Eating disorders and suicidality: what we know, what we don't know, and suggestions for future research

Suicide is the second leading cause of death among individuals with anorexia nervosa (AN), and suicidal behavior is elevated in bulimia nervosa (BN) and binge eating disorder (BED) relative to the general population. This paper reviews the suicidality literature within each ED, as well as theoretical explanations for the elevated risk for suicidality among those with EDs. Approximately one-quarter to one-third of people with AN, BN, or BED have thought about suicide, and one-quarter to one-third of people with AN and BN have attempted suicide. Relative to gender and aged matched comparison groups, individuals with AN are 18 times more likely to die by suicide, and individuals with BN are seven times more likely to die by suicide. However, the majority of the research in this area is cross-sectional or retrospective, which leaves the timing of the mortality risk unclear. Longitudinal work that is designed to examine dynamic and acute fluctuations in suicidality among ED samples is needed in order to determine meaningful risk factors.