Elsevier

Biological Psychiatry

Volume 84, Issue 5, 1 September 2018, Pages 345-354
Biological Psychiatry

Archival Report
Prevalence and Correlates of DSM-5–Defined Eating Disorders in a Nationally Representative Sample of U.S. Adults

https://doi.org/10.1016/j.biopsych.2018.03.014Get rights and content

Abstract

Background

Few population-based data on the prevalence of eating disorders exist, and such data are especially needed because of changes to diagnoses in the DSM-5. This study aimed to provide lifetime and 12-month prevalence estimates of DSM-5–defined anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions.

Methods

A national sample of 36,306 U.S. adults completed structured diagnostic interviews (Alcohol Use Disorder and Associated Disabilities Interview Schedule-5).

Results

Prevalence estimates of lifetime AN, BN, and BED were 0.80% (SE 0.07%), 0.28% (SE 0.03%), and 0.85% (SE 0.05%), respectively. Twelve-month estimates for AN, BN, and BED were 0.05% (SE 0.02%), 0.14% (SE 0.02%), and 0.44% (SE 0.04%). The odds of lifetime and 12-month diagnoses of all three eating disorders were significantly greater for women than for men after adjusting for age, race and/or ethnicity, education, and income. Adjusted odds ratios (AORs) of lifetime AN diagnosis were significantly lower for non-Hispanic black and Hispanic respondents than for white respondents. AORs of lifetime and 12-month BN diagnoses did not differ significantly by race and/or ethnicity. The AOR of lifetime, but not 12-month, BED diagnosis was significantly lower for non-Hispanic black respondents relative to that of non-Hispanic white respondents; AORs of BED for Hispanic and non-Hispanic white respondents did not differ significantly. AN, BN, and BED were characterized by significant differences in age of onset, persistence and duration of episodes, and rates of current obesity and psychosocial impairment.

Conclusions

These findings for DSM-5–defined eating disorders, based on the largest national sample of U.S. adults studied to date, indicate some important similarities to and differences from earlier, smaller nationally representative studies.

Section snippets

Sample

NESARC-III included 36,309 noninstitutionalized U.S. civilians 18 years of age and older 12, 13. Respondents completed computer-assisted face-to-face personal interviews between April 2012 and June 2013. NESARC-III employed multistage probabilistic sampling with counties or groups of contiguous counties as primary sampling units, groups of U.S. Census–defined blocks as secondary sampling units, and households within secondary sampling units as tertiary sampling units. Within each household,

Prevalence Estimates of EDs: Lifetime and 12-Month Rates, Overall and by Sociodemographic Characteristics

Prevalence estimates of lifetime AN, BN, and BED diagnoses were 0.80% (SE 0.07%), 0.28% (SE 0.03%), and 0.85% (SE 0.05%), respectively (Table 1). Prevalence estimates of 12-month AN, BN, and BED diagnoses were 0.05% (SE 0.02%), 0.14% (SE 0.02%), and 0.44% (SE 0.04%), respectively (Table 2). Supplemental Table S3 summarizes sensitivity analyses showing the impact of discrepancies between our coding and that of the NESARC-III (listed in Supplemental Table S2) as well as exploring the impacts of

Discussion

This study, with a nationally representative sample of 36,309 adults in the United States who were assessed with lay-administered diagnostic interviews, provides new prevalence estimates of EDs based on DSM-5 criteria. Prevalence estimates of lifetime AN, BN, and BED were 0.80%, 0.28%, and 0.85%, respectively, and 12-month estimates were 0.05%, 0.14%, and 0.44%, respectively. These prevalence estimates are based on our recoding of NESARC-III ED data because inspection of the original NESARC-III

Acknowledgments and Disclosures

This work was supported, in part, by the National Institutes of Health (Grant No. K24 DK070052 to CMG). The article was prepared using a limited-access dataset obtained from the National Institute on Alcohol Abuse and Alcoholism. This article does not reflect the opinions or views of the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute on Alcohol Abuse and Alcoholism, or the United States Government.

Although CMG reports no relevant direct or indirect

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