Self-reported eating disorder psychopathology prevalence in community-based female and male Albertans: Gender and age group comparisons

Update on the epidemiology and treatment of eating disorders among older people

PURPOSE OF REVIEW

We reviewed the recent literature on the epidemiology and treatment of eating disorders among middle-aged and older women and men.

RECENT FINDINGS

Recent studies show that among older female persons, the prevalence rates with full diagnoses of eating disorders based on DSM-IV or DSM-5 criteria are between 2.1 and 7.7%, and among older men less than 1%. These studies show that the prevalence of eating disorders decreases by age in women, but it does not get towards zero even in very high age. Middle age, with a peak around 50, is also a critical time for the occurrence of eating disorders in men. Women who reported severe menopausal symptoms showed more eating disorder pathology compared with those with low symptoms during menopausal transition.

SUMMARY

Eating disorders do occur in middle and older age of both sexes. Shame and stigmatization have decreased, and medical awareness and explicit assessment of eating behavior in all age groups have developed. What puberty is for eating disorders in adolescence and young age is menopausal transition for midlife women. Also in men, associations with hormonal disturbances are possible. Treatment approaches should consider treatment strategies tailored to older women and men, addressing the context of midlife and aging.

Epidemiology of binge eating disorder: prevalence, course, comorbidity, and risk factors

PURPOSE OF REVIEW

Binge eating disorder (BED) is a new diagnosis in the Fifth Edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5) and the Eleventh Revision of the International Classification of Diseases (ICD-11).

RECENT FINDINGS

DSM-5 BED is currently estimated to affect 1.5% of women and 0.3% of men worldwide; a lifetime diagnosis of DSM-5 BED is reported by 0.6-1.8% of women and 0.3-0.7% of men. In adolescence, BED is even more prevalent, but often transient. Many adults with BED report longstanding symptoms; less than half are recognized in healthcare. Commonly co-occurring conditions include obesity, type 2 diabetes, and hypertension. In a nationally representative US-based study, up to 23% of individuals with BED had attempted suicide, and virtually all (94%) reported lifetime mental health symptoms: 70% mood disorders, 68% substance use disorders, 59% anxiety disorders, 49% borderline personality disorder, and 32% posttraumatic stress disorder. Data on mortality are scarce, but the standardized mortality ratio of BED is estimated to be 1.5-1.8. Various minority statuses, deprivation, violence, trauma, and major mental illness may increase the risk of BED.

SUMMARY

BED is often invisible and overlooked, perhaps due to societal biases. For this reason, prevention, detection, and management of BED are closely linked with social justice and equity.