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Comorbidity between types of eating disorder and general medical conditions

Published online by Cambridge University Press:  23 July 2021

Natalie C. Momen*
Affiliation:
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark
Oleguer Plana-Ripoll
Affiliation:
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark
Cynthia M. Bulik
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; and Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
John J. McGrath
Affiliation:
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; and Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia; and Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Queensland, Australia
Laura M. Thornton
Affiliation:
Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Zeynep Yilmaz
Affiliation:
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark; and Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; and Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Liselotte Vogdrup Petersen
Affiliation:
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; and Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
*
Correspondence: Natalie C. Momen. Email: ncm@econ.au.dk

Abstract

Background

Comorbidity with general medical conditions is common in individuals with eating disorders. Many previous studies do not evaluate types of eating disorder.

Aims

To provide relative and absolute risks of bidirectional associations between (a) anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified and (b) 12 general medical conditions.

Method

We included all people born in Denmark between 1977 and 2010. We collected information on eating disorders and considered the risk of subsequent medical conditions, using Cox proportional hazards regression. Absolute risks were calculated using competing risks survival analyses. We also considered risks for prior medical conditions and subsequent eating disorders.

Results

An increased risk was seen for almost all disorder pairs (69 of 70). Hazard ratios for those with a prior eating disorder receiving a subsequent diagnosis of a medical condition ranged from 0.94 (95% CI 0.57−1.55) to 2.05 (95% CI 1.86−2.27). For those with a prior medical condition, hazard ratios for later eating disorders ranged from 1.35 (95% CI 1.26–1.45) to 1.98 (95% CI 1.71–2.28). Absolute risks for most later disorders were increased for persons with prior disorders, compared with reference groups.

Conclusions

This is the largest and most detailed examination of eating disorder–medical condition comorbidity. The findings indicate that medical condition comorbidity is increased among those with eating disorders and vice versa. Although there was some variation in comorbidity observed across eating disorder types, magnitudes of relative risks did not differ greatly.

Type
Paper
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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