Table 1 Summary of included reviews

Álvarez Ruiz et al., [25]

Eating disorder (ED) particularly bulimia nervosa and binge eating disorder

Bipolar disorders (BD)

Systematic review

18 studies on ED in patients with BD,

8 studies on BD in patients with ED

General population

(n = 7,750, age range = not reported,

sex = males and females)

N/A

High comorbidity of bipolar disorder and ED, particularly of bulimia nervosa and binge eating disorder. However, further research needed to determine assessment, treatment and disease etiology.

45%

Baskin & Galligan, [17]

Disordered eating

Depressive and anxiety symptoms, obsessive compulsive symptoms

Systematic review

11 prospective cohort and 14 cross sectional / retrospective studies

Pregnant and post-partum period women (n = 318,049, age range = not reported, sex = females)

N/A

Strong evidence for association between disordered eating and depression and anxiety symptoms during pregnancy. Limited evidence for association between disordered

eating and obsessive-compulsive symptoms during pregnancy for association between

disordered eating and depressive symptoms during the post-partum period.

81%

Conti et al., [8]

Binge eating disorder (BED)

Suicidality (i.e. suicidal ideation or attempted and/or committed suicide)

Systematic review

12 cross-sectional studies

5 longitudinal studies

General population

(n = 71,610,

age range = not reported but generally involved adolescents and adults,

sex = males and females)

N/A

BED was significantly associated with higher risk of suicidal behaviors (SB) and suicidal ideation (SI). The correlation between BED and suicide risk is important but there was a lack of studies investigating the size impact of BED on suicide risk.

72%

Cucchi et al., [28]

Eating disorders (ED), anorexia nervosa (AN) and bulimia nervosa (BN)

Non-suicidal self-injury (NSSI)

Systematic review with meta-analysis component

29 studies

General population (n = 6,575,

age range = 16–30 years old,

sex = males and females)

Any ED diagnosis:

Prevalence of NSSI = 27.3% (23.8–31.0%)

AN diagnosis only: Prevalence of NSSI = 21.8% (18.5–25.6%)

BN diagnosis only: Prevalence of NSSI = 32.7% (26.9–39.1%)

Lifetime history of NSSI is highly prevalent among adolescents and young adults with ED, and correlates positively with a history of suicidal attempt.

72%

Drakes et al., [31]

Eating disorders

Obsessive-compulsive disorder

Systematic review with meta-analysis component

59 studies

General population

(n = unclear,

age range = 12–60 years,

sex = males and females)

Aggregate lifetime and current prevalence of obsessive-compulsive disorder was 13.9% [95% CI 10.4, 18.1] and 8.7% [95% CI 5.8, 11.8] respectively across EDs

Obsessive-compulsive disorder is prevalent among individuals with a primary diagnosis of eating disorder.

72%

Farstad et al., [29]

Eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN)

Personality disorders (PDs)

Systematic review with meta-analysis component

14 studies

General population (nn= 1,884, age range = not reported, sex = males and females)

Pooled prevalence rates ranged from 0% (0–4%) (schizoid) to 30% (0–56%) (obsessive-compulsive) in individuals with ED

Avoidant and obsessive-compulsive PDs were associated with restricting AN and binge-eating disorder while borderline and paranoid PDs were associated with binge-eating/purging AN, BN and other EDs.

63%

Fornaro et al., [26]

Eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED)

Bipolar disorder (BD)

Systematic review with meta-analysis component

47 studies

General population (n = 15,146,

age range = not reported, sex = males and females)

BED occurred in 12.5% (95%C.I.=9.4–16.6%) of BD cases. BD occurred in 9.1% (95%C.I.=3.3–22.6%) of BED cases.

BN occurred in 7.4% (95%C.I.=6–10%) of

BD cases. BD occurred in 6.7% (95%C.I.=12-29.2%) of BN cases.

AN occurred in 3.8% (95%C.I.=2–6%) of BD cases. BD occurred in 2% (95%C.I.=1–2%) of AN cases.

The comorbidity between ED and BD was present in a considerable number of patients.

72%

Goldstein & Gvion, [27]

Anorexia nervosa (AN) and bulimia nervosa (BN)

Suicidality (i.e. suicidal ideation or attempted and/or death by suicide)

Systematic review

36 cross sectional studies

2 longitudinal studies

General population (nn= 2,321,441, age range = not reported, sex = males and females)

N/A

AN and BN were associated with an increased risk of suicidal behaviours and ideation.

63%

Kaisari et al., [22]

Disordered eating behavior

Attention Deficit Hyperactivity Disorder (ADHD)

Systematic review

72 studies including 37 cross sectional studies, 11 case-control studies, 6 cohort studies, 7 longitudinal studies, 2 secondary analysis of the National Longitudinal study of Adolescent Health, 3 experimental studies, 3 retrospective studies, 5 prospective studies and 1 epidemiological study

General population (n = 115,418, age range = unclear but includes children, adolescents and adults, sex = males and females)

N/A

Positive association between ADHD and disordered eating. Impulsivity symptoms of ADHD were positively associated with overeating in anorexia nervosa and bulimia nervosa. Further research is needed to determine the direction of relationship and underlying mechanisms.

90%

Kerr-Gaffney et al. [11]

Eating disorders (ED), including anorexia nervosa (AN) and bulimia nervosa (BN)

Social anxiety disorder (SA)

Systematic review with meta-analysis component

38 cross-sectional studies, 12 included in meta-analysis

General population (n = 8,501,

age range = 12–45 years old, sex = males and females)

AN diagnosis: d = 1.65 (1.03–2.27)

BN diagnosis: d= 0.71 (0.47–0.95)

Significant differences of AN and BN between ED groups and healthy controls. High levels of SA are associated with more severe form of ED.

81%

Levin & Rawana, [12]

Eating disorders (ED), including

disordered eating, anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED)

Attention-deficit/hyperactivity disorder (ADHD)

Systematic review

37 studies, including 27 cross sectional studies.

General population (n = 74,852 participants, age range = 5–49 years old, sex = males and females)

N/A

Childhood ADHD increases the risk of disordered eating or developing ED in later life.

72%

Lloyd et al., [18]

Anorexia Nervosa (AN)

Anxiety

Systematic review

8 studies, including 4 retrospective case control studies and 4 prospective cohort studies

General population (n = 1,670,312, age range = unclear,

sex = males and females)

N/A

Anxiety disorder diagnosis in general may predict increased anorexia nervosa risk. However, longitudinal associations between specific anxiety disorders and subsequent AN onset unclear.

81%

Mandelli et al., [32]

Eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED)

Obsessive-compulsive disorder

Systematic review with meta-analysis component

32 studies

General population (n = unclear,

mean age range = 15–45 years, sex = males and females

Lifetime and current comorbidity rates: 19% and 14% in AN patients; 13% and 9% in BN patients.

Higher lifetime estimates based on prospective follow up studies: 44% in AN patients; 19% in BN patients.

OCD comorbidity in EDs is a significant phenomenon, affecting almost one fifth of the patients in cross-sectional observations and up to nearly 40% in prospective follow-up studies.

81%

Miller et al., [30]

Eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED)

Border personality disorder (BPD) symptoms

Systematic review with meta-analysis component

122 studies

General population (n = unclear,

age range = 12 years and above, sex = males and females

Affective instability was the BPD symptom most elevated, while anger was the BPD symptom least elevated, in patients with EDs compared to controls.

Nine symptoms of borderline personality disorder were significantly elevated in patients with EDs compared to controls. Certain symptoms of BPD play a more prominent role in the comorbidity between BPD and EDs than others.

Nazar et al., [24]

Eating disorders (ED), including anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED)

Attention-Deficit/Hyperactivity disorder (ADHD)

Systematic review with meta-analysis component

17 studies

General population (n = 38,421, age range = 9–44 years old, sex = males and females)

Pooled effect

ED diagnosis in ADHD: OR = 3.82 (2.34–6.24)

AN diagnosis in ADHD: OR = 4.28 (2.24–8.16)

BN diagnosis in ADHD: OR = 5.71 (3.56–9.16)

BED diagnosis in ADHD: OR = 4.13 (3-5.67)

ADHD diagnosis in ED: OR = 2.57 (1.30–5.11)

The risk having an ED for individuals with ADHD is increased three-fold and the risk of having ADHD for individuals with ED is increased by two-fold.

90%

Nicholls et al., [19]

Binge eating disorder (BED)

Emotions and eating behavior

Systematic review

15 studies, with

13 studies reported on adults and 2 studies reported on children

General population (n = 2,858,

age range = 10–47 years old,

sex = males and females)

N/A

Depression was consistently associated with binge eating. Negative mood was found to be an antecedents of binge eating within an adult BED-obese sample. However, findings were mixed regarding the role of stress, anger, and positive emotions.

72%

Puccio et al., [20]

Eating pathology

Depression

Systematic review with meta-analysis component

42 studies assessing longitudinal relationship between eating pathology and depression

General population (n  = 73,115,

age range = 6–50 years old,

sex = males and females)

Correlation value for eating pathology on depression = 0.13 (0.09–0.17) with p < 0.001

Correlation value for depression predicting eating pathology = 0.16 (0.10–0.22), p < 0.001.

Eating pathology is one of the risk factors for depression and vice-versa.

63%

Silva et al., [9]

Body image

Depression

Systematic review

5 cross-sectional studies

General population

(n  = 35,518,

age range = 18 years and older,

sex = males and females)

N/A

Depression or depressive symptoms were associated with body image for both men and women.

63%