Eating Disorders Linked to Increased Risk for Early Death

Megan Brooks

May 08, 2012

May 8, 2012 (Philadelphia, Pennsylvania) — Eating disorders increase the risk of dying prematurely, a large study shows.

The mortality rates in the study fit with the "serious nature of eating disorders," Jaana T. Suokas, MD, PhD, from Helsinki University Central Hospital in Finland, reports.

Presented here at the American Psychiatric Association's 2012 Annual Meeting, the study involved 2329 women and 113 men treated in a specialized eating disorder clinic at Helsinki University Central Hospital between 1995 and 2010.

The clinic includes an outpatient clinic and a hospital ward. Eating disorders were treated mostly (81%) in outpatient care, but about one half (45%) of patients with anorexia nervosa (AN) also required inpatient care.

For each patient, 4 control participants were selected from the National Central Population Register and matched for age, sex, and place of residence. Mortality data were obtained from the National Causes of Death Register. A Poisson regression model was used to calculate relative risks for mortality due to all causes, all external causes of injuries and accidents, and suicide.

Anorexia Particularly Risky

The study showed that patients with an eating disorder were at increased risk of dying prematurely relative to control participants.

Patients with AN had a greater than 6-fold increased risk of dying from any cause (relative risk [RR], 6.52; 95% confidence interval [CI], 3.42 - 12.42), whereas for patients with bulimia nervosa (BN), the risk was nearly 3-fold higher (RR, 2.97; 95% Cl, 1.89 - 4.65). In patients with binge eating disorder, the relative risk of dying from any cause was 1.78 (95% Cl, 0.55 - 5.77).

The risk for death in patients with AN was highest during the first years after admission to the eating disorders clinic but declined after that, whereas in BN, the mortality risk started to rise 2 years after the admission, Dr. Suokas reported.

In addition, the relative risk for suicide was elevated in patients with AN (RR, 5.10; 95% CI, 1.37 - 18.98) and BN (RR, 6.07; 95% Cl, 2.48 - 14.86).

Dr. Suokas' research supports a metaanalysis published last year in the Archives of General Psychiatry and reported by Medscape Medical News that showed that patients with any type of eating disorder have a significantly increased risk for death, with AN linked to the highest mortality and suicide rates.

Commenting on the findings for Medscape Medical News, Kathryn Zerbe, MD, director of the Oregon Psychoanalytic Institute in Portland, who was not involved in the study, said it is "not only a good reminder of the high risk of mortality and suicide but confirms other data collected in numerous studies over the years."

In fact, Dr. Zerbe said that some prior studies have shown even higher death rates, "and one wonders what a longer follow-up to this study might yield."

Dr. Suokas and Dr. Zerbe have disclosed no relevant financial relationships.

American Psychiatric Association's 2012 Annual Meeting. Abstract NR8-08. Presented May 8, 2012.

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