{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T21:09:08Z","timestamp":1788815348526,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Institute for Maternal and Child Health\u2014IRCCS \u201cBurlo Garofolo\u201d","award":["34\/2017"],"award-info":[{"award-number":["34\/2017"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Eating disorders (EDs), including anorexia nervosa (AN) and bulimia nervosa (BN), are severe mental health conditions affecting physical and psychosocial health. Structural gender inequality may shape the burden of EDs across sexes and regions. We analyzed Global Burden of Disease Study 2023 estimates to assess the relationship between gender inequality and ED burden in Europe. Years Lived with Disability (YLD) for AN and BN were extracted by sex and five-year age groups (10\u201339\u2009years) from 1990 to 2023 across 35 countries. Gender inequality was measured using the Gender Inequality Index (GII). Mixed linear regression was applied with year, age group, sex, GII, and their interactions as fixed effects, and country and year as random intercept and slope, respectively. YLDs increased over time across most countries and age groups, with females consistently experiencing the highest burden. For AN, higher levels of GII were significantly associated with greater YLD rates in both males (\u03b2\u2009=\u200929.28; 95% CI: 22.2 to 36.4) and females (\u03b2\u2009=\u200985.3; 95% CI: 42.1 to 128.6), with a stronger effect for females. For BN, GII was inversely associated with YLDs among males (\u03b2 = \u2013645.6; 95% CI: \u2013732.8 to \u2013558.3), whereas a positive association was observed among females (\u03b2\u2009=\u2009794.7; 95% CI: 659.1 to 930.2). Higher burden of AD and BN among young Europeans in more gender-equal settings coexisted with sex-specific patterns associated with increasing gender inequality, underscoring the complexity of gender-related factors and the need for gender-sensitive mental health strategies.<\/jats:p>","DOI":"10.1093\/eurpub\/ckag069","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T11:45:01Z","timestamp":1776253501000},"source":"Crossref","is-referenced-by-count":0,"title":["Gender inequalities and the burden of anorexia and bulimia in Europe, 1990\u20132023: findings from the global burden of disease study 2023"],"prefix":"10.1093","volume":"36","author":[{"given":"Giulia","family":"Zamagni","sequence":"first","affiliation":[{"name":"Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health\u2014IRCCS \u201cBurlo Garofolo\u201d , Trieste,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Fabbro","sequence":"additional","affiliation":[{"name":"AREA Science Park , Trieste,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Paola","family":"Rapagnani","sequence":"additional","affiliation":[{"name":"Azienda Unit\u00e0 Sanitaria Locale (AUSL) Romagna , Cesena,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Beghi","sequence":"additional","affiliation":[{"name":"Azienda Unit\u00e0 Sanitaria Locale (AUSL) Romagna , Cesena,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis","family":"Ayuso-Mateos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, Universidad Aut\u00f3noma de Madrid (UAM) , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-2790","authenticated-orcid":false,"given":"Benedetta","family":"Armocida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular, Endocrine-metabolic Diseases and Aging, Istituto Superiore di Sanit\u00e0-ISS , Rome,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2002-0127","authenticated-orcid":false,"given":"Paola","family":"Bertuccio","sequence":"additional","affiliation":[{"name":"University of Pavia Department of Public Health, Experimental and Forensic Medicine, , Pavia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"de Girolamo","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli , Brescia,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Gialluisi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Neurologico Mediterraneo NEUROMED , Pozzilli,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep Maria","family":"Haro","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Kissimova-Skarbek","sequence":"additional","affiliation":[{"name":"Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College , Krak\u00f3w,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilde","family":"Leonardi","sequence":"additional","affiliation":[{"name":"Neurology, Public Health, Disability Unit & Coma Research Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Maurel","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health\u2014IRCCS \u201cBurlo Garofolo\u201d , Trieste,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Raggi","sequence":"additional","affiliation":[{"name":"Neurology, Public Health, Disability Unit & Coma Research Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7774-548X","authenticated-orcid":false,"given":"Lorenzo","family":"Monasta","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health\u2014IRCCS \u201cBurlo Garofolo\u201d , Trieste,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Castelpietra","sequence":"additional","affiliation":[{"name":"Centre Neuch\u00e2telois De Psychiatrie , Marine-Epagnier,","place":["Switzerland"]},{"name":"Health Research Institute, Mental Health Policy Unit, University of Canberra , Canberra,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,7]]},"reference":[{"key":"2026090716332277900_ckag069-B1","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM-5)","author":"American Psychiatric Association","year":"2013","edition":"5th ed"},{"key":"2026090716332277900_ckag069-B2","doi-asserted-by":"publisher","first-page":"1583672","DOI":"10.3389\/fnut.2025.1583672","article-title":"Gender differences in eating 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