DOI: 10.1001/jamapsychiatry.2026.3457 ISSN: 2168-622X
Global Burden of Anorexia Nervosa and Bulimia Nervosa, 1990 to 2023, With Forecasts to 2050
Ruhai Bai, Wanyue Dong, Xu Wang, Aihua Zhang, Damian F. Santomauro, , Hasan Aalruz, Olumide Abiodun, Richard Gyan Aboagye, Khaled M. Aboshanab, Lucas Guimarães Abreu, Amr Selim Abu Lila, Hana J. Abukhadijah, Mohammad S. Abu-Mahfouz, Nuhu Lawan Adamu, Babatope Oluwadamilare Adebiyi, Saheed Ayodeji Adekola, Miracle Ayomikun Adesina, Habeeb Omoponle Adewuyi, Amaha K Adhanu, Obed Adonteng-Kissi, Percival Delali Agordoh, Salome Wumpini Agordoh, César Agostinis Sobrinho, Abdul Momin Rizwan Ahmad, Khabir Ahmad, Ali Ahmed, Md Faisal Ahmed, Shakeel Ahmed, Kenni Wojujutari Ajele, Oluwabusayomi O. Akeju, Oladipo Vincent Akinmade, Wole Akosile, Ashley E. Akrami, Ahmad Al Athamneh, Salah Al Awaidy, Duaa Fayiz Al Maghaireh, Omar Al Omari, Mohammad Ahmmad Mahmoud Al Zoubi, Mohammad Khursheed Alam, Muath A. Alammar, Shams M. F. Al-Anzi, Mohammed Albashtawy, Abdulelah Mastour Aldhahir, Bezawit Abeje Alemayehu, Baidaa Alhalabi, Fadwa Naji Alhalaiqa, Mohammad Jamil Alhawajreh, Ashraf Alhumaidi, Ahmed Naif Ali, Mohammed Usman Ali, Hamid Alinejad Rokny, Samah W. Al-Jabi, Ahmad Alkhatib, Sameer Abdulmalik Alkubati, Sabah Al-Marwani, Joseph Uy Almazan, Rajaa M. Al-Raddadi, Bandar Alsaif, Abdalkarem Fedgash Alsharari, Eman Alshawish, Zaid Altaany, Yasmin Altwaijri, Masoud Aman Mohammadi, Tarek Tawfik Amin, Dickson A Amugsi, Abhishek Anil, A.H. Sruthi Anil Kumar, Prapti Anjana, Anayochukwu Edward Anyasodor, Hossein Arabi, Aleksandr Y. Aravkin, Demelash Areda, Jorge Arias de la Torre, Benedetta Armocida, Danilo Arnone, Gustavo Aires Arruda, Nabiy Arystan, Bryndís Björk Ásgeirsdóttir, Syed Amir Ashraf, Bernard Kwadwo Yeboah Asiamah-Asare, Samuel Babajide Atoyebi, Yonas Alemu Atra, Camila Ospina Ayala, Jose L. Ayuso-Mateos, Eid M. S. Azzam, Sheeba B, Alpha Umaru Bai-Sesay, Wondu Feyisa Balcha, Yatan Pal Singh Balhara, Jose Balmori-de-la-Miyar, Olaitan Johnson Balogun, Salam Bani Hani, Farhat Bano, Suzanne Lyn Barker-Collo, Amadou Barrow, Muhammad Irfan Bashir, Shahid Bashir, Shahid Bashir, Azadeh Bashiri, Mohammad-Mahdi Bastan, Kavita Batra, Narasimha M. Beeraka, Andrej Belančić, Samiun Nazrin Bente Kamal Tune, Mansi Sanjaykumar Bhadiyadra, Sonu Bhaskar, Sudip Bhattacharya, Catherine Bisignano, Bruno Bizzozero-Peroni, Mahmut Bodur, Alejandro Botero-Carvajal, Andreea Breazu, Akeem Olayinka Busari, Senthilkumar C, Sanjay C J, Ismael Campos-Nonato, Sandra Carvalho, Giulio Castelpietra, Francieli Cembranel, Joshua Chadwick, Rama Mohan Chandika, Miyuru Chandradasa, Yu Chang, Hana Chen, Dong-Woo Choi, Yun-jung Choi, Sunghyun Chung, Arrigo Francesco Giuseppe Cicero, Iolanda Cioffi, Cain C. T. Clark, Samuele Cortese, Ilaria Cosentini, Claudia Cosma, Natália Cruz-Martins, Ferran Cuenca-Martínez, Omid Dadras, Namrata Dagli, Neha Dahiya, Xiaochen Dai, Ngoc Bao Dang, Rahul Ravindra Darunde, Aso Mohammad Darwesh, Alejandro de la Torre-Luque, Sindhura Deekonda, Hunegnaw Almaw Derseh, Nishrita Devnath, Sadia Din, Jasmin Dönicke, Emeka W Dumbili, Hasan Durmuş, Ejemai Eboreime, Faranak Ebrahimian Sadabad, Venkata Ravikanth Eddula, Iffat Elbarazi, Mohamed Elhoumed, Gihan ElNahas, Asim Ahmed Elnour, Mahmoud E. Elrggal, Mona Metwally El-Sayed, Abdelgawad Salah Eltahawy, Munachimso Anthony Emesobum, Collins Nduka Esomchi, Adeniyi Francis Fagbamigbe, Nour Fakih, MoezAlIslam Ezzat Faris, Andre Faro, Fauzia Ashfaq, Feten Fekih-Romdhane, Tommaso Filippini, Alexander Finnemore, Sofia Catherine Finnemore Capon Diaz, Florian Fischer, Federica Fogacci, Carlos Forner Álvarez, Paolo Fusar-Poli, Yaseen Galali, Khadijat Oladayo Ganiyu, Jacopo Garlasco, Tsion S. Gebre, Ali Gerami Matin, Lemma Getacher, Roya Ghafoury, Arin Ghamkhar, Lobna Gharaibeh, Sama Ghoba, Ehsan Gholami, Zainab Gholami, Alessandro Gialluisi, Vaitsa Giannouli, Syed Abdullah Gilani, Gamze Gökulu, Mahaveer Golechha, Melika Golmohammadi, Changhao Gu, Sheffali Gulati, Bruno Gutiérrez, Aryamawit Habteyesus, Souheil Hallit, Fatimah Othman Hamarasool, Mohd Anul Haq, Josep Maria Haro, Eka Mishbahatul Marah Has, Towhid Hasan, Divna M. Haslam, Md Saquib Hasnain, Simon I. Hay, Abdelaziz Hendy, Hans W. Hoek, Yu Hong, Praveen Hoogar, Md Sabbir Hossain, Syed Billal Hossain, Mehdi Hosseinzadeh, Mila Nu Nu Htay, Waqar Husain, Segun Emmanuel Ibitoye, Fatma Magdi Ibrahim, Rasha Ibrahim, Aamir Ilyas Abbasi, Danish Iqbal, Mujahid Iqbal, Md Mojahedul Islam, Md Saiful Islam, Md Shahinul Islam, Aloysia Ispriantari, Oluyinka Ajibola Iyiola, Roxana Jabbarinejad, Jaison Jacob, Haitham Jahrami, Sanobar Jaka, Arshad Jamal, Sathish Kumar Jayapal, Yovanthi Anurangi Jayasinghe, George Vellaramcheril Joy, Jacek Jerzy Jozwiak, Malik E. Juweid, Hema Shree K, Sanjay Kalra, Kyungmin Kang, Suvarna Jyothi Kantipudi, Paschalis Karakasis, Reddy Praneeth Karnam, Mariam Mofleh Kawafha, Aïmen Khacharem, Yousef Saleh Khader, Sidra Khalid, Anas Husam Khalifeh, Noman Khalique, Ammar Ahmad Khan, Iman Waheed Khan, Mohammad Idreesh Khan, Ruby Khan, Zahid Khan, Sameer Uttamaro Khasbage, Mehdi Khezeli, Parisa Khoshvaght, Fireza Husnul Khotimah, Jagdish Khubchandani, Christian Kieling, Jinho Kim, Shivakumar K.M. Kondlahalli, Isaac Koomson, Konstantinos Kotsis, Archana Koul, Garry Kuan, Emmanuel Kumah, Chandan Kumar, Manasi Kumar, Pardeep Kumar, Rakesh Kumar, Sumeet Kumar, Donata Kurpas, Dian Kusuma, Timo Lajunen, Agung Dwi Laksono, Savita Lasrado, Areeba Latif, Long Khanh-Dao Le, Hoi Leong Lee, Seung Won Lee, Jose E. Leon-Rojas, Mengyi Li, Zhengrui Li, Yanxue Lian, Ambreen Liaqat, Yushan Liu, Erand Llanaj, Mariia Lopatkina, José Francisco López-Gil, Pincheng Luo, Oleh Lushchak, Ellina Lytvyak, Zheng Feei Ma, Nozad Hussein Mahmood, Iman Fahmi Mahmoud, Birhanemaskal Malkamu, J. Jenifer Florence Mary, Sugeng Mashudi, Neeta Mathur, Rita Mattiello, Khurshid A. Mattoo, Giuseppe Mazzola, Chioma Ngozichukwu Pauline Mbachu, John J. McGrath, John Robert Carabeo Medina, Khurram Mehboob, Riffat Mehboob, Vini Mehta, Tesfahun Mekene Meto, Herbert Melariri, Aamir Raoof Memon, Giovanni Merlino, Tomislav Mestrovic, Paul Anthony Miller, Ted R. Miller, Giuseppe Minervini, Long Chiau Ming, Tridip Mitra, Farduus Ibraahim Mohamed, Fatima Awad Elkarim Elfaki Mohamed, Mustapha Mohammed, Zaidan Mohammed, Afrasim Moin, Ali H. Mokdad, Sabrina Molinaro, Lorenzo Monasta, Anthony Kwame Morgan, Reza Mosaddeghi-Heris, Md Shihab Mostafa, Faraz Mughal, Christopher J. L. Murray, Sukumar Muthusamy, Woojae Myung, Prasad Nalabothu, Rizwan Naqvi, Shumaila Nargus, Zakira Naureen, Cuong Tat Nguyen, Trang Nguyen, Yeshambel T. Nigatu, Vikram Niranjan, Stanley Nkemjika, Lawrence Achilles Nnyanzi, Mehran Nouri, Chimezie Igwegbe Nzoputam, Ogochukwu Janet Nzoputam, Promise Okereke, Oluwaseyi Isaiah Olabisi, Andrew T. Olagunju, Adetayo Olorunlana, Michal Ordak, Sergej M. Ostojic, Olutosin Ademola Otekunrin, Mohamed S. Othman, Ilker Ozsahin, Dimpal Manilal Paija, Raul Felipe Palma-Alvarez, Bunga A. Paramashanti, Shahina Pardhan, Romil R. Parikh, Chulwoo Park, Arpit Parmar, Bhargav Umeshchandra Patel, Mitesh Patel, Ashlesh Patil, Shankargouda Patil, Flavia Pennisi, Maria Odete Pereira, Simone Perna, Hai Quang Pham, Thantrira Porntavetus, Fabio Porru, Amit Porwal, Farzad Pourghazi, Jagadeesh Puvvula, Xiang Qi, Nuzul Qur’aniati, Maja R. Radojčić, Alberto Raggi, Yashpal Singh Raghav, Mosiur Rahman, Setyaningrum Rahmawaty, Humam Rajha, Pushp Lata Rajpoot, Nurgali Amanbaiuly Rakhymbayev, Mahmoud Mohammed Ramadan, Kadar Ramadhan, Rajath Rao, Dhwani Ravi, Salman Rawaf, Ateeq Rehman, Wajiha Rehman, Moattar Raza Rizvi, Megan L. Rolfzen, Debby Syahru Romadlon, Luca Ronfani, Basema Ahmad Saddik, Ehsan Sadeghi, Bassem Sadek, Rida Fatima Saeed, Rajesh Sagar, Amene Saghazadeh, Dominic Sagoe, Narjes Saheb Sharif-Askari, Gülsüm Şahin Bodur, Vaibhav Sahni, Binaya Krushna Sahu, Joseph W. Sakshaug, Luciane B. Salaroli, Mohamed A. Saleh, Giovanni A. Salum, Senthilkumar Sankararaman, Aswini Saravanan, Mete Saylan, Yashendra Sethi, Yara Shaalan, Arash Shaban-Nejad, Shazlin Shaharudin, Syed Monowar Alam Shahid, Endrit Shahini, Moyad Jamal Shahwan, Masood Ali Shaikh, Muhammad Aaqib Shamim, Alfiya Shamsutdinova, Dan Shan, Sumaira Sharif, Amin Sharifan, Gaurav Sharma, Kamlesh Sharma, Shreya Sharma, Nishat Ahmed Sheikh, Premalatha K. Shetty, Priyanka Arun Shirali, Shirindokht Shirazi, Mohammad Shokouhifar, Deborah Oluwaseun Shomuyiwa, Md Kaoser Bin Siddique, Arif J. Siddiqui, Akanksha Singh, Harpreet Singh, Jasvinder A. Singh, Jawahar Singh, Poornima Suryanath Singh, Siddharth Singh, Vanshika Singh, Kannan Sridharan, Elena Stănculescu, Mark A. Stokes, Brendon Stubbs, Mark J. M. Sullman, Marjia Sultana, Rafael Tabarés-Seisdedos, Celine Tabche, Zanan Mohammed-Ameen Taha, Niloofar Taheri, Mircea Tampa, Jianye Tan, Kit-Aun Tan, Hongliang Tao, Mohammad-Hassan Tayarani-Najaran, Abainash Tekola, Reem Temsah, Masayuki Teramoto, Rekha Thapar, Khaled Trabelsi, Nguyen Tran Minh Duc, Domenico Trico, Samuel Joseph Tromans, Evangelia Tsermpini, Tabussam Tufail, Lawrence Sena Tuglo, Abdulkadir Usman Sambo, Rakesh Vadakkethil Radhakrishnan, Zahir Vally, Giloume Van Der Walt, Sven Vanneste, Akshaya Kumar Verma, Giacomo Pietro Vigezzi, Vignesh Vikram, Sofia Almeida von Humboldt, Shu Wang, Xing Wang, Yaojie Wang, Nuwan Darshana Wickramasinghe, Faustine Williams, Gemechu Kumera Wirtu, Tewodros Eshete Wonde, Natsuhiko Yamada, Hanwen Yang, Yuichiro Yano, Kuanysh A. Yergaliyev, Renjulal Yesodharan, Yazachew Engida Yismaw, Dong Keon Yon, Naohiro Yonemoto, Muhammad Sohail Zafar, Giulia Zamagni, Kourosh Zarea, Seema Zargar, Michael Zastrozhin, Mohammed Zawiah, Eyael M. Zeru, Zhichang Zhang, Sa’ed H. ZyoudImportance
Eating disorders are a major cause of nonfatal mental health burden, yet global evidence on their long-term trends, geographic distribution, and future trajectories remains limited.
Objective
To estimate the global, regional, and national prevalence and disability burden of anorexia nervosa and bulimia nervosa—and mortality attributable to anorexia nervosa—from 1990 to 2023, and to forecast prevalence to 2050.
Design, Setting, and Participants
Using Global Burden of Disease (GBD) 2023 methods, data were synthesized from systematic literature reviews, population surveys, and vital registration systems. Estimates were produced for 204 countries and territories from 1990 to 2023, with forecasts through 2050. These data were analyzed from October 2025 to August 2026.
Exposure
Anorexia nervosa or bulimia nervosa diagnosis.
Main Outcomes and Measures
Counts and age-standardized rates with 95% uncertainty intervals (UIs) for anorexia nervosa and bulimia nervosa prevalence, years lived with disability (YLDs), and disability-adjusted life-years (DALYs), and anorexia nervosa mortality, reported by age, sex, and location.
Results
In 2023, an estimated 18.1 million people (95% UI, 13.9-24.0) globally were living with anorexia nervosa or bulimia nervosa, of whom 12.6 million (69.4%) were female, 5.5 million were male (30.6%), and 41.2% were aged 10 to 24 years. These cases accounted for 3.83 million DALYs (95% UI, 2.23-5.69). Since 1990, the global number of prevalent cases increased by 71.0%, while age-standardized prevalence and DALY rates rose by about 21%. Females experienced substantially higher prevalence and DALY rates than males. The highest age-standardized prevalence rates were observed in high-income regions, particularly Australasia and Western Europe, whereas the largest relative increases in age-standardized prevalence occurred in East Asia, South Asia, and Southeast Asia. Forecasts indicate continued increases in prevalent cases through 2050.
Conclusions and Relevance
This GBD 2023 analysis found that anorexia nervosa and bulimia nervosa contribute substantially to global nonfatal health loss. These findings support the integration of eating disorders into mental health surveillance, prevention, and service planning worldwide.