Health impacts of eating disorders last many years

The health impact of an eating disorder – including diabetes, renal and liver failure, as well as fractures – can last for years, UK research has shown.

It highlights the need for continued monitoring by GPs for long-term physical health outcomes in individuals with a history of eating disorders, the Manchester University researchers said.

The study of GP records from 24,000 patients with an eating disorder and 493,000 matched controls found the risks to be particularly high in the first year after diagnosis.

But tracking outcomes for 10 years showed an ongoing heightened risk of a number of health issues.

Most (89%) of the patients with an eating disorder were female with 14.5% diagnosed with anorexia; 20.5% with bulimia, 5% a binge eating disorder and 60% where the eating disorder was unspecified.

Within the first 12 months, people with eating disorders were six times more likely to be diagnosed with renal failure and nearly seven times more likely to be diagnosed with liver disease.

They were also at significantly heightened risks of osteoporosis (six times as high), heart failure (twice as high), and diabetes (three times as high).

After five years, the risks of renal failure and liver disease were still two and a half to four times higher, with 110 and 26 more cases than would be expected, respectively, per 10,000 people at 10 years.

The study also showed risks of poor mental health were significantly higher 12 months after an eating disorder diagnosis and although they were lower, these heightened risks persisted after five years.

Death from any cause within the first 12 months of diagnosis was more than four times as high, and for unnatural deaths, including suicide, it was five times as high.

Five years later these risks were still two and three times higher, the researchers reported in BMJ Medicine.

Because the medical records data didn’t include the severity of the eating disorder, it was not possible to study a possible link with worse outcomes, they noted.

The number of teenage girls seeking help from their GP for an eating disorder soared in the years after the pandemic.

Analysis of data from more than 9 million GP records showed that in 2023, the rates of eating disorders in young people were 42% higher than would be expected for 13-to-16-year-old girls based on figures from the previous decade.

‘Our data describe the substantial long term effects of eating disorders and emphasise the potential opportunity for primary care to have a greater role in offering support and long term monitoring for individuals who are recovering from an eating disorder,’ they concluded

‘A closer and more cohesive management approach in primary and specialist care may also be needed, for both physical (nephrology, cardiology, and endocrinology) and mental health services to provide this support.’

They also pointed out there is a ‘potential gap’ in care where patients’ difficulties are too complex for low intensity brief interventions, ‘but not complex enough for specialist teams’.

‘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,’ they concluded.