Anorexia nervosa affects roughly 0.6% to 1.6% of women and 0.1% to 0.3% of men over their lifetime. Applied to current global population figures, that translates to tens of millions of people worldwide living with the condition at some point in their lives. The numbers have climbed sharply in recent years, particularly among adolescents during and after the COVID-19 pandemic.
Lifetime Prevalence by Gender
Anorexia is far more common in women than men, though the gap varies depending on the study. The female-to-male ratio ranges from roughly 2:1 to as high as 10:1 across different eating disorders. For anorexia specifically, the best estimates place lifetime prevalence at 0.6% to 1.6% of women and 0.1% to 0.3% of men. In the United States alone, with a population over 330 million, those percentages mean somewhere between 1 and 4 million women and several hundred thousand men will experience anorexia at some point.
These numbers almost certainly undercount the real burden. Because most research has focused on female participants, male cases are poorly studied and frequently missed. Men with eating disorders often present differently, focusing on muscularity rather than thinness, which can delay recognition and diagnosis. Up to 5% of young women experience symptoms that fall just below the diagnostic threshold, and nearly 13% of adolescent girls report disordered eating patterns that could progress to a full diagnosis.
When Anorexia Typically Develops
The median age of onset is 18, but the distribution isn’t evenly spread. Research shows two distinct peaks. About 75% of cases fall into an early-onset group with a mean age around 16. The remaining cases cluster in a later-onset group averaging around 23 to 24 years old, with the dividing line falling at roughly age 22. The classic picture of anorexia as a disorder that begins in the mid-teen years is accurate for most people, but a significant minority develop it in their twenties or later.
On college campuses, where social pressures, life transitions, and stress converge, screenings reveal clinically significant eating behaviors in 4% to 13% of students. That rate is several times higher than the general population and reflects both new-onset cases and existing ones that worsen in that environment.
The COVID-19 Surge
The pandemic triggered a dramatic spike in eating disorder cases, especially among young people. Emergency department visits for new-onset eating disorders among adolescents jumped 170% above expected rates in 2021. For teens with pre-existing eating disorders, emergency visits surged even higher, reaching 238% above expected levels that same year. A pediatric center in Ontario, Canada documented a more than doubling of new anorexia diagnoses during the first year of the pandemic compared to prior years.
The numbers have come down since that 2021 peak, but they haven’t returned to pre-pandemic levels. As of 2023, emergency visits for new eating disorders among adolescents remained 37% above expected rates, and visits for pre-existing cases stayed 53% above expected. Social isolation, disrupted routines, increased social media use, and loss of access to treatment all contributed to this sustained increase.
Differences Across Race and Ethnicity
Anorexia has long been stereotyped as a condition affecting affluent white women, but the reality is more complicated. A large study of U.S. college students found that Indigenous students (American Indian, Alaska Native, or Native Hawaiian) had the highest odds of receiving an anorexia diagnosis, more than twice the odds of white students and nearly four times the odds of Black students. Biracial and multiracial students also had significantly elevated rates.
White students did have higher odds of diagnosis than Black, Hispanic/Latino, and Asian students, roughly 1.5 to 1.7 times higher. But these gaps may partly reflect differences in who gets screened and diagnosed rather than who actually develops the disorder. Clinicians are less likely to suspect eating disorders in people of color, and cultural barriers can delay help-seeking. The bottom line: anorexia occurs in every racial and ethnic group, and the populations most affected aren’t always the ones people expect.
Why Anorexia Is the Deadliest Mental Illness
Anorexia carries the highest mortality rate of any psychiatric disorder. A meta-analysis of 30 studies found that people with anorexia are about five times more likely to die during a given period than the general population of the same age and sex. That elevated risk comes from both the medical consequences of severe malnutrition, including heart failure, organ damage, and dangerous electrolyte imbalances, and from suicide.
The financial toll is substantial too. People with eating disorders pay nearly $1,900 more per year in healthcare costs than those without. When other mental health conditions are also present, which is common, the impact on employment and earnings grows dramatically. Those with both an eating disorder and a co-occurring condition like depression or anxiety earn roughly $19,000 less per year than their peers.
How Anorexia Is Diagnosed
A diagnosis requires three core features. First, the person restricts food intake enough to maintain a body weight significantly below what’s normal for their age, sex, and physical health. Second, they experience intense fear of gaining weight or engage in persistent behavior to prevent it, even when already underweight. Third, they have a distorted perception of their own body, place excessive importance on weight or shape in how they evaluate themselves, or fail to recognize the seriousness of their low weight.
Severity is graded by BMI in adults. A BMI of 17 or above is classified as mild, 16 to 16.99 as moderate, 15 to 15.99 as severe, and below 15 as extreme. Notably, the diagnostic criteria no longer require the loss of menstrual periods, a change that broadened recognition of the disorder in men, pre-adolescent girls, and women using hormonal contraception. For children and adolescents, BMI percentiles relative to age replace the fixed numbers used for adults.
The Gap Between Prevalence and Treatment
The lifetime prevalence figures, as striking as they are, capture only people who meet full diagnostic criteria. They don’t account for the much larger group with atypical anorexia, where all the psychological and behavioral features are present but the person’s weight hasn’t dropped below a clinical threshold. They also miss the millions with subclinical symptoms that cause real suffering without qualifying for a formal diagnosis. When you include the full spectrum of restrictive eating disorders and disordered eating, the number of people affected is many times larger than the headline statistics suggest.