Death rates in eating disorders

Anorexia nervosa is a very serious mental disorder and a number of studies have been carried out into mortality rates among people with anorexia. The standardised mortality ratio (SMR) is the ratio of actual deaths to expected deaths. If firemen, for example, have an SMR of 8, compared to people of a similar age in the general population then that means they are 8 times more likely to die earlier. Studies have estimated the SMR for anorexia at anything between 0 and 17.8. A Swedish study followed 6,009 women who had been discharged from hospital after treatment for anorexia between 1973 and 2003. Every death in Sweden is recorded on a central register, so the researchers were able to compare deaths among the women with anorexia to deaths among women of a similar age in the general population. The overall SMR for anorexia was 6.2. Anorexia itself, psychoactive substance use and suicide were the main causes of excess mortality but the SMR was significantly increased for almost all natural and unnatural causes of death and remained significantly high even 20 years after the first hospitalisation. The mortality from anorexia had fallen in the last two decades. Younger age and a longer hospital stay at first hospitalisation were associated with less mortality whereas the presence of other mental and physical health problems increased the risk of death.

Papadopoulos, Fotios C. ... [et al] - Excess mortality, causes of death and prognostic factors in anorexia nervosa British Journal of Psychiatry January 2009, 194(1), 10-17