED prevalence estimates of 1.19% (95% CI 1.04–1.37%) [13]. Similarly, a cohort study of women in mid-life [14] reported a prevalence of 1.03% (0.73–1.46) of DSM-5 BED.…”