Eating Disorders, 3 Million Patients in Italy, 8 Out of 10 Are Women

In Italy, over 3 million people live with an eating disorder, including anorexia, bulimia, and binge eating disorder. Anorexia nervosa alone affects approximately 1% of the population, with over 540,000 cases, 90% of which are women. According to the Istituto Superiore di Sanità, the most frequent age of onset is between 15 and 25 years old, but cases among minors are increasing: during the first half of 2020, new diagnoses of eating disorders grew by 40% compared to the previous year.

Even in Europe the picture is worrying: the prevalence in children reaches 2%, the highest globally. Numbers that highlight the urgency of an approach based on solid clinical foundations and not influenced by media simplifications or ideological narratives. In view of World Eating Disorders Day, which is held on June 2 throughout the world, the Italian Society of Psychiatry (SIP) invites us to bring attention back to the complexity of eating disorders, which for too long have been reduced to "cultural" problems or mere body image.

Body positivity against stereotypes

“In recent years,” observes Liliana Dell’Osso , psychiatrist and president of SIP, “media attention has grown and campaigns to combat aesthetic stereotypes and negative social stimuli have multiplied. However, this communicative impetus has often generated confusion, overlapping different concepts – health and politics, disease and culture, nature and environment – ​​and neglecting the clinical-biological basis of the disease. A clear example is the body positivity movement where the just fight against aesthetic stereotypes has merged with the principle of inclusiveness, but risking unknowingly encouraging incorrect behavior or hindering access to care.”

Mental and physical health

It is therefore essential to find a balance between mental health and physical health. “Excessive body weight, for example,” she explains, “should not be a cause for shame or social exclusion, but should still be corrected to prevent metabolic and cardiovascular complications, which can sometimes be serious.” Another risk is represented by so-called “ideological alibis,” which can legitimise extreme pathological conditions – both in excess and in defect – hindering awareness and access to therapies. In particular, the SIP president underlines how an exclusively environmental vision of eating disorders has overshadowed a determining factor: individual neurobiological vulnerability. “In many patients, traits of the autistic spectrum are observed, such as mental rumination on narrow interests,” explains Dell’Osso. “In girls, these aspects often go unnoticed due to social camouflage strategies.”

Anorexia

Even clinical history shows that eating disorders are not a “product of modern society”. Symptoms and behaviors compatible with anorexia are documented in different eras and cultural contexts, demonstrating that not everything can be traced back to the aesthetic models imposed by contemporaneity. “Just as not everyone develops a post-traumatic disorder after a stressful event – ​​concludes Dell'Osso – in the same way, not everyone reacts to environmental stimuli with an eating disorder. Greater awareness of individual vulnerability factors is needed, to ensure early diagnosis and more effective treatments”.