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Epidemiology and Population Health

Prevalence of obesity and comorbid eating disorder behaviors in South Australia from 1995 to 2015



Obesity and eating disorders are often studied and treated separately. While the increases in obesity prevalence are well known, examination of its co-occurrence with eating disorders, a problem also of public health concern, is important because eating disorder behaviors are known to contribute to obesity onset and maintenance, and vice versa.


Data from large cross-sectional representative statewide community samples of people in the years of 1995 (n=3001), 2005 (n=3047) and 2015 (n=3005) were analyzed. Data were collected using a structured, self-report interview that included demographic, health-related, weight, height and eating disorder behavior questions. Eating behavior questions assessed binge eating, very strict dieting/fasting and purging, and were derived from the Eating Disorder Examination. Logistic regression analyses were conducted comparing prevalence of obesity, eating disorder behaviors and their co-occurrence.


The prevalence of obesity or binge eating, or obesity with comorbid binge eating, each increased significantly from 1995 to 2005 (P<0.001 for each comparison) and continued to increase significantly from 2005 to 2015 (P<0.001 for each comparison). The highest increases from 1995 to 2015 were in the prevalence of obesity with comorbid binge eating (7.3-fold), or obesity with comorbid very strict dieting/fasting (11.5-fold). The prevalence of very strict dieting/fasting also increased significantly from 1995 to 2015 (3.8-fold). The prevalence of purging, or obesity with comorbid purging, did not change significantly from 1995 to 2015.


There were statewide increases during the 20 years from 1995 to 2015 in the independent prevalence of obesity, binge eating and very strict dieting/fasting, and even higher increases in the prevalence of obesity with comorbid binge eating, and obesity with comorbid very strict dieting/fasting. These findings support the need for more integrated approaches to both the prevention and treatment of obesity and eating disorder behaviors, namely binge eating and very strict dieting/fasting.

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This work was supported by the CAPES Foundation, Ministry of Education of Brazil, via a postgraduate scholarship to FQdL, and via the National Health and Medical Research Council (NHMRC) of Australia via a Project Grant and Senior Research Fellowship to AS. The costs of the Health Omnibus Survey questions specific to the present study were funded by internal research grants to PH from the University of Adelaide, James Cook University and Western Sydney University. AS has received payment from Eli Lilly, the Pharmacy Guild of Australia, Novo Nordisk and the Dietitians Association of Australia for seminar presentation at conferences, and has served on the Nestle Health Science Optifast VLCD Advisory Board since 2016. She is also the author of The Don’t Go Hungry Diet (Bantam, Australia and New Zealand, 2007) and Don’t Go Hungry For Life (Bantam, Australia and New Zealand, 2011). ST receives royalties from Hogrefe and Huber, and McGraw-Hill Publishers, and has also been the recipient of an honorarium from Shire Pharmaceuticals. PH receives royalties from Hogrefe and Huber, McGraw-Hill, PLoS Medicine and BioMed Central publishers.

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Correspondence to F Q da Luz.

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da Luz, F., Sainsbury, A., Mannan, H. et al. Prevalence of obesity and comorbid eating disorder behaviors in South Australia from 1995 to 2015. Int J Obes 41, 1148–1153 (2017).

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