Australia Leads the World in Anorexia and Bulimia Rates as Global Cases Climb
Australia has the highest prevalence of anorexia nervosa and bulimia nervosa in the world, with an estimated 1,026.5 cases per 100,000 people affected by one of the two disorders, according to a study published in JAMA Psychiatry.
The findings, drawn from the Global Burden of Disease 2023 analysis and reported by Xinhua, reveal that global cases of the two eating disorders rose 71 percent between 1990 and 2023. Worldwide, the analysis estimated that about 18.1 million people were living with anorexia or bulimia in 2023, comprising 3.92 million cases of anorexia and 14.2 million cases of bulimia. Researchers project these figures will continue to rise through 2050.
Damian Santomauro, a senior author of the study and an epidemiologist at the University of Queensland, told the Australian Broadcasting Corporation (ABC) that Australia’s ranking was “surprising and concerning.” While high-income settings generally show elevated rates of eating disorders, Dr. Santomauro noted he was surprised to see Australia’s figures sit so high compared to the United States or Western Europe.
Sarah Cox, a clinical psychologist with the Butterfly Helpline, told ABC that the study validates long-standing reports from healthcare professionals, families, and individuals with lived experience. “Eating disorders are serious mental illnesses that affect a significant number of people in Australia, and that the number of people affected is growing,” Ms. Cox said.
Females Represent Nearly Seventy Percent of Global Cases
The data shows that mental disorders now account for more than 17 percent of all disability worldwide, placing them on par with or more burdensome than certain physical disorders, according to Dr. Santomauro. Females accounted for nearly 70 percent of the global cases, while approximately 41 percent of all cases affected individuals aged 10 to 24.
Regionally, the largest increases in case numbers occurred in East Asia, South Asia, and Southeast Asia. Globally, the two eating disorders resulted in a loss of 3.81 million disability-adjusted life years.
Discussing the drivers behind the long-term increase, Dr. Santomauro pointed to the potential role of digital environments. He noted that increased time online, exposure to Instagram, and body image issues encountered by youth today are hypotheses for why prevalence has climbed.
At the same time, methodological differences in data collection may partially explain Australia’s distinct standing. Dr. Santomauro pointed out that Australian surveys tend to utilize different methodologies compared to international counterparts, though he emphasized that this factor alone does not account for the high numbers. Ms. Cox added that Australia's strong research framework may simply allow the country to track the problem more clearly than other nations.
Barriers to Care in Diverse Communities
For individuals managing these conditions, systemic hurdles remain a prominent concern. Jeanette Chan, an economist, public policy professional, and person with lived experience of an eating disorder, told ABC about the specific difficulties faced by people from migrant and non-Western backgrounds.
“Growing up as a migrant, I didn’t have a lot of language or understanding around what mental health was or what mental health issues were,” Ms. Chan said, noting the added complexities in a multicultural society like Australia.
The study’s authors urge healthcare systems worldwide to integrate eating disorders directly into mental health surveillance, prevention, early detection, and care planning as cases continue on their projected trajectory toward 2050.
