Krug · Clinical psychology review 2025 · systematic review and meta-analysis of observational studies · n=?

A meta-analysis of mortality rates in eating disorders: An update of the literature from 2010 to 2024.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational cohort studies reporting standardized mortality ratios

PubMed 39889307 · doi:10.1016/j.cpr.2025.102547 · record verified 2026-08-26

What was done

Authors conducted a systematic review and meta-analysis of studies published from 2010 to October 29, 2024, across four databases (PsycINFO, MEDLINE, Embase, Web of Science). Studies reporting standardized mortality ratios (SMRs) in individuals with diagnosed eating disorders (formal diagnoses and self-reports) were included. Random-effects meta-analyses and meta-regression were performed.

What was found

Meta-analysis of effect sizes showed significantly elevated mortality across eating disorders: weighted SMR = 3.39 (95% CI: 2.90 to 3.95), p < .001, with high heterogeneity (I² = 95.1%, Q(df=73) = 1492.39, p < .001). Subgroup SMRs were: anorexia nervosa 5.21 (k = 30), eating disorder not otherwise specified 2.51 (k = 8), bulimia nervosa 2.20 (k = 18), and binge eating disorder 1.46 (k = 3).

Why it matters

This provides an updated 15-year synthesis of mortality risk across eating disorder diagnoses, confirming substantially elevated premature mortality especially among individuals with anorexia nervosa.

Limits

The total number of participants is not reported in the abstract. Statistical heterogeneity across studies was extremely high (I² = 95.1%). Inclusion criteria allowed self-reported diagnoses alongside clinical diagnoses, and the evidence base for binge eating disorder was limited to only three effect sizes (k = 3).