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Time Trends in Age at Onset of Anorexia Nervosa and Bulimia Nervosa

J Clin Psychiatry 2009;70(12):1715-1721
10.4088/JCP.09m05176blu

Objective: This study aims to explore the time trends in age at onset of anorexia nervosa and bulimia nervosa.

Method: The sample was composed of 1,666 anorexia nervosa subjects and 793 bulimia nervosa subjects (according to DSM-IV criteria) without previous anorexia nervosa consecutively referred to our outpatient unit in the period between 1985 and 2008. Time trends in illness onset were analyzed according to the year of birth of subjects.

Results: In both anorexia nervosa and bulimia nervosa, age at onset showed a significant decrease according to year of birth. A regression model showed a significant independent effect of socioeconomic status, age at menarche, and number of siblings in predicting age at onset lower than 16 years.

Conclusion: Age at onset of anorexia nervosa and bulimia nervosa is decreasing in younger generations. The implications of our findings in terms of long-term outcome remain to be understood. Biologic and sociocultural factors explaining this phenomenon need to be explored in future studies.


Submitted: February 28, 2009; accepted March 25, 2009.

Corresponding author: Paolo Santonastaso, MD, Clinica Psichiatrica, Dipartimento di Neuroscienze via Giustiniani 3, 35128 Padova, Italy (paolo.santonastaso@unipd.it).