What question did this study set out to answer?

This study aims to analyze the trends and patterns of eating disorders among women of childbearing age from 1990 to 2021.

March 25, 2026Open Access

Patterns and trends of eating disorders among women of childbearing age: a comprehensive analysis from 1990 to 2021 with future predictions

Key Points

This study aims to analyze the trends and patterns of eating disorders among women of childbearing age from 1990 to 2021.
Utilized data from the Global Burden of Disease Study 2021.
Quantified disease burden using disability-adjusted life years (DALYs).
Assessed trends using estimated annual percentage change (EAPC).
Evaluated correlation between socioeconomic development and disease burden.
Projected future trends with a Bayesian Age-Period-Cohort model.
In 2021, the burden of eating disorders reached 2,035,736 DALYs.
Global age-standardized DALY rates increased from 93.45 to 106.05 per 100,000 population from 1990 to 2021.
Bulimia nervosa consistently had a higher burden compared to anorexia nervosa.
ASDR positively correlated with the Sociodemographic Index, especially in high-SDI regions.
Future projections indicate an increase in ASDR to 109.84 by 2035 with shifts towards younger age groups.

Abstract

Abstract Purpose Eating disorders (EDs) among women of childbearing age (WCBA; defined by the World Health Organization as women aged 15–49 years) have emerged as a significant public health concern on a global scale. This study aims to explore the patterns and trends of EDs—specifically anorexia nervosa (AN) and bulimia nervosa (BN), as defined by the Global Burden of Disease (GBD) 2021—among WCBA from 1990 to 2021. Methods Using data from the GBD Study 2021, we quantified the disease burden using disability-adjusted life years (DALYs) and age-standardized DALY rates (ASDR). Temporal trends were assessed via the estimated annual percentage change (EAPC). Relationships between socioeconomic development and burden were evaluated using Spearman’s correlation with the Sociodemographic Index (SDI). Future trends were projected using a Bayesian Age-Period-Cohort (BAPC) model. Results In 2021, the global burden of EDs in WCBA reached 2,035,736 DALYs (95% UI: 1,229,250–3,188,529). From 1990 to 2021, the global ASDR rose from 93.45 to 106.05 per 100,000 population, with an EAPC of 0.48 (95% CI 0.44–0.52). BN consistently imposed a higher burden than AN. ASDR was positively correlated with SDI ( r = 0.808, P < 0.001), with high-SDI regions exhibiting the highest burden, while the middle-SDI quintile and the East Asian region showed the most rapid increases. By 2035, the global ASDR is projected to reach 109.84, with peak burdens shifting toward the 20–29 age group. Conclusions The global burden of EDs among WCBA is substantial and increasing, particularly in rapidly urbanizing and high-income regions. Given the intersection of EDs with reproductive health, integrated screening within obstetric and gynecological care is urgently needed. Public health strategies should prioritize BN and regions undergoing rapid socioeconomic transition to mitigate this escalating crisis. Level of evidence Level IV, evidence obtained from multiple time series (descriptive time-trend analysis).

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