Researchers have identified many different causes for eating disorders, ranging from genetic risk factors to the culture a person grows up in.
However, no single factor causes all eating disorders. Instead, a group of factors elevate the risk. The more risk factors a person has, the higher their risk of disordered eating.
This does not guarantee a person will get an eating disorder, though. Some people with many risk factors may never develop one of these conditions, while others who have relatively few risk factors might.
In this article, we explore the research on what causes eating disorders.
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A complex interaction of multiple factors can cause eating disorders. Some of the most significant include:
Biological factors
While researchers have not identified a specific gene or group of genes that lead to eating disorders, these conditions tend to run in families. Family culture can partially explain this, but biological factors may also play a role.
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Each person’s own neurobiology may also play a role. For example, serotonin helps regulate appetite, and so biological conditions that affect serotonin, such as depression, may elevate the risk of eating disorders.
Psychological factors
Certain psychological traits correlate with a higher risk of disordered eating. They
- perfectionism
- impulsivity
- obsessive-compulsive traits
- anxiety
- low self-esteem
- emotional dysregulation, which is when a person finds it difficult to manage their emotions, particularly negative emotions
- avoidant behavior, which is when a person often avoids things they find distressing or that might lead to distress
People are also more at risk of developing an eating disorder if they have a personal history of other mental health conditions, such as depression or substance use disorder.
Early childhood trauma, especially sexual abuse, may also increase the risk of eating disorders, as well as other eating disorder risk factors, such as anxiety.
Cultural factors
A cultural emphasis on thinness can
This emphasis can exist within specific families and peer groups or, more broadly, across nations. When these ideas spread elsewhere, so too can eating disorders.
Exposure to media emphasizing thinness also plays an important role. A 2020 review of previous research notes that while social media can be a valuable source of support and information, it can also become harmful.
Looking at the curated images of others can encourage comparison, which can lead to body dissatisfaction. This is not only true for photos that portray thinness, but also for photos that portray athletic, strong bodies.
This type of content has associations with orthorexia. Orthorexia is not a clinically recognized eating disorder but has many similarities to one.
Social factors
The behavior of others can reinforce cultural norms around body weight. People are more likely to develop an eating disorder if they experience:
- bullying, particularly relating to weight or appearance
- other forms of weight stigma, such as discrimination or stereotyping
- less social support or loneliness
While some risk factors and causes for eating disorders are well-established and heavily researched, scientists are continuing to find links between these conditions and other factors.
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- disturbances in the gut microbiome, which may affect appetite regulation
- diabetes, which has some associations with overly restrictive dieting, laxative misuse, and diabulimia
- early puberty, which can result in body dissatisfaction if a person’s body changes faster than their peers
- birth weight, with a low birth weight having associations with anorexia and a high birth weight with binge eating disorder
Researchers are still learning how these factors relate to eating disorders.
Anyone can develop an eating disorder, but they may be more prevalent among certain groups,
- females
- white or European people
- LGBTQIA+ people
The reasons for this are complex, relating to the cultural norms and concepts people have about gender and beauty. Rates of eating disorders among different groups may also be changing.
For example, a 2020 literature review notes that, previously, “curvy” bodies were the ideal for females in the Arab world, as these cultures associated this body type with fertility.
However, the authors found evidence of an increasing desire for thinness among Arabian people due to factors such as increased wealth, Western influence, and social media.
Much of the research to date has focused on European people, meaning they may be overrepresented in the data. Conversely, people who fear mental health stigma may also feel afraid to report their symptoms, meaning they are underrepresented in the statistics.
Researchers have noticed a higher prevalence of eating disorders among those with neurodivergence, such as autistic people.
Researchers do not yet fully understand this connection. It could be that similar factors contribute to both eating disorders and neurodivergence. It could also be that the presence of one influences the development of another.
For example, in a 2020 study on eating disorders in autistic women, several participants felt that their disordered eating was actually a symptom of autism rather than a distinct diagnosis.
According to the study, 70% of autistic people have at least one other diagnosis, including eating disorders. Between 25% and 30% percent of women with anorexia meet diagnostic criteria for autism, in comparison to 1% of the general population.
Disordered eating may be a manifestation of:
- anxiety or stress
- wanting to stick to rigid routines
- sensory issues with certain textures, smells, or flavors
- an attempt to control one’s environment
Neurodivergence may also increase the risk of certain personality traits associated with eating disorders, as well as exposure to trauma. There are also protective factors that neurodivergent people may find harder to access, such as emotional support.
However, research into the role of neurodivergence in eating disorders is relatively new and still ongoing.
Eating disorders, especially anorexia nervosa, have a high death rate as compared to other mental health diagnoses. Treatment can help and may even save a person’s life. The earlier a person seeks treatment, the less likely they are to experience severe adverse effects.
A person should seek help if they:
- worry that their eating behavior might not be healthy
- feel very preoccupied with food, dieting, or their body
- perceive their body very differently than others do
- find it hard to stop dieting, eating to excess, purging, or exercising
- have extreme aversions to foods, making it difficult to eat a balanced diet
- are undergoing eating disorder treatment but not getting better
- have concerns about a loved one
Help is available
Eating disorders can severely affect the quality of life of people living with these conditions and those close to them. Early intervention and treatment greatly improve the likelihood of recovery.
Anyone who suspects they or a loved one may have an eating disorder can contact the National Alliance for Eating Disorders, which offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options.
For general mental health support at any time, people can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).
Many other resources are also available, including:
- The National Association of Anorexia Nervosa and Associated Disorders
- F.E.A.S.T., which provides support and educational resources to friends and family who want to help someone living with an eating disorder
Eating disorders are complex and can occur for many reasons. Biological factors may play a role, but so too can culture, media exposure, social pressure, or other mental health factors.
In some cases, the things that contribute to an eating disorder are not clear. However, with treatment, people with eating disorders can and do recover.
Anyone who is concerned about themselves or a loved one can seek support from helplines, their doctor, or a mental health professional with expertise in disordered eating.