No single country holds a definitive “#1” ranking for eating disorders, but the United States consistently reports among the highest rates in the world, alongside other wealthy Western nations like Australia, much of Western Europe, and parts of East Asia. The clearest pattern in global data is this: the wealthier and more developed a country is, the higher its eating disorder burden tends to be. A 2025 analysis covering 204 countries from 1990 to 2021 found a strong statistical correlation between a nation’s level of economic development, education, and income and its rates of eating disorder diagnoses, disability, and death.
Why Wealthy Nations Top the List
Researchers use something called the sociodemographic index, a composite measure of a country’s income, education levels, and fertility rates, to rank nations by overall development. Countries that score highest on this index, places like the United States, the United Kingdom, Australia, Canada, and Nordic countries, consistently bear the greatest eating disorder burden. The correlation is remarkably strong. Death rates from eating disorders track almost perfectly with national development levels, with a correlation coefficient of 0.87 out of a possible 1.0.
This doesn’t mean wealth causes eating disorders directly. Rather, wealthier societies tend to produce the conditions that fuel them: intense social pressure around appearance, widespread exposure to idealized body images through media, and high levels of competition and stress. At the same time, these countries have more healthcare infrastructure, which means more people get diagnosed and counted in the statistics. In lower-income countries, someone with the same condition may never see a doctor or receive a formal diagnosis.
Prevalence Rates in Western Countries
In Western nations, anorexia nervosa affects between 0.1% and 5.7% of women, depending on the country and how the study was designed. Bulimia nervosa ranges from 0.3% to 7.3% in women across Western populations. For men, bulimia rates range up to about 2.1%. These figures don’t include binge eating disorder, which is the most common eating disorder overall and pushes the total numbers higher still. In the United States alone, one person dies as a direct consequence of an eating disorder roughly every 52 minutes, and eating disorders carry the second-highest mortality rate of any psychiatric illness, behind only opioid addiction.
Non-Western countries report lower numbers. Bulimia rates in women outside the West range from about 0.46% to 3.2%. But these figures are rising, and they almost certainly undercount the true number of cases.
How Culture Shapes What Gets Counted
One of the biggest complications in comparing countries is that eating disorders don’t always look the same across cultures. In Hong Kong and India, for example, people with anorexia often don’t report a “fear of fatness” or desire to be thin, which is considered a defining feature of the condition in Western diagnostic systems. Instead, they may restrict food for religious reasons or based on unconventional beliefs about nutrition. Because the standard diagnostic criteria were built around Western experiences, people in other cultures can have serious, life-threatening eating behaviors that don’t technically meet the clinical definition.
Cultural attitudes toward body size also affect how visible eating disorders are. In many non-Western societies, a fuller body is associated with prosperity, fertility, and success. In such settings, the social pressure to be thin is weaker, and eating disorders genuinely appear to be less common, not just less reported. Societies that more tightly restrict women’s social roles also tend to have lower rates, suggesting that the pressure of navigating broad social expectations and competing identities plays a role in driving these conditions.
The Urban Factor
Within any given country, where you live matters. A study published in The British Journal of Psychiatry found that bulimia nervosa was five times more common in large cities than in rural areas. The relationship followed a clear dose-response pattern: the more urbanized the area, the higher the rate. Rural areas saw about 7 new cases per 100,000 women per year, urbanized areas saw roughly 17, and large cities saw about 26.
Interestingly, anorexia nervosa showed no such pattern. Rates were similar whether someone lived in a city or the countryside. This suggests that the two disorders respond to different environmental triggers. Bulimia may be more sensitive to the social comparison, media exposure, and lifestyle pressures concentrated in urban environments, while anorexia appears driven more by individual biological and psychological factors.
Rates Are Rising Globally
The gap between Western and non-Western countries is narrowing. As countries urbanize, gain internet access, and absorb Western media and beauty standards, their eating disorder rates climb. The Global Burden of Disease data shows that from 1990 to 2021, increases in disability from eating disorders tracked with rising development levels. Countries that were rapidly modernizing saw the steepest growth in their eating disorder burden over that period.
This trend means the question of “which country has the most eating disorders” is a moving target. Two decades ago, the answer pointed almost exclusively to the U.S. and Western Europe. Today, countries across East Asia, the Middle East, and Latin America are seeing meaningful increases, particularly among young women in cities. The core pattern holds: as a society grows wealthier and more connected to global media, eating disorders follow.