Prevalence of Eating Disorders in People With Borderline Personality Disorder: A Systematic Review and Meta-Analysis

The aim of the study was to estimate the prevalence of eating disorders (EDs) across the borderline personality disorder (BPD) population.

After protocol registration (number = CRD42023415721), we systematically searched PubMed/MEDLINE, PsycINFO and Web of Science for articles that allowed the assessment of the proportion of at least one ED in a sample of patients with BPD. Risk of bias was estimated using the Joanna Briggs Institute (JBI) checklist for studies reporting prevalence data, and we used a random-effects meta-analytic model. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) statement.

A total of 34 articles were included, with 20 reports (N = 4107) related to EDs without distinction, and 20 (n = 3901), 20 (n = 4369), seven (n = 766), and six (n = 1773) reports related to anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS), respectively. The overall frequency of EDs in BPD was estimated to be 29.7% (95% CI = [21.6%, 38.4%]), while the frequencies of AN, BN, BED, and EDNOS were estimated to be 9.98% (95% CI = [5.6%, 15.3%]), 16.3% (95% CI = [12.1%, 21.1%]), 16.3% (95% CI = [6%, 30%]) and 18.8% (95% CI = [10.6%, 28.6%]), respectively. The overall risk of bias was moderate, there was no publication bias, and the certainty levels of our evidence were low.

This meta-analytic review highlights the high frequency of EDs in BPD. It could serve as a basis for exploring the determinants of these comorbidities.

Through this systematic review and meta-analysis, we found a high prevalence of EDs and their subtypes in patients with BPD.