How Many Children Have Eating Disorders?

Anorexia nervosa

Research suggests that about one percent (1%) of female adolescents have anorexia. That means that about one out of every one hundred young women between ten and twenty are starving themselves, sometimes to death. There do not seem to be reliable figures for younger children and older adults, but such cases, while they do occur, are not common.

Bulimia nervosa

Research suggests that about four percent (4%), or four out of one hundred, college-aged women have bulimia. About 50% of people who have been anorexic develop bulimia or bulimic patterns. Because people with bulimia are secretive, it is difficult to know how many older people are affected. Bulimia is rare in children.

Males with eating disorders

Only about 10% of people with anorexia and bulimia are male. This gender difference may reflect our society's different expectations for men and women. Men are supposed to be strong and powerful.

They feel ashamed of skinny bodies and want to be big and powerful. Women, on the other hand, are supposed to be tiny, waif-like, and thin. They diet to lose weight, making themselves vulnerable to binge eating. Some develop rigid and compulsive overcontrol. Dieting and the resulting hunger are two of the most powerful eating disorders triggers known.

What age groups are affected?

Anorexia and bulimia affect primarily people in their teens and twenties, but studies report both disorders in children as young as six and individuals as old as seventy-six.

Overweight and obesity

Studies suggest that about sixty percent of adult Americans, both male and female, are overweight. About one third (34%) are obese, meaning that they are 20% or more above normal, healthy weight. Many of these people have binge eating disorder.

In addition, about 31 percent of American teenage girls and 28 percent of boys are somewhat overweight. An additional 15 percent of American teen girls and nearly 14 percent of teen boys are obese. (Archives of Pediatrics and Adolescent Medicine, January 2004) Causes include fast food, snacks with high sugar and fat content, use of automobiles, increased time spent in front of TV sets and computers, and a generally more sedentary lifestyles than slimmer peers.

Binge eating disorder

A recent study reported in Drugs and Therapy Perspectives reports that about one percent of women in the United States have binge eating disorder, as do thirty percent of women who seek treatment to lose weight. In other studies, up to two percent, or one to two million adults in the U.S., have problems with binge eating.

Eating disorders and substance abuse

About 72% of alcoholic women younger than 30 also have eating disorders. (Health magazine, Jan/Feb 2002)

What about compulsive exercising?

Because anorexia athletica is not a formal diagnosis, it has not been studied as rigorously as the official eating disorders. We have no idea how many people exercise compulsively.

Body dysmorphic disorder (includes muscle dysmorphic disorder)

Not yet an official diagnosis, but may achieve that status soon. Body Dysmorphic Disorder (BDD) affects about two percent of people in the U.S. and strikes males and females equally, usually before age eighteen (70% of the time). Sufferers are excessively concerned about appearance, body shape, body size, weight, perceived lack of muscles, facial blemishes, and so forth. In some cases BDD can lead to steroid abuse, unnecessary plastic surgery, and even suicide. BDD is treatable and begins with an evaluation by a mental health care provider.

Subclinical eating disorders

We can only guess at the vast numbers of people who have subclinical or threshold eating disorders. They are too much preoccupied with food and weight. Their eating and weight control behaviors are not normal, but they are not disturbed enough to qualify for a formal diagnosis.

Eating disorders in Western and non-Western countries

In a study reported in Medscape's General Medicine 6(3) 2004, prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in female subjects. Prevalence rates for bulimia nervosa ranged from 0% to 2.1% in males and from 0.3% to 7.3% in female subjects.

Prevalence rates in non-Western countries for bulimia nervosa ranged from 0.46% to 3.2% in female subjects. Studies of eating attitudes indicate abnormal eating attitudes in non-Western countries have been gradually increasing, presumably because of the influence, at least in part, of Western media: movies, TV shows, and magazines. Researchers conclude that the prevalence of eating disorders in non-Western countries is lower than that of Western countries, but it appears to be increasing.

Mortality and recovery rates

Without treatment, up to twenty percent (20%) of people with serious eating disorders die. With treatment, that number falls to two to three percent (2-3%).

With the appropriate eating disorders treatment, about sixty percent (60%) of people with eating disorders recover. They maintain healthy weight. They eat a varied diet of normal foods and do not choose exclusively low-cal and non-fat items. They participate in friendships and romantic relationships. They create families and careers. Many say they feel they are stronger people and more insightful about life in general and themselves in particular than they would have been without the disorder.

In spite of treatment, about twenty percent (20%) of people with eating disorders make only partial recoveries. They remain too much focused on food and weight. They participate only peripherally in friendships and romantic relationships. They may hold jobs but seldom have meaningful careers. Much of each paycheck goes to diet books, laxatives, jazzercise classes, and binge food.

The remaining twenty percent (20%) do not improve, even with treatment. They are seen repeatedly in emergency rooms, eating disorders programs, and mental health clinics. Their quietly desperate lives revolve around food and weight concerns, spiraling down into depression, loneliness, and feelings of helplessness and hopelessness.

Please note: The study of eating disorders is a relatively new field. We have no good information on the long-term recovery process. We do know that recovery usually takes a long time, perhaps on average three to five years of slow progress that includes starts, stops, slides backwards, and ultimately, movement in the direction of mental and physical health.

If you believe you are in the forty percent of people who do not recover from eating disorders, give yourself a break. Get into treatment and stay there. Give it all you have. You may surprise yourself and find you are in the sixty percent after all.

Miscellaneous statistics

From England: A 1998 survey done by Exeter University included 37,500 young women between twelve and fifteen. Over half (57.5%) listed appearance as the biggest concern in their lives. The same study indicated that 59% of the twelve and thirteen-year-old girls who suffered from low self-esteem were also dieting.

Dieting teens: More than half of teenaged girls are, or think they should be, on diets. They want to lose all or some of the forty pounds that females naturally gain between 8 and 14. About three percent of these teens go too far, becoming anorexic or bulimic.

Unrealistic expectations: Magazine pictures are electronically edited and airbrushed. Many entertainment celebrities are underweight, some anorexically so. How do we know what we should look like? It's hard. The table below compares average women in the U. S. with Barbie Doll and department store mannequins. It's not encouraging. (Health magazine, September 1997; and NEDIC, a Canadian eating disorders advocacy group)

Determining accurate statistics is difficult.

Because physicians are not required to report eating disorders to a health agency, and because people with these problems tend to be secretive, denying that they even have a disorder, we have no way of knowing exactly how many people in this country are affected.

We can study small groups of people, determine how many of them are eating disordered, and then extrapolate to the general population. The numbers are usually given as percentages, and they are as close as we can get to an accurate estimate of the total number of people affected by eating disorders.

Now, that having been said, the journal Clinician Reviews [13(9]) 2003] estimates that each year about five million Americans are affected by an eating disorder. But there is disagreement.

The National Association of Anorexia Nervosa and Associated Disorders states that approximately eight million people in the U.S. have anorexia nervosa, bulimia, and related eating disorders. Eight million people represents about three percent (3%) of the total population. Put another way, according to ANAD, about three out of every one hundred people in this country eats in a way disordered enough to warrant treatment. If you want to know how they arrived at this number, e-mail their staff.

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