{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T06:00:13Z","timestamp":1792908013494,"version":"4.5.0"},"reference-count":57,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"unspecified","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/W002418\/1"],"award-info":[{"award-number":["MR\/W002418\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/X030539\/1"],"award-info":[{"award-number":["MR\/X030539\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR303520"],"award-info":[{"award-number":["NIHR303520"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,12]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine primary care contacts among individuals with eating disorders (EDs) and assess differences across diagnoses and ethnic backgrounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Matched cohort study using retrospective primary care data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Primary care electronic health records from the Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) covering 1 January 2010 to 31 December 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>46\u2009473 individuals aged 18\u201365 years, with a recorded ED diagnosis or a referral to ED services, matched by age, sex and practice location (ratio 1:3) to 145\u2009286 individuals without an ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary\/secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcome was the number of primary care contacts in 24 months prior to ED diagnosis or referral to ED specialist service. Secondary outcomes examined whether ethnicity impacted likelihood of referral to specialist ED services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most individuals had a diagnosis of anorexia nervosa (43.0%), followed by bulimia nervosa (13.8%) and other specified feeding and ED (6.6%). 40.6% were aged 18\u201325 years, 79.5% were female and ethnicity was predominantly White (83.7%), with smaller proportions Asian (6.3%) and Black (3.4%). Compared with non-ED controls, cases had approximately double the rate of primary care contacts (incidence rate ratio (IRR)=1.96, 95%\u2009CI 1.94 to 1.98). Elevated contact rates were observed across all ED diagnostic groups, with IRRs ranging from 1.78 (95% CI 1.75 to 1.82) for anorexia nervosa to 2.45 (95% CI 2.09 to 2.88) for avoidant\/restrictive food intake disorder (all p&lt;0.001). Contact rates were significantly lower across all minoritised ethnic groups compared with White individuals. Referral odds were significantly lower among Asian (OR=0.78, 95%\u2009CI 0.65 to 0.94)\u2009and Black patients (OR=0.56, 95%\u2009CI 0.41 to 0.79).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is a need to increase ED awareness within minoritised communities, alongside culturally inclusive primary care adaptations to support help-seeking for EDs. Targeted education for clinicians and patients in primary care may also improve screening and recognition of EDs across diverse presentations and communities, facilitating access to timely, evidence-based care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data availability statement<\/jats:title>\n                    <jats:p>The dataset from this study is held securely at the Medicines and Healthcare products Regulatory Agency. Access may be granted on completing a data request. The CPRD Ethnicity Record sources underlying data from HES and primary care data copyright 2025, re-used with the permission of The Health &amp; Social Care Information Centre.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119143","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T15:56:04Z","timestamp":1782316564000},"page":"e119143","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Primary care use among adults with eating disorders in England: a population-based cohort study using electronic health records"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3697-535X","authenticated-orcid":false,"given":"Jessica","family":"Wilkins","sequence":"first","affiliation":[{"name":"Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina L","family":"Allen","sequence":"additional","affiliation":[{"name":"Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"},{"name":"Eating Disorders Outpatients Service, South London and Maudsley NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7620-4902","authenticated-orcid":false,"given":"Alexandru","family":"Dregan","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Gao","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Scuffell","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, School of Life Course and Population Sciences, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London, UK"},{"name":"Eating Disorders Outpatients Service, South London and Maudsley NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"2026062408551804000_16.6.e119143.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjmed-2025-001438","article-title":"Adverse outcomes in patients with a diagnosis of an eating disorder: primary care cohort study with linked secondary care and mortality records","volume":"4","author":"Morgan","year":"2025","journal-title":"BMJ Med"},{"key":"2026062408551804000_16.6.e119143.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-026691","article-title":"Epidemiology of eating disorders in primary care in children and young people: a Clinical Practice Research Datalink study in England","volume":"9","author":"Wood","year":"2019","journal-title":"BMJ Open"},{"key":"2026062408551804000_16.6.e119143.3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1192\/bjp.2019.153","article-title":"Shining the light on eating disorders, incidence, prognosis and profiling of patients in primary and secondary care: national data linkage study","volume":"216","author":"Demmler","year":"2020","journal-title":"Br J Psychiatry"},{"key":"2026062408551804000_16.6.e119143.4","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1002\/eat.24306","article-title":"The Unmet Treatment Need for Eating Disorders: What Has Changed in More Than 10\u2009Years? 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