Binge eating and purging can have an obvious impact on medical health. Problems can arise with the heart, teeth, digestive system, and kidneys leading to long-term medical issues and, in the worst cases, death. In the face of all these medical issues, the risk of death by suicide is often overlooked. A new study released online this week investigated the unique contribution of bulimia in suicide risk.
Suicide is most often discussed in relation to mood disorders like depression and bipolar disorder. Many people with eating disorders also suffer from mood disorders making it difficult to tease apart if eating disorders independently contribute to suicide risk. A group of researchers from Florida State University examined this question in a study soon to be published in the Journal of Psychiatric Research.
The researchers examined data collected on college students from the 1990s and early 2000s. The students in the study completed interviews to assess their mental health diagnosis. Among those diagnosed with an eating disorder, over 2/3 met criteria for another disorder (e.g. depression, anxiety, drug addiction) The students were also asked if they had ever considered suicide, made plans to commit suicide, or attempted to commit suicide.
Among all the students with an eating disorder history, 27.9% reported experiencing serious suicidal thoughts, forming specific plans, or attempting suicide. The highest rates of suicidal risk were among people suffering from bulimia (45.2%), followed by anorexia (34.6%), and eating disorder not otherwise specified (includes binge eating, 27.9%).
Based on interview responses, researchers were able to focus on students suffering from eating disorders, but not mood disorders, who had serious thoughts of suicide. They found that bulimia was strongly associated with suicide risk even after taking into account other disorders in statistical models. This wasn’t the case for anorexia or eating disorder not otherwise specified. Though another study did find higher rates of completed suicide among people suffering from anorexia vs bulimia.
Given the strong relationship between bulimia and suicidality, it’s clearly important to talk more about any thoughts of suicide. Health providers can be more conscious of suicide risk in treatment, family members can gently ask questions, and people with bulimia should remember they aren’t alone in thoughts of suicide and can reach out for help.
Dr. Gupta is a professor at Barnard College of Columbia University and provides individual therapy at Tribeca Psychology
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