Common causes for eating disorders

What are the main causes of eating disorders? 

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.

A 2023 article reports that if one identical twin has an eating disorder, the other twin has a 50% chance of developing one. This suggests that genetics may make some people more susceptible to these conditions.

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 include:

• 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 increase the risk of restrictive eating disorders, such as anorexia nervosa. This is because portraying thinness as an ideal makes it seem aspirational or implies that only certain body shapes and sizes are acceptable.

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

Other possible causes

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.

A 2023 rapid review of 284 prior studies investigated many known risk factors, as well as some emerging connections, such as:

• 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.

Who is most at risk of eating disorders?

Anyone can develop an eating disorder, but they may be more prevalent among certain groups, including:

• 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.

Eating disorders and neurodivergence

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.

When to seek help

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

Summary

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.