Prevalence of eating disorders in South Asian countries: a systematic analysis of Global Burden of Disease (1990-2021)

Prakasini Satapathy; Vijay Kumar; Mahalaqua Nazli Khatib; Lalji Baldaniya; Suhas Ballal; V Kavitha; Laxmidhar Maharana; Renu Arya; Ganesh Bushi; Muhammed Shabil; Rukshar Syed; Manika Gupta; Sunil Kumar; Sabah Ansar; Sanjit Sah; Diptismita Jena; Edward Mawejje

doi:10.1007/s40519-025-01746-z

Prevalence of eating disorders in South Asian countries: a systematic analysis of Global Burden of Disease (1990-2021)

Eat Weight Disord. 2025 Apr 26;30(1):37. doi: 10.1007/s40519-025-01746-z.

Authors

Prakasini Satapathy^#^{1

2}, Vijay Kumar^#³, Mahalaqua Nazli Khatib^#⁴, Lalji Baldaniya⁵, Suhas Ballal⁶, V Kavitha⁷, Laxmidhar Maharana⁸, Renu Arya⁹, Ganesh Bushi¹⁰, Muhammed Shabil^{11

12}, Rukshar Syed¹³, Manika Gupta¹⁴, Sunil Kumar¹⁵, Sabah Ansar¹⁶, Sanjit Sah^{17

18

19}, Diptismita Jena^{20

21}, Edward Mawejje²²

Affiliations

¹ University Center for Research and Development, Chandigarh University, Mohali, Punjab, India.
² Faculty of Data Science and Information Technology, INTI International University, Nilai, Malaysia.
³ Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
⁴ Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India.
⁵ Marwadi University Research Center, Department of Pharmaceutical Sciences, Faculty of Health Sciences, Marwadi University, Rajkot, Gujarat, 360003, India.
⁶ Department of Chemistry and Biochemistry, School of Sciences, JAIN (Deemed to Be University), Bangalore, Karnataka, India.
⁷ Department of Chemistry, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, India.
⁸ Department of Pharmaceutical Sciences, Siksha 'O' Anusandhan (Deemed to Be University), Bhubaneswar, Odisha, 751030, India.
⁹ Department of Pharmacy, Chandigarh Pharmacy College, Chandigarh Group of Colleges-Jhanjeri, Mohali, Punjab, 140307, India.
¹⁰ School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India.
¹¹ Noida Institute of Engineering and Technology (Pharmacy Institute), Greater Noida, India.
¹² Medical Laboratories Techniques Department, AL-Mustaqbal University, 51001, Hillah, Babil, Iraq.
¹³ IES Institute of Pharmacy, IES University, Bhopal, Madhya Pradesh, 462044, India.
¹⁴ New Delhi Institute of Management, Tughlakabad Institutional Area, New Delhi, India.
¹⁵ Department of Microbiology, Graphic Era (Deemed to Be University), Clement Town, Dehradun, 248002, India.
¹⁶ Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, 11433, Riyadh, Saudi Arabia.
¹⁷ Department of Paediatrics, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed-to-Be-University), Pimpri, Pune, Maharashtra, 411018, India.
¹⁸ Department of Public Health Dentistry, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed-to-Be-University), Pimpri, Pune, 411018, Maharashtra, India.
¹⁹ Department of Medicine, Korea University, Seoul, South Korea.
²⁰ Centre of Research Impact and Outcome, Chitkara University, Rajpura, Punjab, 140417, India.
²¹ University of Cyberjaya, Persiaran Bestari, Cyber 11, 63000, Cyberjaya, Selangor Darul Ehsan, Malaysia.
²² School of Public Health, Makerere University College of Health Sciences, Mulago Hill, Kampala, Uganda. emawejje62@gmail.com.

^# Contributed equally.

Abstract

Background: Eating disorders (EDs) have traditionally been viewed as a Western phenomenon, but their prevalence in South Asia has risen due to urbanization, globalization, and Westernized beauty ideals. This systematic analysis examines trends and prevalence of Anorexia nervosa (AN) and Bulimia nervosa (BN) using the Global Burden of Disease (GBD) data from 1990 to 2021.

Methods: This analysis used data from the GBD study on age-standardized prevalence rates (ASPRs) for AN and BN, as well as their total percentage changes (TPCs) from 1990 to 2021. Trends were analyzed using Joinpoint regression to identify changes over time and calculate annual percent changes (APCs) and average annual percent changes (AAPCs). Geospatial patterns and temporal changes were visualized using QGIS software. The correlation between the Sociodemographic Index (SDI) and the DALY rate was assessed using R software.

Results: The ASPR of EDs increased significantly from 1990 to 2021, with BN peaking in the 20-24 age group and AN in the 15-19 and 20-24 age groups. Females exhibited the highest rates of increase, while notable rises were also observed in males. Bhutan recorded the highest ASPR for both AN and BN, with varying temporal percentage changes across countries. A significant positive correlation was found between the SDI and DALY rates across 21 global regions, with anorexia nervosa showing the strongest correlation (r = 0.75, p < 0.001).

Conclusions: The rising burden of EDs in South Asia underscores an urgent need for culturally sensitive prevention strategies and public health policies. Targeted interventions addressing sociocultural drivers are essential to mitigate the growing impact of EDs in this region.

Level of evidence: Level V, Descriptive study.

Keywords: Appetite disorders; Binge-eating disorder; Food addiction; Global Burden of Disease; South Asia.

MeSH terms

Adolescent
Adult
Anorexia Nervosa* / epidemiology
Asia / epidemiology
Bulimia Nervosa* / epidemiology
Feeding and Eating Disorders* / epidemiology
Female
Global Burden of Disease* / trends
Humans
Male
Prevalence
Young Adult