A new study tracking more than half a million people in England offers one of the clearest pictures to date of the long-term health consequences of eating disorders.
The findings, published in BMJ Medicine, show that conditions such as anorexia, bulimia and binge eating disorder are linked to heightened risks across many organ systems and that these risks often remain elevated for years after diagnosis.
Researchers analyzed anonymized medical and hospital records for 24,709 people ages 10 to 44 who were diagnosed with an eating disorder between 1998 and 2018. Each person was matched with up to 20 individuals of the same age and sex who did not have an eating disorder, totaling more than 493,000 controls. Participants were followed for as long as 10 years.
Eating disorders are known to affect both physical and mental health, but this study highlights how wide-reaching those effects can be. Within the first year of diagnosis, people with eating disorders were significantly more likely to develop conditions including liver disease, renal failure, osteoporosis, heart failure and diabetes. They also had higher rates of depression and self-harm and a greater risk of death from both natural and unnatural causes.
The elevated risks did not disappear with time. Although they declined after the first year, many remained substantially higher than expected even after five or 10 years. The researchers note that these long-lasting patterns emphasize the need for long-term monitoring, not just short-term treatment during periods of acute illness.
“Our data describe the substantial long term effects of eating disorders and emphasise the potential opportunity for primary care to have a greater role in offering support and long term monitoring for individuals who are recovering from an eating disorder,” the study authors wrote. They also pointed to a gap in services for people whose needs fall between brief outpatient care and specialist-level treatment.
A linked editorial from clinicians at McMaster University echoed those concerns, noting that eating disorders often remain under-recognized in medical settings. They argue that medical training does not always prepare primary care providers to identify early warning signs or monitor long-term risks, despite being the clinicians most likely to see patients over time.
Because eating disorders affect many organ systems, including bone, cardiovascular, endocrine and renal health, the authors say care must be coordinated and ongoing. It is also important to note that this study reflects associations observed in large-scale medical records. The dataset did not include information on illness severity, making it impossible to identify which clinical features predict worse outcomes.
Still, the large size and long follow-up offer valuable insight. For individuals and families, the findings reinforce something many clinicians already emphasize: recovery from an eating disorder is not only about restoring eating patterns but also about monitoring long-term physical and emotional health. Early care matters, but continued support matters too.
If you or someone you love is struggling with disordered eating, reaching out to a qualified health care provider can be an important first step toward care and long-term support.
This research was supported by the UK National Institute for Health and Care Research.