Excessive mortality observed in anorexia nervosa

(HealthDay)—Mortality is increased among patients with eating disorders, with higher mortality for those with anorexia nervosa (AN) compared with bulimia nervosa (BN), binge eating disorder (BED), and eating disorder not otherwise specified (ED-NOS), according to a study published online Jan. 15 in the International Journal of Eating Disorders.

Manfred Maximilian Fichter, M.D., and Norbert Quadflieg, from the University of Munich in Germany, examined long-term mortality, causes of death, and predictors of early death in eating disorders. Data were reviewed for 5,839 inpatients (1,639 treated for AN; 1,930 treated for BN; 363 treated for BED; and 1,907 treated for ED-NOS) , all of whom were followed for vital status through the German civil registry office.

The researchers found that the standardized mortality ratios were 5.35 for AN, 1.49 for BN, 1.50 for BED, and 2.39 and 1.70, respectively, for narrowly-defined and widely-defined ED-NOS. Earlier death was seen for patients with AN, compared with patients with BN, BED, and ED-NOS, which did not differ. Major predictors of a shorter time to death included AN diagnosis, chronicity, later age at onset, not living in a relationship, and an irregular type of discharge from index inpatient treatment. In BN only, suicidality was a univariate predictor of shorter time to death. Patients with AN mostly died from natural causes related to their eating disorder.

"Mortality in AN is excessive and considerably higher than in BN, BED, and ED-NOS," the authors write.

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