Yes, Eating Disorders Can Be Deadly

We often hear about the dangers of obesity, but we hear less commonly about the risks of eating disorders. Eating disorders may seem benign, but this is a myth. Every 62 minutes someone dies as a direct result of an eating disorder.

Early intervention markedly improves treatment outcome, which is one reason to ensure individuals with eating disorders receive a prompt diagnosis and access to treatment, preferably evidenced-based wherever possible.

Studies report varying death rates from eating disorders, but there are common findings. Collectively, eating disorders have the highest death rates among all mental illnesses. In most studies, anorexia nervosa has the highest mortality rate of the different eating disorders. In a recent study by Fichter and colleagues, individuals with anorexia nervosa experienced a standardized mortality rate of 5.0 – that is, they were five times more likely to have died over the study period than age-matched peers in the general population. Individuals with bulimia nervosa and binge eating disorder had a standardized mortality rate of 1.5 (were 1.5 times more likely to die than peers without eating disorders).

A meta-analysis by Arcelus and colleagues found similar standardized mortality rates to Fichter’s study: 5.86 for anorexia nervosa, 1.93 for bulimia nervosa, and 1.92 for eating disorder not otherwise specified (EDNOS). Research has demonstrated higher death rates for bulimia nervosa and EDNOS than these figures. According to one study, the mortality rate for anorexia nervosa patients aged 25 to 44 followed after hospital discharge was 14 times that of age-matched non-eating disordered peers. (That’s 14 times!)

Eating disorders cause a number of medical problems. No system of the body is immune to the effects of malnutrition. As for causes of death, suicide and cardiovascular complications top the list. Fichter and colleagues found that three-quarters of the deaths for patients with an anorexia nervosa diagnosis were due to cardiovascular complications related to low body weight. A study by Huas and colleagues found that there are two main predictors of death for individuals with bulimia nervosa: a history of prior suicide attempts and a lower minimum BMI. Across a number of studies, suicide is a common cause of death, and an elevated suicide rate is found amongst all eating disorder diagnoses. Studies have shown that approximately 20% of the individuals with anorexia who had died had committed suicide, and 23% of the bulimia nervosa deaths were from suicide. 

Patients with anorexia nervosa seem to tend to die at an earlier age than those with bulimia nervosa or binge eating disorder, primarily in early adulthood. Predictors of shorter time to death include a higher number of lifetime eating disorder hospitalizations, premature discharge from the hospital, alcohol abuse, older age of eating disorder onset, poorer social adjustment, and lower body mass index at the time of hospitalization.

Often, people with eating disorders won’t know they have a problem or an eating disorder. It is common for patients with eating disorders to not believe their problem is serious. If you are a loved one of a person with an eating disorder, please encourage your loved one to get help. If you are suffering from an eating disorder and are not in treatment, please reach out to a treatment professional. With treatment, most people with eating disorders do recover!