• In Italy, over 3.5 million people suffer from eating and nutritional disorders.
• Only one in five patients receives specialist care, often with months or years of delay from the onset of symptoms.
• The Italian startup Comestai offers an online therapy pathway with multidisciplinary teams.

In Italy, over 3.5 million people suffer from eating and nutritional disorders (Dan), accounting for approximately 6 per cent of the population. Nine out of ten are women. The pandemic accelerated an already worrying trend: from 2019 to 2022, new cases in Italy rose from around 680,000 to over 1.45 million, an increase of 115 per cent. In paediatric settings, admissions to Ospedale Bambino Gesù for eating disorders increased by 64 per cent (+60 per cent) from 2019, with a 50 per cent rise in incidence among children under 12. Faced with these figures, the startup Comestai aims to bring therapies closer and more accessible through digital tools.

Eating and nutritional disorders in Italy

In recent years, eating disorders have taken on the character of a public health emergency in Italy. In 2023 there were 1.68 million new cases, a sharp increase compared to around 680,000 in 2019. The main disorders include anorexia, bulimia, binge eating, avoidant/restrictive food intake disorder and other atypical forms. Among these, anorexia affects approximately 1 per cent of the population – over 540,000 cases, 90 per cent of which are women – while episodes of uncontrolled eating, associated with compensatory mechanisms, are particularly frequent between the ages of 12 and 25.

In recent years there has also been a growing phenomenon of orthorexia nervosa, a disorder that still lacks an official classification in the DSM-5. The term refers to a pathological obsession with healthy, natural and "pure" eating. Those who suffer from it eliminate entire categories of food deemed "impure", impose rituals on meal preparation and consumption, and experience intense feelings of guilt if they fail to follow their own rules. Over time, this behaviour can compromise social relationships, physical health and quality of life, even though it is often mistaken for a simple "focus on wellbeing". According to recent studies, orthorexia affects up to 6–7 per cent of the population, with higher prevalence among young adults, university students, athletes and people who move in environments related to nutrition or fitness. Social media, with the spread of extreme healthy lifestyle models, also appears to play a role.

Difficulties in accessing care for eating disorders

The clinical impact is severe: anorexia nervosa has the highest mortality rate of all psychiatric disorders and, overall, around 4,000 deaths related to eating disorders occur in Italy each year. This gravity is compounded by a lack of adequate care: only one in five patients receives specialist treatment. Dedicated facilities, though numerous (there are approximately 126–180 public or accredited centres), are not enough to meet demand, with long waiting lists, geographical disparities and costs that are not always affordable. The average delay between onset and first intervention is 30 months for anorexia, 53 months for bulimia and 43 months for binge eating disorders. Italy's public health system attempted to respond with a fund of 25 million euros over 2022–23, of which only 3 per cent was used and 59 per cent committed. There is a shortage of facilities, multidisciplinary teams and timely interventions, leading to drop-outs and serious complications. The urgent need for timely and accessible care makes it crucial to promote renewed attention to the issue, in support of innovative and inclusive solutions.

Comestai: digital accessibility as a key strength

The Italian startup Comestai, part of the LifeGate Way ecosystem, can count on a specialised multidisciplinary team of psychologists, psychiatrists, dietitians, nutritionists and educators who work in integrated teams, guaranteeing rapid access from anywhere in Italy without travel, additional costs or waiting lists. The first consultation is free: it is a no-commitment orientation session to assess the most suitable pathway, which is then built in a personalised way with nutritional plans, psychological and family therapy, and medical monitoring available online but with the option of in-person sessions.

Comestai's philosophy involves people-first language delivered in a safe environment, ensuring the focus remains on the person rather than the illness. The digital platform, integrated with artificial intelligence, helps reduce waiting times, monitor patient engagement, lower drop-out rates and improve the patient experience. Numerous studies show that multidisciplinary online treatments are as effective as in-person ones and, particularly in the medical-psychological field, the integration of artificial intelligence makes it possible to track symptoms and adapt the care pathway in real time. Up to 97 per cent of patients have psychiatric comorbidities (anxiety, depression) or behavioural disorders: at Comestai, family therapy plays a central role, with dedicated sessions to provide practical tools for patients' caregivers.