50-year trends in the incidence of anorexia nervosa in Rochester, Minn.: a population-based study

TLDR

The study aimed to quantify incidence and prevalence of anorexia nervosa and its 50‑year trends among Rochester residents from 1935 to 1984. Researchers screened 13,559 medical records for diagnostic criteria and identified 181 confirmed cases of anorexia nervosa. Incidence among girls 10‑19 followed a quadratic pattern, dropping from 16.6 to 7.0 to 26.3 per 100,000 person‑years, while rates for women 20+ and males remained stable, a linear rise was seen in females 15‑24, and overall age‑adjusted incidence was 14.6 (females) versus 1.8 (males) with prevalence 269.9 versus 22.5 per 100,000, indicating anorexia nervosa is more common than previously thought and a frequent chronic illness in adolescent girls.

Abstract

The aim of the study was to determine incidence and prevalence rates and long-term trends in incidence of anorexia nervosa by identifying all persons residing in the community of Rochester, Minn., during the 50-year period 1935 through 1984 who had the disorder.From a community-based epidemiologic resource, 13,559 medical records with diagnoses of amenorrhea, starvation, weight loss, anorexia nervosa, or other conditions were screened to identify true cases of anorexia nervosa determined by using standard diagnostic criteria.One hundred eighty-one residents (166 female and 15 male) fulfilled the diagnostic criteria for anorexia nervosa; these were the incidence cases. Due to a quadratic trend in the rates for girls 10-19 years old, the incidence rate among female residents fell from 16.6 per 100,000 person-years in the 1935-1939 period to a low of 7.0 in 1950-1954 and increased to 26.3 in 1980-1984. The incidence rates for women 20 years old and older and for males remained constant. For females 15-24 years old, there was a linear increase. The overall age-adjusted incidence rate per 100,000 person-years was 14.6 for females and 1.8 for males. The prevalence rate per 100,000 population was 269.9 for females and 22.5 for males.Anorexia nervosa is more common than previously recognized. Among girls 15-19 years old it is a very common chronic illness. Its incidence has increased among females 15-24 years old but not among older women or among males.