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

Biol Psychiatry. 2018 Sep 1;84(5):345-354. doi: 10.1016/j.biopsych.2018.03.014. Epub 2018 Apr 17.


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.

Keywords: Anorexia nervosa; Binge-eating disorder; Bulimia nervosa; Impairment; Obesity; Prevalence.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Anorexia Nervosa / complications
  • Anorexia Nervosa / diagnosis
  • Anorexia Nervosa / epidemiology
  • Binge-Eating Disorder / complications
  • Binge-Eating Disorder / diagnosis
  • Binge-Eating Disorder / epidemiology
  • Body Mass Index
  • Bulimia Nervosa / complications
  • Bulimia Nervosa / diagnosis
  • Bulimia Nervosa / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Feeding and Eating Disorders / complications
  • Feeding and Eating Disorders / diagnosis*
  • Feeding and Eating Disorders / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / complications
  • Obesity / diagnosis
  • Obesity / epidemiology
  • Prevalence
  • United States
  • Young Adult