The global prevalence of eating disorders in children and young people: a systematic review and meta-analysis

Abstract The increase in eating disorder (ED) presentations among children and young people (CYP) during the Covid-19 pandemic represents a global health concern, given the associated morbidity and mortality associated with these conditions. We conducted a meta-analysis to estimate the worldwide pooled prevalence of EDs in CYP at a population level. We searched MEDLINE, EMBASE, PsycINFO and LILACS for all English-language studies reporting population level ED prevalence data between January 2013 to February 27th, 2024. The primary outcome was overall prevalence of EDs. We used a random-effects model for the meta-analysis, I 2 statistics to assess heterogeneity, and the Hoy scale for quality assessment. This study is registered with PROSPERO, number CRD42022333223. Sixteen studies including 77,714 children and young people from 12 countries met eligibility criteria and were included in the systematic review, whilst twelve studies with 56,758 participants provided data suitable for inclusion in the meta-analysis. Study quality was moderate; ten studies were classified with a low risk of bias, one with moderate and five with high. The global point prevalence for any ED was 5.23% (95% confidence interval (CI) 0.41 to 10.05, I 2 = 99.95%). The commonest type was Other Specified Feeding or ED (point prevalence of 4.88%, 95% CI 1.46 to 8.30, I 2 = 99.42%), which, like all types of ED was more common among girls (5.25%, 95% CI 0.32 to 10.18, I 2 = 99.69%) than boys (3.97%, 95% CI 0.45 to 7.49, I 2 = 97.77%), although confidence intervals overlapped. Our findings illustrate the urgent need to expand service provision as well as to evaluate and develop strategies for early ED identification in children and young people, given a global prevalence of 1 in 20.