The association between eating disorders and mental health: an umbrella review

OBJECTIVE: There have been an increasing number of systematic reviews indicating the association between eating disorders (ED), including its risk factors, with mental health problems such as depression, suicide and anxiety. The objective of this study was to conduct an umbrella review of these reviews and provide a top-level synthesis of the current evidence in this area. METHOD: A systematic search was performed using four databases (MEDLINE Complete, APA PyscInfo, CINAHL Complete and EMBASE). The inclusion criteria were systematic reviews (with or without meta-analysis), published in the English language between January 2015 and November 2022. The quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal tools for use of JBI Systematic reviews. RESULTS: A total of 6,537 reviews were identified, of which 18 reviews met the inclusion criteria, including 10 reviews with meta-analysis. The average quality assessment score for the included reviews was moderate. Six reviews investigated the association between ED and three specific mental health problems: (a) depression and anxiety, (b) obsessive-compulsive symptoms and (c) social anxiety. A further 3 reviews focused on the relationship between ED and attention deficit hyperactivity disorder (ADHD) while 2 reviews focused on ED and suicidal-related outcomes. The remaining 7 reviews explored the association between ED and bipolar disorders, personality disorders, and non-suicidal self-injury. Depression, social anxiety and ADHD are likely to have a stronger strength of association with ED relative to other mental health problems. DISCUSSION: Mental health problems such as depression, social anxiety and ADHD were found to be more prevalent among people suffering from eating disorders. Further research is necessary to understand the mechanism and health impacts of potential comorbidities of ED. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40337-022-00725-4.