Dr. David Herzog is a premier researcher on eating behaviors and disorders. He and his colleagues investigated mortality as part of his Longitudinal Study of Anorexia and Bulimia Nervosa. Beginning in 1987, 246 treatment-seeking women with anorexia or bulimia nervosa were interviewed semi-annually to obtain information about their eating behaviors, mood disorders, substance use, health, work, and relationships.

1. Mortality in Eating Disorders:
Anorexia Nervosa Vs. Bulimia
Nervosa
By Dr David Herzog

2. Introduction

Dr. David Herzog is a premier researcher
on eating behaviors and disorders. He
and his colleagues investigated mortality
as part of his Longitudinal Study of
Anorexia and Bulimia Nervosa.
Beginning in 1987, 246 treatmentseeking women with anorexia or bulimia
nervosa were interviewed semi-annually
to obtain information about their eating
behaviors, mood disorders, substance
use, health, work, and relationships.

3. Study Results

Of the 246 participants, 16 (6.5%) died over a
total median follow-up time of 20 years.
Among the 186 women with a lifetime history
of anorexia nervosa, 14 (7.5%) died. Among
the 60 individuals with bulimia nervosa and
no history of anorexia nervosa, two (3.3%)
died. Four of the 16 deaths were the result of
suicide; all four of these individuals had
anorexia nervosa and employed methods of
suicide that were highly lethal. The suicide
rate for anorexia nervosa is 25 times higher
than expected for women of similar age.

4. About Premature Deaths

The risk of premature death for the patients with
anorexia nervosa was highest during the first 10
years of follow-up and among individuals with the
longest duration of illness. Most of the women
who died entered the study with a long duration
of illness. With one exception, those who died
reported an illness duration spanning seven to
twenty-five years prior to entry into the study. All
of the deaths among the women with anorexia
nervosa occurred in middle adulthood, with all
but three deaths occurring between ages 35 and
48 years. Predictors of mortality for anorexia
included alcohol abuse, low body mass index,
long duration of illness and poor social
adjustment.

5. Conclusion

The findings of this study underscore
the need for early detection and
treatment and suggest that among
patients with a long duration of illness
– particularly when substance abuse,
low weight or poor psychosocial
functioning are also present – the risk
for mortality increases substantially.