Abstract
PURPOSE: Eating disorders (EDs) among women of childbearing age (WCBA; defined by the World Health Organization as women aged 15-49 years) have emerged as a significant public health concern on a global scale. This study aims to explore the patterns and trends of EDs-specifically anorexia nervosa (AN) and bulimia nervosa (BN), as defined by the Global Burden of Disease (GBD) 2021-among WCBA from 1990 to 2021. METHODS: Using data from the GBD Study 2021, we quantified the disease burden using disability-adjusted life years (DALYs) and age-standardized DALY rates (ASDR). Temporal trends were assessed via the estimated annual percentage change (EAPC). Relationships between socioeconomic development and burden were evaluated using Spearman's correlation with the Sociodemographic Index (SDI). Future trends were projected using a Bayesian Age-Period-Cohort (BAPC) model. RESULTS: In 2021, the global burden of EDs in WCBA reached 2,035,736 DALYs (95% UI: 1,229,250-3,188,529). From 1990 to 2021, the global ASDR rose from 93.45 to 106.05 per 100,000 population, with an EAPC of 0.48 (95% CI 0.44-0.52). BN consistently imposed a higher burden than AN. ASDR was positively correlated with SDI (r = 0.808, P < 0.001), with high-SDI regions exhibiting the highest burden, while the middle-SDI quintile and the East Asian region showed the most rapid increases. By 2035, the global ASDR is projected to reach 109.84, with peak burdens shifting toward the 20-29 age group. CONCLUSIONS: The global burden of EDs among WCBA is substantial and increasing, particularly in rapidly urbanizing and high-income regions. Given the intersection of EDs with reproductive health, integrated screening within obstetric and gynecological care is urgently needed. Public health strategies should prioritize BN and regions undergoing rapid socioeconomic transition to mitigate this escalating crisis. Level of evidence Level IV, evidence obtained from multiple time series (descriptive time-trend analysis).