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Impact of eating disorders on paid or unpaid work participation and performance: a systematic review

Ubhi S, Bani-Fatemi A, Howe A, Safi F, Aniserowicz A, Nowrouzi-Kia B

Eating and weight disorders : EWD, 2025

20,367 participants

Abstract

Objective: Eating disorders (EDs), including binge eating disorders (BEDs), bulimia nervosa (BN) and anorexia nervosa (AN), can inflict adverse effects on well-being, daily functioning, and workplace performance, presenting significant occupational, social, and economic challenges. This systematic review seeks to explore the relationship between ED symptomatologies and their impacts on work performance.

Methods: This systematic review adhered to The Preferred Reporting Items for Systematic Reviews and Meta-analyses. Formal methods of critical appraisal for both qualitative and quantitative studies were utilized. Six studies were included.

Results: Participants across all studies (n = 20,367) exhibited heightened levels of presenteeism, absenteeism, work productivity impairment, and higher annual burden costs compared to their non-ED counterparts.

Conclusion: Impaired decision-making, cognitive inflexibility, and poor executive functioning significantly impact work participation and performance, underscoring the need for workplace policies that reduce stigma and stress, and calls for further research into how environmental factors and interventions affect ED recovery.

Level of evidence: Level I, systematic review.

How strong is the evidence?

Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 20,367 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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