Eating disorders such as anorexia, bulimia, and binge eating have been found to cause a range of complex and enduring physical and mental health impacts, according to a groundbreaking study conducted by the universities of Keele and Manchester. The research highlights that the elevated risks associated with these disorders can persist for years, even after recovery is assumed.
Previous studies have already established that individuals diagnosed with eating disorders face heightened risks of severe conditions like diabetes, renal and liver failure, fractures, and premature death, particularly within the first year of diagnosis. However, the new findings, published in the journal BMJ Medicine, underscore the need for ongoing interventions from diverse health services to improve patient outcomes.
Long-Term Health Implications
The research, led by Dr. Cathy Morgan from Manchester and Professor Carolyn Chew-Graham OBE from Keele, was funded by the National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Research Collaboration (GM PSRC). By utilizing the Clinical Practice Research Datalink, the team analyzed anonymized electronic health records from 1998 to 2018, which were linked to Hospital Episode Statistics data and death records across England.
The study encompassed over 24,000 patients diagnosed with an eating disorder, each matched for age, sex, and GP practice with up to 20 individuals without such a diagnosis, totaling 493,001 participants. Over a decade, researchers tracked the mental and physical health of these patients to gain insights into their health trajectories post-diagnosis.
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 diagnosis.
Persistent Risks and Mental Health Challenges
The analysis revealed that patients with eating disorders faced significantly higher risks of poor physical and mental health, as well as premature death. Although the greatest risks were within the first year of diagnosis, they persisted for many years thereafter. In particular, individuals were at a substantially increased risk of developing renal failure, liver disease, osteoporosis, heart failure, and diabetes.
Mental health risks were also pronounced, with elevated rates of depression and self-harm observed within the first 12 months. These risks, while reduced, continued beyond five years post-diagnosis. The risk of death from any cause was notably higher in the initial year and persisted for up to a decade, albeit at a diminished rate.
Expert Insights and Recommendations
Dr. Cathy Morgan emphasized the importance of raising awareness among healthcare providers about the lasting effects of eating disorders. “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,” she stated.
Professor Carolyn Chew-Graham OBE 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.
Implications for Healthcare Systems
The findings underscore the necessity for a coordinated approach to healthcare that bridges primary and specialist services. Continuous monitoring of patients, even after they are considered recovered, is crucial. This requires education and training for primary care clinicians and the commissioning of such work in primary care settings.
The study’s revelations call for a reevaluation of how healthcare systems address eating disorders, emphasizing the need for sustained support and intervention strategies that extend beyond the initial treatment phase. As the healthcare community grapples with these findings, the focus must shift towards ensuring comprehensive care that addresses both immediate and long-term health challenges faced by individuals with eating disorders.
