Table of ContentsView AllTable of ContentsOverall Risk FactorsSpecific Eating Disorder Risk FactorsGenetic FactorsEnvironmental FactorsGene and Environment InterplayEpigenetics
Table of ContentsView All
View All
Table of Contents
Overall Risk Factors
Specific Eating Disorder Risk Factors
Genetic Factors
Environmental Factors
Gene and Environment Interplay
Epigenetics
When a person gets sick, it’s natural to want to understand why. With eating disorders, which are associated with many myths and negative stereotypes, the question of causation can be incredibly confusing.
The culture at large commonly blames eating disorders on oversimplified explanations, such as themedia’s promotion of unrealistically slender modelsor bad parenting. Even some health professionals buy into these overly simplistic explanations.
This article explores some of the risk factors that may increase the likelihood that a person might develop an eating disorder, including the impact of both environmental and genetic variables. It also discusses the potential causes of specific eating disorders, such as binge eating disorder, anorexia nervosa, bulimia nervosa, and purging disorder.
1:28Watch Now: Common Signs of an Eating Disorder
1:28
Watch Now: Common Signs of an Eating Disorder
Risk Factors for Eating Disorders
Many factors have been, or are being, studied as possible contributors to the development of eating disorders. Across all types of eating disorders, it is likely that mental health and body image-related factors play a significant role in causing eating disorders.
In general, most experts agree thateating disorders are complicated illnessesthat stem not from a single cause but from a complex interaction ofbiological, psychological, social, and environmental factors.
Mental Health
Mental health risk factors can include anxiety,depression, low self-esteem, and trauma such aschildhood sexual abuse. Social stressors, such as peer pressure andbullying, may also be involved.
Why It’s Important to Have High Self-Esteem
Body Image
Risk factors related to eating behaviors and body image may also be tied to the development of eating disorders. These could include:
Family Dynamics
Family dysfunction has long been cited as a cause of eating disorders. However, families don’t cause eating disorders in a simple, straightforward manner.
While growing up in a dysfunctional home could increase the risk for many psychological problems, including eating disorders, it does not condemn a child to an eating disorder or any other psychological disorder.
Why Parenting Styles Matter When Raising Children
Other Factors
Early childhood feeding, eating, or gastrointestinal problems can also contribute to the development of eating disorders.
RecapScientists can’t say exactly what causes an eating disorder or predict who will develop an eating disorder. There are many different pathways to the development of an eating disorder.
Recap
Scientists can’t say exactly what causes an eating disorder or predict who will develop an eating disorder. There are many different pathways to the development of an eating disorder.
Risk Factors for Specific Eating Disorders
Risk factor research focuses on identifying traits or experiences thatprecedethe development of a specific eating disorder (not just the overall category of eating disorders). For a risk factor to be shown as acausal factor, the risk factor must comebefore the developmentof the eating disorder.
The risk factor(s) must also be capable of being manipulated to prevent the occurrence of the disorder. For example, smoking is a causal risk factor for lung cancer; it comes before the development of the disease, and not smoking reduces one’s risk of developing lung cancer.
Because eating disorders are relatively rare and diverse disorders, it is difficult and expensive to perform the large and long-term studies needed to better assess risk factors.
To date, there is limited research that has successfully demonstrated causality; however, a 2016 study found the following causal risk factors for specific eating disorders:
Anorexia Nervosa
People withanorexia nervosarestrict their food intake, have an intense fear of weight gain, and have adistorted perceptionof their weight and health. A low body mass index (BMI)—essentially, underweight—has been identified as a risk factor. However, anorexia nervosa can still happen in people with a BMI in the normal range.
Problems With BMIBody mass index (BMI) is a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age. Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.
Problems With BMI
Body mass index (BMI) is a dated, biased measure that doesn’t account for several factors, such as body composition, ethnicity, race, gender, and age. Despite being a flawed measure, BMI is widely used today in the medical community because it is an inexpensive and quick method for analyzing potential health status and outcomes.
Bulimia Nervosa
Binge Eating Disorder
Binge eating disorderis similar to bulimia nervosa butwithout the purging aspect. This eating disorder was added to the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) in 2013.
One study noted that in girls, the following were associated with binge eating in adulthood:
A 2017 study suggested thatnegative urgency, described as a “tendency to act impulsively when distressed,” is also involved.
Purging Disorder
Identifying actualcausal factorsfor a specific eating disorder is complicated. Determining whether these factors are present in an individual can be difficult. Also, the presence of these factors predicts higher risk butdoes not guaranteethe development of an eating disorder.
Coming from a family with a history of eating disorders can increase a person’s risk of developing an eating disorder. A portion of this increased risk could be due to the modeling of eating disorder-linked behaviors within a family (e.g., observing a family member dieting).
However, twin study research, which can isolate the role of genetics, suggests that approximately 40% to 60% of the risk for anorexia nervosa, bulimia nervosa, and binge eating disorder arises from genetic influence.
Latest Research
The largest and most rigorous genetic investigation of eating disorders ever conducted, the Anorexia Nervosa Genetics Initiative (ANGI), is currently underway in the United States, Sweden, Australia, the United Kingdom, and Denmark. This research could provide more information about the genetic profile that contributes to eating disorders.
These findings do not imply that there is a single eating disorder gene or even that genescauseeating disorders. Some individuals may inherit traits such as anxiety, fear, perfectionism, or moodiness that have been associated with the development of an eating disorder. These aspects oftemperamenthave also been linked to several other disorders.
For some people, variations in several different genes contribute to traits that, in turn, increase or decrease their risk for eating disorders.
Prevalence in Families
Some people with eating disorders are able to identify several other family members who also have eating disorders. There are certain families in which the risk of eating disorders is much higher than in the general population, but such families are relatively rare.
Even a high-risk family history indicating an increased genetic risk does not mean a person is destined to develop an eating disorder. Conversely, not everyone with an eating disorder can identify another family member with one.
Most eating disorder cases are sporadic, with no family history. Given the smaller size of today’s families, there is often not enough data to determine whether a specific individual has a genetic tendency.
Eating disorders arestigmatizeddiseases, and family members often do not share their struggles with their disorder.
Much of the earlier research on eating disorders examined environmental risk factors. As a result, they are frequently blamed for causing eating disorders. Environmental factors include events and influences in an individual’s life, such as:
Influences such as gender, ethnicity, or certain athletic settings can strengthen or lessen other environmental factors.
Thinspo: What It Is and How It Impacts Body Image
The tripartite model is one model for understanding some of the socio-cultural risk factors for eating disorders. It proposes that exposure to media, peer, and parental messagesallcontribute to whether a person idealizes thinness and engages in social comparison. Idealization and social comparison may lead to poor body image and various forms of disordered eating.
RecapSociety and culture influence eating behavior, as well as our concept of ideal body shape. However, such environmental factors cannot fully account for the presence of eating disorders. If they did, 100% of the people exposed to the environmental factor(s) would develop an eating disorder, which we know is not the case.
Society and culture influence eating behavior, as well as our concept of ideal body shape. However, such environmental factors cannot fully account for the presence of eating disorders. If they did, 100% of the people exposed to the environmental factor(s) would develop an eating disorder, which we know is not the case.
Protective Environmental Factors
Some environmental factors could help protect people from developing eating disorders. These could include:
Techniques that help groups and individuals question and challenge unrealistic beauty ideals (including the glorification of thinness and thestigmatization of overweight people) are also helpful and protective. People are starting to practicebody positivity and neutrality.
Social and environmental changes, such as improving the status and power of women, reducing theobjectificationof both men and women, and increasing respect for people of all sizes and shapes, will benefiteveryone, not just those at risk for eating disorders.
These changes help create kinder, safer, and likely more protective communities.
The Sexualization of Young Girls and Mental Health Problems
Neither genes (nature) nor environment (nurture) cause eating disorders independently. Eating disorders are likely the result of a complicated interplay of these factors.
Even when a precipitating factor (such as a traumatic event) can be identified, there is almost always a combination of other contributing factors that play a role. The precipitating factor is most likely the trigger that knocked over the first domino and tripped a cascade of events.
Genetic susceptibility may influence their response to specific stressors. For example:
The emerging field of epigenetics, the study of whether, how, and when genes are expressed, offers further insight. Epigenetics explains that certain environmental factors determine the expression of genes or even turn specific genes on or off in the next generation.
The stress that parents experience alters their behavior and can turn genes on and off in offspring who were not even exposed to that stressor.
In terms of eating disorders, there is evidence that the longer a person has anorexia nervosa, the greater the chance they will have alterations in how their genes are expressed. It appears that malnourishment could turn on or off certain genes, which influence the course of the disorder. However, epigenetic studies of eating disorders are in their infancy.
Final Thoughts
Just as environmental factors can increase a person’s susceptibility to an eating disorder, the converse is also true: Changing the environment can facilitate prevention and recovery. For example, growing up with warm, nurturing parents could mitigate genes predisposing someone to anxiety. However, chance and luck also play a role, and individuals vary in their genetic risk.
Even in the face of every preventative measure, some people with extremely high genetic risks may still go on to develop an eating disorder after just one or two triggering events that are outside of their control. Others with low genetic risk may show resilience to developing an eating disorder even in the face of many potential environmental risk factors.
When someone develops an eating disorder, it’s no one’s fault. The cause of eating disorders is too complex to attribute blame to any one person, event, or gene.
If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.For more mental health resources, see ourNational Helpline Database.
If you or a loved one are coping with an eating disorder, contact theNational Eating Disorders Association (NEDA) Helplinefor support at1-800-931-2237.
For more mental health resources, see ourNational Helpline Database.
9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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