How frequent are consuming problems in adults searching for weight problems remedy?

In 2022, the worldwide prevalence of weight problems in adults (≤18 years) was round 16%, greater than double what it was in 1990 (World Well being Group, 2025). Adults with weight problems are extra in danger for disordered consuming and consuming problems (EDs), with binge-eating and binge-eating dysfunction (BED) essentially the most steadily studied (Da Luz et al., 2018).

Analysis on different EDs is much less in depth. Nonetheless, a scientific overview from 2021 reported atypical anorexia nervosa (AAN; having the signs of anorexia with out being underweight; learn Eleana’s weblog to study extra) to be current in 0.15% to 13% of females with weight problems. Curiously, this was extra prevalent than these presenting with anorexia with low weight inside the group, but was referred for ED care much less usually (Harrop et al., 2021).

As such, analysis has discovered that adults with EDs usually tend to obtain weight-loss remedy over remedy for his or her ED (Hart et al., 2011; Kaur et al., 2022; Palavras et al., 2011). This can be a trigger for concern, because it means that this inhabitants of people with EDs should not receiving acceptable care.

Nonetheless, proof for the complete spectrum of EDs and disordered consuming behaviours is missing. There must be a extra full understanding of how prevalent EDs are amongst adults searching for weight problems remedy, as it’s at the moment tough to find out the kind and scale of psychological well being help wanted. Due to this fact, the intention of this systematic overview and meta-analysis (Melville et al, 2025) was to estimate the prevalence of disordered consuming and EDs in adults searching for remedy for weight problems.

Most analysis thus far on the prevalence of consuming problems in these with weight problems has targeted on binge-eating dysfunction and binge-eating behaviours, that means a considerable portion of the image is lacking.

Strategies

Three databases had been looked for research that contained:

1. Adults or a combined pattern of adolescents and adults the place the imply age was ≥18 years with both an chubby or overweight BMI.
2. These searching for weight problems remedy.
3. A prognosis of an ED or disordered consuming behaviour by scientific interview or validated questionnaire on the time of entry into weight problems remedy.
4. A minimal pattern dimension of 325 members.

All EDs and disordered consuming behaviours (e.g., lack of management consuming, drive for thinness) had been included. Research had been excluded in the event that they contained members (1) searching for each weight problems and ED remedy, or (2) with weight problems as a part of a broader syndrome. Overseas language research had been translated utilizing Google Lens in order that they is also included.

Research had been double screened independently by 4 authors. Knowledge was independently extracted from included research by two reviewers and methodological high quality of research was independently assessed by one reviewer, with accuracy checks by one other reviewer.

A random-effects mannequin was used within the meta-analysis to pool prevalence estimates of EDs and disordered consuming behaviours. Subgroup analyses and exams for publication bias and small research results had been additionally performed.

The overview was prospectively registered on PROSPERO (CRD42023461340) and reported in accordance with the JBI Guide for Proof Synthesis and PRISMA tips.

Outcomes

Research traits

Eighty-five research had been included on this systematic overview, printed between 1985 and 2025. Most research had been printed both within the USA (n = 43) or Italy (n = 17). Knowledge got here from 94,295 members (75.9% feminine, median age = 44 years [IQR = 5], median BMI = 46 kg/m2 [IQR = 10]). Essentially the most reported weight problems therapies had been bariatric surgical procedure (n = 49), behavioural weight administration (n = 9), or a number of remedy choices (n = 8).

Prevalence charges had been reported for a number of EDs and disordered consuming behaviours, however BED (n = 46) and self-report binge consuming (n = 32) had been the most typical. No research reported on avoidant/restrictive meals consumption dysfunction, pica, rumination, or purging dysfunction.

Prevalence estimates

BED and binge consuming behaviours

For these reporting BED, the pooled prevalence was:

• 17% (95% CI [12 to 22], 19 research) as assessed by scientific interview utilizing DSM-IV standards with a prediction interval (an estimate of the place a future commentary will probably fall) of 0% to 42%.
• 14% (95% CI [7 to 22], 10 research) when assessed by DSM-5 standards with a prediction interval of 0% to 43%.
• 12% (95% CI [9 to 16], 17 research) from self-report questionnaires.

The authors additionally discovered proof of publication bias and small research results for all three BED prevalences, the place the prevalence of BED elevated because the research pattern decreased.

For these reporting binge consuming behaviour based on the Binge Consuming Scale, the pooled prevalence was:

• 26% (95% CI [23 to 28], 12 research) for reasonable binge consuming severity with a prediction interval of 18% to 33%.
• 12% (95% CI [8 to 16], 18 research) for extreme binge consuming severity with a prediction interval of 0% to 31%.
• Nonetheless, extreme self-report binge consuming was re-examined following the removing of 1 research from 1985 (Marcus et al., 1985) attributable to this research being an outlier. Following the removing of this research, the pooled prevalence was 10% (95% CI [8 to 12], 17 research) with a prediction interval of two% to 19%.

Once more, there was a chance of bias for self-report extreme binge consuming, however this was not discovered for reasonable severity self-report binge consuming behaviour.

Different EDs

When assessed by scientific interview, the pooled prevalence of:

• Night time consuming syndrome was 5% (95% CI [2 to 9], 5 research) with a prediction interval of 0% to 17%.
• Bulimia nervosa was 1% (95% CI [0 to 1], 9 research) with a prediction interval of 0% to 2%.
• Issues the place the kind was not specified was 11% (95% CI [4 to 18], 9 research) with a prediction interval of 0% to 36%.

Solely two research reported AAN, with the prevalence 0.2% in a single research assessed by scientific interview (Lin et al., 2013). The second research had no reported instances (Hilbert et al., 2022). Egger’s exams had been vital for bulimia nervosa and consuming problems when not specified, indicating potential proof of bias the place prevalence elevated as research pattern dimension decreased.

Sensitivity analyses

Put up-hoc sensitivity analyses examined the potential bias of smaller research, on condition that prevalence estimates generally elevated as research pattern sizes decreased. Apart from BED when assessed by DSM-5 scientific interview, exams remained vital when the minimal pattern dimension elevated, demonstrating that prevalence tended to lower with bigger samples.

Meta-regression

The ultimate 12 months of information assortment was discovered to be considerably related to the prevalence of self-report extreme binge consuming, the place binge consuming decreased over time (p < 0.01).

Subgroup-analyses

Varied post-hoc subgroup analyses had been performed, together with remedy sort, scientific interviews, and intercourse, however no vital variations had been discovered.

High quality evaluation

While no research had been excluded primarily based on the standard evaluation, inadequate reporting meant that two domains had been usually chosen as ‘unclear’: (1) the reliability of measurements and (2) clearly described response charges.

Binge consuming dysfunction and binge consuming behaviour remained essentially the most studied outcomes within the context of weight problems therapies, with a couple of research reporting prevalence charges on evening consuming dysfunction, bulimia nervosa, and atypical anorexia nervosa.

Conclusions

This was the primary complete overview to estimate the prevalence of each EDs and disordered consuming behaviours inside adults searching for remedy for weight problems. General, analysis has primarily targeted on BED and binge-eating behaviours, with restricted analysis on different forms of EDs or disordered consuming behaviours.

As such, this overview estimates that:

• roughly 14% of adults searching for weight problems remedy may have binge-eating dysfunction (BED),
• an estimated 26% might have self-reported reasonable binge-eating,
• 5% might have evening consuming syndrome, and
• 1% might have bulimia nervosa.

Binge-eating dysfunction happens in roughly 14% of adults searching for remedy for weight problems, with 26% reporting reasonable binge-eating. Analysis on different forms of consuming problems and disordered consuming behaviours is restricted.

Strengths and limitations

This research had varied strengths, together with however not restricted to:

• The usage of rigorous strategies. This overview recognized articles from a number of related databases, employed double unbiased screening strategies, contacted authors of eligible research for lacking info, and investigated potential publication and small pattern biases. Methods akin to this assist to make sure that related research should not missed, and that conclusions are dependable.
• The cumulative pattern was giant, containing over 94,000 individuals from 85 research, spanning a number of nations over 40 years. This helps to make the prevalence estimates extra dependable, consultant, and helpful by way of informing screening of weight problems therapies sooner or later.
• The usage of prediction intervals in addition to confidence intervals additionally improves transparency and future applicability, because it helps to estimate what prevalence may be in future research.

Regardless of this, there have been nonetheless some limitations:

• While the pattern was giant, some teams remained underrepresented. For instance, most members had been White, and from increased socioeconomic backgrounds. Additionally, solely members who had been actively searching for weight problems remedy had been included on this research. All of this prevents us from with the ability to generalise to different populations (e.g., untreated people) the place prevalence would possibly differ.
• There was an underrepresentation in some remedy settings, with most research reporting on bariatric surgical procedure. Because of this different, non-surgical therapies, had been probably underpowered which could end in deceptive conclusions, or a bias in direction of particular therapies (akin to surgical procedure). Nonetheless, the authors set a minimal pattern dimension of 325 members in every research to assist alleviate this.
• Prevalence estimates may additionally be influenced by modifications in remedy sorts and diagnostic standards over time (e.g., use of DSM-IV to DSM-5), given the 40-year information span included inside this research. Because of this the identical ED may be recognized or categorized otherwise over time, doubtlessly influencing prevalence estimates and making comparisons throughout time much less legitimate.

This overview used rigorous strategies to seize prevalence info on consuming problems and disordered consuming behaviour throughout a 40-year span, together with over 94,000 members.

Implications for observe

Given the estimated prevalence of EDs and disordered consuming behaviours co-occurring with weight problems, routine screening of ED signs needs to be performed earlier than entry into weight problems remedy programmes to make sure people are referred for essentially the most appropriate remedy. It will be helpful if this screening coincides with additional coaching of clinicians inside these programmes to recognise indicators and signs of EDs, together with binge consuming and BED, alongside different EDs discovered to be prevalent on this overview’s inhabitants, akin to evening time consuming and bulimia nervosa. This might assist to determine not solely the presence of an ED however what sort, to help in selections round best suited remedy.

Additional analysis on this space can be wanted. Firstly, analysis on the only remedy pathways for people with co-occurring weight problems and EDs/disordered consuming is necessary, to make sure acceptable care and improved long-term outcomes. There must also be an funding in analysis with under-researched populations, akin to ethnic minority teams, those that haven’t sought formal remedy, or these searching for non-surgical or community-based therapies, to additional perceive prevalence charges inside these populations. With out such analysis, our understanding of the prevalence of EDs inside this inhabitants is restricted and can’t be generalised to people from these teams. To help this, weight problems remedy programmes may additionally implement prevalence monitoring as customary, to additional perceive prevalence charges over time.

Routine screening of consuming problems and disordered consuming behaviours needs to be applied as a part of routine screening to weight problems remedy programmes, to determine and help people in receiving essentially the most acceptable care.

Assertion of pursuits

None.

Hyperlinks

Major paper

Melville, H., Lister, N. B., Libesman, S., Seidler, A. L., Cheng, H. Y., Kwan, Y. L., Garnett, S. P., Baur, L. A., & Jebeile, H. (2025). The Prevalence of Consuming Issues and Disordered Consuming in Adults Looking for Weight problems Remedy: A Systematic Overview With Meta‐Analyses. Worldwide Journal of Consuming Issues, 58(9), 1644–1661. https://doi.org/10.1002/eat.24483

Different references

Da Luz, F. Q., Hay, P., Touyz, S., & Sainsbury, A. (2018). Weight problems with Comorbid Consuming Issues: Related Well being Dangers and Remedy Approaches. Vitamins, 10(7), 829. https://doi.org/10.3390/nu10070829

Frisira, E. (2023). “You Don’t Look Anorexic”: unmasking weight stigma in sufferers with atypical anorexia nervosa. The Psychological Elf.

Gormally, J., Black, S., Daston, S., & Rardin, D. (1982). The evaluation of binge consuming severity amongst overweight individuals. Addictive Behaviors, 7(1), 47–55. https://doi.org/10.1016/0306-4603(82)90024-7

Harrop, E. N., Mensinger, J. L., Moore, M., & Lindhorst, T. (2021). Restrictive consuming problems in increased weight individuals: A scientific overview of atypical anorexia nervosa prevalence and consecutive admission literature. Worldwide Journal of Consuming Issues, 54(8), 1328–1357. https://doi.org/10.1002/eat.23519

Hart, L. M., Granillo, M. T., Jorm, A. F., & Paxton, S. J. (2011). Unmet want for remedy within the consuming problems: A scientific overview of consuming dysfunction particular remedy searching for amongst group instances. Scientific Psychology Overview, 31(5), 727–735. https://doi.org/10.1016/j.cpr.2011.03.004

Hilbert, A., Staerk, C., Strömer, A., Mansfeld, T., Sander, J., Seyfried, F., Kaiser, S., Dietrich, A., & Mayr, A. (2022). Nonnormative Consuming Behaviors and Consuming Issues and Their Associations With Weight Loss and High quality of Life Throughout 6 Years Following Weight problems Surgical procedure. JAMA Community Open, 5(8), e2226244. https://doi.org/10.1001/jamanetworkopen.2022.26244

Kaur, J., Dang, A. B., Gan, J., An, Z., & Krug, I. (2022). Night time Consuming Syndrome in Sufferers With Weight problems and Binge Consuming Dysfunction: A Systematic Overview. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.766827

Lin, H.-Y., Huang, C.-Ok., Tai, C.-M., Lin, H.-Y., Kao, Y.-H., Tsai, C.-C., Hsuan, C.-F., Lee, S.-L., Chi, S.-C., & Yen, Y.-C. (2013). Psychiatric problems of sufferers searching for weight problems remedy. BMC Psychiatry, 13(1), 1. https://doi.org/10.1186/1471-244X-13-1

Marcus, M. D., Wing, R. R., & Lamparski, D. M. (1985). Binge consuming and dietary restraint in overweight sufferers. Addictive Behaviors, 10(2), 163–168. https://doi.org/10.1016/0306-4603(85)90022-X

Palavras, M. A., Kaio, G. H., Mari, J. de J., & Claudino, A. M. (2011). Uma revisão dos estudos latino-americanos sobre o transtorno da compulsão alimentar periódica. Brazilian Journal of Psychiatry, 33, s81–s94. https://doi.org/10.1590/S1516-44462011000500007

World Well being Group. (2025). Weight problems and chubby. https://www.who.int/news-room/fact-sheets/element/obesity-and-overweight

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