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Urbanisation and the incidence of eating disorders

Centre for Eating Disorders Ursula, Leidschendam, The Netherlands;

DAPHNE VAN HOEKEN, PhD

Parnassia Psychiatric Institute, The Hague, The Netherlands;

AAD I. M. BARTELDS, MD

Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands;

ERIC F. VAN FURTH, PhD

Centre for Eating Disorders Ursula, Leidschendam and Department of Psychiatry, Leiden University, Leiden, The Netherlands;

HANS W. HOEK, MD, PhD

Parnassia Psychiatric Institute, The Hague, Department of Psychiatry, Groningen University, Groningen, The Netherlands and Department of Epidemiology, Columbia University, New York, USA

Correspondence: G. van Son, Centre for Eating Disorders Ursula, PO Box 422, 2260 AK Leidschendam, The Netherlands. Tel: +31 (0)70 444 1444; email: g.vanson{at}centrumeetstoornissen.nl

Declaration of interest None.

The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose–response relation with degree of urbanisation and was five times higher in cities than in rural areas. Remarkably, anorexia nervosa showed no association with urbanisation. We conclude that urban life is a potential environmental risk factor for bulimia nervosa but not for anorexia nervosa. These findings provide a promising avenue for further research into the aetiology of eating disorders.

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