{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T05:40:24Z","timestamp":1775194824267,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005851","name":"Shahid Beheshti University of Medical Sciences","doi-asserted-by":"publisher","award":["33201"],"award-info":[{"award-number":["33201"]}],"id":[{"id":"10.13039\/501100005851","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to report the burden of bulimia nervosa (BN) in the Middle East and North Africa (MENA) region by age, sex, and sociodemographic index (SDI), for the period 1990\u20132019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Estimates of the prevalence, incidence, and disability\u2010adjusted life\u2010years (DALYs) attributable to BN were retrieved from the Global Burden of Disease study 2019, between 1990 and 2019, for the 21 countries in the MENA region. The counts and age\u2010standardized rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 2019, the estimated regional age\u2010standardized point prevalence and incidence rates of BN were 168.3 (115.0\u2013229.6) and 178.6 (117.0\u2013255.6) per 100,000, which represented 22.0% (17.5\u201327.2) and 10.4% (7.1\u201314.7) increases, respectively, since 1990. Moreover, in 2019 the regional age\u2010standardized DALY rate was 35.5 (20.6\u201355.5) per 100,000, which was 22.2% (16.7\u201328.2) higher than in 1990. In 2019, Qatar (58.6 [34.3\u201392.5]) and Afghanistan (18.4 [10.6\u201329.2]) had the highest and lowest age\u2010standardized DALY rates, respectively. Regionally, the age\u2010standardized point prevalence of BN peaked in the 30\u201334 age group and was more prevalent among women. In addition, there was a generally positive association between SDI and the burden of BN across the measurement period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In the MENA region, the burden of BN has increased over the last three decades. Cost\u2010effective preventive measures are needed in the region, especially in the high SDI countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Public Significance<\/jats:title><jats:p>This study reports the estimated burden of BN in the MENA region and shows that its burden has increased over the last three decades.<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.23835","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T13:40:11Z","timestamp":1666878011000},"page":"394-406","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The estimated burden of bulimia nervosa in the Middle East and North Africa region, 1990\u20132019"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7986-9072","authenticated-orcid":false,"given":"Saeid","family":"Safiri","sequence":"first","affiliation":[{"name":"Research Center for Integrative Medicine in Aging, Aging Research Institute Tabriz University of Medical Sciences  Tabriz Iran"},{"name":"Department of Community Medicine, Faculty of Medicine Tabriz University of Medical Sciences  Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7230-8934","authenticated-orcid":false,"given":"Maryam","family":"Noori","sequence":"additional","affiliation":[{"name":"Student Research Committee, School of Medicine Iran University of Medical Sciences  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8692-9720","authenticated-orcid":false,"given":"Seyed Aria","family":"Nejadghaderi","sequence":"additional","affiliation":[{"name":"Research Center for Integrative Medicine in Aging, Aging Research Institute Tabriz University of Medical Sciences  Tabriz Iran"},{"name":"Systematic Review and Meta\u2010analysis Expert Group (SRMEG) Universal Scientific Education and Research Network (USERN)  Tehran Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0950-2619","authenticated-orcid":false,"given":"Ali","family":"Shamekh","sequence":"additional","affiliation":[{"name":"Student Research Committee Tabriz University of Medical Sciences  Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1628-1348","authenticated-orcid":false,"given":"Nahid","family":"Karamzad","sequence":"additional","affiliation":[{"name":"Nutrition Research Center, Department of Biochemistry and Diet Therapy, School of Nutrition and Food Sciences Tabriz University of Medical Sciences  Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7920-6818","authenticated-orcid":false,"given":"Mark J. 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