Eating Disorders in Australia

Prevalence

• Approximately one million Australians are living with an eating disorder in any given year; that is, 4% of the population.¹
• Many more people experience disordered eating (i.e., behaviours consistent with an eating disorder such as restrictive dieting, binge eating, vomiting, laxative use) that do not meet criteria for an eating disorder.² Approximately a third (31.6%) of Australian adolescents engage in disordered eating behaviours within any given year.³
• Eating disorder symptoms are on the rise with at least weekly binge eating increasing almost six-fold since the late 1990s and strict dieting increasing almost four-fold⁴ with parallel increases in other behavioural and cognitive eating disorder symptoms (e.g. increased dieting, decreased quality of life).⁵
• Of people with an eating disorder, 3% have anorexia nervosa, 12% bulimia nervosa, 47% binge eating disorder (BED) and 38% other eating disorders.¹
• There is limited research on the prevalence of eating disorders among Aboriginal and Torres Strait Islander peoples. However, emerging research suggests that Aboriginal and Torres Strait Islander peoples experience eating disorders and body image issues at a similar or higher rate than non-Indigenous people.⁶

Co-occurring conditions

A person with an eating disorder is at increased risk of experiencing another mental health or medical condition at the same time (known as a comorbidity). Comorbid conditions experienced by people living with eating disorders may be connected to their eating disorder symptoms and behaviours, for example osteoporosis.

For other comorbidities, the direction and mechanisms underlying any connection are unclear and a focus of future research.

Mental health 

Research suggests that over 80% of adults diagnosed with an eating disorder have at least one more psychiatric disorder.⁷ The most common psychiatric comorbidities associated with eating disorders include:

• mood disorders (e.g. major depressive disorder)
• anxiety disorders (e.g. generalised anxiety disorder, social anxiety)
• post-traumatic stress disorder (PTSD) and trauma
• substance misuse
• personality disorders (avoidant, borderline, obsessive compulsive)
• sexual dysfunction
• non-suicidal self injury

Medical

The following comorbidities have been shown to have an increased prevalence in people living with an eating disorder compared with the general population:

• Type 1 and 2 diabetes
• Polycystic ovarian syndrome (PCOS)
• Weak or fragile bones (e.g., osteopenia, osteoporosis)
• Low blood pressure (hypotension)
• Digestive issues (e.g., irritable bowel syndrome)
• Joint pains
• Headache and migraine
• Menstrual problems (e.g., loss of menstruation)
• Sleep problems

References

1. Deloitte Access Economics. Paying the price: The economic and social impact of eating orders in Australia. Australia: Deloitte Access Economics; 2012. 
2. Hay P, Mitchison D, Collado AEL, González-Chica DA, Stocks N, Touyz S. Burden and health-related quality of life of eating disorders, including Avoidant/Restrictive Food Intake Disorder (ARFID), in the Australian population. J Eat Disord. 2017;5(1):1-10. 
3. Sparti C, Santomauro D, Cruwys T, Burgess P, Harris M. Disordered eating among Australian adolescents: prevalence, functioning, and help received. Int J Eat Disord. 2019;52(3):246-54. 
4. Da Luz F, Sainsbury A, Mannan H, Touyz S, Mitchison D, Hay P. Prevalence of obesity and comorbid eating disorder behaviors in South Australia from 1995 to 2015. Int J Obes 2017;41(7):1148-53 
5. Mitchison D, Hay P, Slewa-Younan S, Mond J. Time trends in population prevalence of eating disorder behaviors and their relationship to quality of life. PLoS One. 2012;7(11):e48450. 
6. Burt A, Mitchison D, Dale E, Bussey K, Trompeter N, Lonergan A, et al. Prevalence, features and health impacts of eating disorders amongst First-Australian Yiramarang (adolescents) and in comparison with other Australian adolescents. J Eat Disord. 2020;8(1):1-10. 
7. Udo T, Grilo CM. Psychiatric and medical correlates of DSM‐5 eating disorders in a nationally representative sample of adults in the United States. Int J Eat Disord. 2019;52(1):42-50.