Trends in the burden of eating disorders in Pakistan over the past three decades: A joinpoint regression analysis

Background: Eating is one of the most and foremost necessities of life. Eating is necessary for a being for growth, development, and maintenance of body and body system. However, a variety of problems are associated with eating, in which eating disorder is of the most common. Anorexia nervosa and bulimia nervosa are two most potential eating disorders mostly prevailing in youth of developing countries like Pakistan. A better understanding of its incidence is a basic requirement for improving its management. However, the temporal trend of eating disorder incidence in Pakistan is still unknown. Methods: The age- and gender-specific incidence and prevalence rates of eating disorders and their subtypes, anorexia nervosa and bulimia nervosa, from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 database. The annual percentage change and average annual percentage changes were calculated using joinpoint regression analysis to observe the trends in the incidence and prevalence rates of eating disorders and their subtypes in Pakistan over the past three decades. Results: From 1990 to 2019, age-standardized incidence rates (ASIRs) and age-standardized prevalence rates (ASPRs) of eating disorders continued to increase in both males and females, and similar trends were observed in anorexia nervosa and bulimia nervosa. ASIR of eating disorders and bulimia nervosa was higher among males as compared to females, during mentioned time frame, but it was reversed in the case of anorexia nervosa where ASIR was higher among females as compared to males. However, ASPRs of eating disorders including both the anorexia nervosa and bulimia nervosa, was higher among females as compared to males. Joinpoint regression analysis showed that the incidence rates and prevalence rates have increased in all age groups. 15-19 and 20-24 years' age groups are having the highest incidence rates of eating disorders, anorexia nervosa and bulimia nervosa, for both males and females. Conclusion: Eating disorder burden continues to rise in Pakistan, particularly among adolescents and young adults. Further etiological studies are required to explain these increases and to facilitate the early identification of high-risk individuals.