The research, led by Catharine Morgan, PhD, from the Division of Informatics, Imaging and Data Science at the University of Manchester, highlights an urgent need for earlier detection and long-term, integrated care approaches.
Morgan explained that eating disorders can disrupt virtually every major organ system. “Malnutrition, rapid changes in weight, and purging behaviours have long-term consequences for the heart, liver, kidneys, and bones. At the same time, many patients struggle with underlying psychological vulnerabilities such as anxiety, depression, or poor stress tolerance, which often continue even after eating stabilises,” she noted.
The study analysed data from English primary care records between 1998 and 2018, linking them with hospital and mortality databases. The cohort included 24,709 individuals aged 10 to 44 with anorexia nervosa, bulimia nervosa, binge eating disorder, or other specified eating disorders. Each patient was matched with up to 20 individuals without an eating disorder, resulting in a comparator group of nearly half a million people.
The key findings of the study were as follows:
- Within the first year after diagnosis, individuals had a sixfold higher risk of developing renal failure.
- The likelihood of liver disease was nearly seven times greater in the first 12 months compared with those without an eating disorder.
- Although these risks declined over time, they remained significantly elevated even after five years.
- By 10 years, cumulative excess cases of physical health complications continued to rise, underscoring the importance of long-term follow-up.
- Rates of depression were more than seven times higher in the first year following diagnosis.
- The risk of self-harm increased nearly tenfold during the same period.
- These mental health concerns reflect both the emotional impact of eating disorders and existing psychological vulnerabilities in affected individuals.
- All-cause mortality risk was more than four times higher in the first year after diagnosis.
- The risk of unnatural death, including suicide, was fivefold higher within the first 12 months.
- Suicide risk was almost 14 times higher in the first year and remained elevated even after 10 years.
The authors emphasised that these findings underscore the importance of sustained, holistic follow-up in primary care settings. Routine monitoring of physical parameters, proactive mental health support, and collaborative care between general practitioners, psychiatrists, and specialists can help mitigate long-term complications.
The study also calls for greater research attention toward understanding how physical comorbidities develop in this population. With eating disorder diagnoses on the rise globally, the authors believe that expanding long-term care frameworks could play a vital role in improving patient outcomes.
Reference:
Morgan C, Carr MJ, Chew-Graham CA, O’Neill TW, Elvins R, Kapur N, et al. Adverse outcomes in patients with a diagnosis of an eating disorder: primary care cohort study with linked secondary care and mortality records. BMJ Medicine. 2025;4:e001438. https://doi.org/10.1136/bmjmed-2025-001438
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