Lay Summary

We are conducting a systematic review investigating the risk of mortality in eating disorders compared with the general population. We will report on all-cause mortality, suicide, and other specific causes of mortality once the review is complete. This review is needed because most research reports on largely female samples, and many studies have been published prior to the release of the DSM-5 when binge eating disorder (BED) diagnoses were considered eating disorders not otherwise specified (EDNOS).

Background

Eating disorders (ED) have the highest mortality rates seen out of all psychiatric diagnoses. Evidence regarding mortality rates in ED is primarily based on female-only/largely female samples and published prior to the release of the DSM-5, when binge eating disorder (BED) diagnoses were considered eating disorders not otherwise specified (EDNOS). An updated and comprehensive review and meta-analysis reporting on all-cause and cause-specific mortality (including both natural and non-natural causes such as suicide) for anorexia nervosa, bulimia nervosa, BED and EDNOS is warranted. This review will evaluate three primary objectives: 1) determine the all-cause mortality risk for individuals presenting with an ED, 2) determine cause-specific mortality risk in ED, and 3) identify moderating factors of mortality in ED.

Methods

This systematic review follows PRISMA 2020 guidelines. Search strategies were developed with a librarian. Screening is being conducted in duplicate and double-blinded. Inclusion criteria are observational studies reporting on all-cause mortality, suicide, and/or other specific-causes of mortality in anorexia nervosa, bulimia nervosa, binge eating disorder, or EDNOS (defined according to DSM/ICD criteria, clinical charts, and/or validated scales). We will run subgroup analyses to look at differences in mortality risk among different age groups and sex.

Results

Screening is ongoing. We will present findings relating to the co-primary outcomes (all-cause mortality, suicide, and natural-cause mortality) and secondary outcomes (other specific-cause mortality) when the review is complete.

Conclusion

This systematic review will provide evidence on the severity of various EDs and differences among age and sex. This may have implications for guiding: 1) clinicians, to offer best treatment practices, and 2) public health policy makers and funders, to enact effective programs and/or provide sufficient resources and support for individuals with an eating disorder.