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Significant association between eating disorders and physical multimorbidity

A UK study has revealed a significant association between eating disorders and physical multimorbidity, revealing new information on the health risks faced by people with these conditions. The research, led by Anglia Ruskin University (ARU) in collaboration with the University of Cambridge's Biomedical Research Centre, explores the complex relationship between eating disorders, physical health, and other issues that can influence it.

Prevalence of possible eating disorder by number of physical conditions. Credit: Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity (2023). DOI: 10.1007/s40519-023-01600-0

Researchers analysed data from 7,403 UK adults, who were asked about 20 physical conditions including cancer, diabetes, eye issues, migraines, digestive problems and heart issues. Influential factors, or mediators, considered included alcohol dependence, insomnia, smoking, perceived stress, obesity and being underweight.


An eating disorder is defined as a pathological relationship with food that leads to significant disruptions in a person's day-to-day life. It is estimated that as many as 3.4 million people in the UK have an eating disorder.


The study found that people with possible eating disorders made up 6.4% of respondents, and individuals within this cohort were 2.11 times more likely to report physical multimorbidity, defined as having two or more physical health conditions concurrently. Anxiety emerged as the leading influential factor in the eating disorder and physical multimorbidity relationship. Insomnia, perceived stress, and depression were also identified to be important.

Previous research has shown that multimorbidity is associated with a significant burden on health care services including care transition costs and primary care, dental care, and hospitalisations. Multimorbidity affects around 42.4% of the world's population.


"We believe this is the first study to investigate the association between eating disorder symptoms, or possible eating disorder, and physical multimorbidity, and also the first to quantify how this association may be explained by a variety of influencing factors,” said lead author Lee Smith, Professor of Public Health at ARU. "This research underscores the complex interplay between mental and physical health. It is essential to recognize that eating disorders can have far-reaching consequences, affecting not only emotional well-being but also physical health. Understanding the role of potential mediators in this relationship is crucial for developing effective interventions."


The findings hold significant implications for public health, highlighting the need for further investigation into the causality and underlying mechanisms of the link between eating disorders and physical multimorbidity. In the long term, this research could guide the development of strategies to reduce multimorbidity in people with eating disorders by addressing influencing factors.


The study, ‘Eating disorders and physical multimorbidity in the English general population’, was published in the journal Eating and Weight Disorders—Studies on Anorexia, Bulimia and Obesity.


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