Age- and Sex-Specific Incidence Trends of Eating Disorders in South Korea: Insights From a Decade of National Health Insurance Data (2012-2021)

Abstract

Objective Research on the incidence trends of eating disorders remains limited in Asia. This study aims to analyze the annual incidence rates and incident case characteristics in the Korean general population.Method The National Health Insurance Service database was used to examine the incidence rates of eating disorders from 2012 to 2021. A total of 34,615 patients with incident eating disorders aged 0-49 years were analyzed. Comorbidity and medication analyses used a 2013-2020 subset. Linear regression analyses and Mann-Kendall trend tests were conducted to examine temporal trends across age and sex. Chi-square and Wilcoxon rank-sum tests were applied for epidemiological and clinical characteristics of the 0-19 and >= 20 age groups.Results Adults' annual incidence rates increased over the study period (tau = 0.689, p = 0.007). The 20-24 age group had the highest incidence (16.75-38.38 per 100,000 person-years). Individuals aged 0-19 years showed a stable incidence rate (tau = 0.244, p = 0.371), although males aged 0-19 years demonstrated a decreasing trend (B = -0.272, SE = 0.091, p = 0.018, 95% CI = [-0.483, -0.061]). Mood and anxiety disorders were the most frequent comorbidities. The 0-19 age group more frequently utilized tertiary healthcare institutions. Antidepressants were prescribed more frequently than antipsychotics. Fluoxetine and aripiprazole were the most common antidepressant and antipsychotic, respectively.Discussion The findings show distinct age- and sex-specific patterns in eating disorder incidence, underscoring the need for a tailored approach. Worldwide differences may offer etiological insights. A limitation is the aggregation of eating disorder subtypes.