Eating disorders like binge-eating and bulimia can have a sustained effect on multiple body systems, even up to a decade after the diagnosis. — TNS
The health impacts of eating disorders, such as anorexia, bulimia and binge-eating, are not only complex, but long-lasting.
This is according to a large tracking study, published Nov 18 (2025) in the open access journal BMJ Medicine.
The risks of serious conditions, such as diabetes, kidney and liver failure, fractures, and premature death, are particularly high within the first 12 months of diagnosis.
But these heightened risks also persist for years, highlighting the need for timely integrated multidisciplinary health services and continued monitoring to improve outcomes, conclude the researchers from the University of Manchester in Britain.
They had scrutinised anonymised medical records in the Clinical Practice Research Datalink, linked to Hospital Episode Statistics and death certification data for people across England from 1998 to 2018.
Some 24,709 people, aged 10 to 44, with a diagnosed eating disorder, were matched for age, sex and general practitioner (GP) practice, with up to 20 others without these disorders (493,001 in total).
Most (89%) of the sample was female.
Among those with eating disorders, 20.5% had bulimia, 14.5% had anorexia and 5% had a binge-eating disorder.
The eating disorder was unspecified in the remaining 60%.
Their mental and physical health were then tracked for 10 years.
Analysis of the data revealed that eating disorders were associated with substantially higher risks of poor physical and mental health, and premature death.
Within the first year of diagnosis, people with eating disorders were six times more likely to be diagnosed with kidney failure and nearly seven times more likely to be diagnosed with liver disease.
They also had significantly heightened risks of osteoporosis (six times as high as those without an eating disorder), heart failure (twice as high) and diabetes (three times as high).
The risks of kidney failure and liver disease were still 2.5 to nearly four times higher after five years.
Similarly, the risks of poor mental health were significantly higher one year after an eating disorder diagnosis.
The risks of depression were seven times higher, while those of self-harm were more than nine times as high.
And although they did go down, these heightened risks persisted after five years.
The risk of death from any cause within the first one year of diagnosis was also more than four times as high, and for unnatural deaths, including suicide, it was five times as high.
After five years, these risks were still two and three times higher respectively.
The risk of suicide itself was nearly 14 times higher in the first year, and still nearly three times higher after 10 years.
The researchers say: “Our data describe the substantial long-term effects of eating disorders and emphasise the potential opportunity for primary care to have a greater role in offering support and long-term monitoring for individuals who are recovering from an eating disorder.
“A closer and more cohesive management approach in primary and specialist care may also be needed, for both physical (nephrology, cardiology and endocrinology) and mental health services to provide this support.”
They add: “A potential gap exists in provision where patients’ difficulties are too complex for low intensity brief interventions, but not complex enough for specialist teams.
”Raising awareness among healthcare providers about the lasting effects of eating disorders and the need for ongoing support in managing current symptoms and recovery is essential.”
In a linked editorial, child and adolescent psychiatrist Dr Jennifer Couturier and research assistant Ethan Nella of McMaster University in Canada, point out that despite the high prevalence of eating disorders, “their consequences are underrecognised”.
They add: “Earlier studies have illustrated the limited education given during medical training on the topic of eating disorders, and the current study emphasises the importance of disseminating this knowledge to all healthcare professionals.
“Medical education should place greater emphasis on the recognition and management of eating disorders, to equip primary care providers, specialists and allied health professionals with the tools to identify early warning signs and monitor ongoing risks associated with eating disorders.”
They conclude: “Multiple organ systems are affected by eating disorders, which then requires an integration of care to adequately treat patients.
“This situation places primary care providers in an ideal position for leading and coordinating [their] care, and suggests that primary care settings would be apt for early and ongoing intervention.”
