Increased rates of eating disorders and their symptoms in women with major depressive disorder and anxiety disorders

Int J Eat Disord. 2020 Nov;53(11):1844-1854. doi: 10.1002/eat.23366. Epub 2020 Aug 26.


Background: Individuals with eating disorders (EDs) have increased rates of major depressive disorder (MDD) and anxiety disorders. Yet, few studies have investigated rates of EDs and their symptoms in individuals presenting with MDD/anxiety disorders. Identifying potential disordered eating in people with MDD/anxiety disorders is important because even subclinical disordered eating is associated with reduced quality of life, and undiagnosed eating pathology may hinder treatment progress for both MDD/anxiety disorders and comorbid EDs.

Method: We compared rates of EDs (anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified feeding and eating disorders) and their symptoms in 130 women with, and 405 women without, lifetime MDD or an anxiety disorder (generalized anxiety disorder, obsessive-compulsive disorder, social phobia, specific phobia, panic disorder, agoraphobia, or post-traumatic stress disorder) recruited from the population-based Michigan State University Twin Registry. Lifetime ED and MDD/anxiety diagnoses, and lifetime clinically significant disordered eating behaviors (e.g., binge eating, excessive exercise) were assessed using the Structured Clinical Interview for DSM-IV (SCID).

Results: Among participants with lifetime MDD or any anxiety disorder, 13% met criteria for a lifetime ED and 39% reported engaging in at least one lifetime clinically significant disordered eating behavior (e.g., binge eating) on the SCID. In contrast, only 3% of participants without a history of MDD/an anxiety disorder met criteria for a lifetime ED, and only 11% reported lifetime clinically significant disordered eating behavior.

Discussion: Our findings suggest that women with MDD and anxiety disorders have elevated rates of EDs, and it is therefore imperative to screen for disordered eating in these populations.

Keywords: anorexia nervosa; anxiety disorders; binge-eating disorder; bulimia nervosa; comorbidity; disordered eating; eating disorders; major depressive disorder; other specified feeding and eating disorders.

Publication types

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

MeSH terms

  • Adolescent
  • Adult
  • Anxiety Disorders / complications*
  • Anxiety Disorders / psychology
  • Comorbidity
  • Depressive Disorder, Major / complications*
  • Depressive Disorder, Major / psychology
  • Feeding and Eating Disorders / diagnosis*
  • Feeding and Eating Disorders / pathology
  • Female
  • Humans
  • Quality of Life
  • Young Adult