The prevalence of disordered eating in America has been steadily increasing over the last few decades. Current research estimates that as many as 1 in 7 men and 1 and 5 women will be diagnosed with an eating disorder by the age of 40 (Ward et al., 2019). This number has nearly doubled since 2006 (Galmiche et al., 2019). Furthermore, current research has shown that recent global phenomena such as the COVID-19 pandemic has also further exacerbated both the development of eating disorders and the worsening of previously diagnosed eating-related disorders. This is largely due to factors such as disruption in regular routines, increased financial insecurity, or overconsumption of eating disorder-promoting media (Rodgers et al., 2020).
Though it is certain that eating disorders are on the rise, the exact factor or factors which may lead to the development of these conditions are still under heavy scrutiny. Researchers tend to agree that risk for eating disorder development is most likely do more so to the intersection of several complex genetic, psychological, and social components rather than a singular root cause. Many of these components can also be associated with multiple eating disorders, with anorexia nervosa, bulimia nervosa, and binge eating disorder being the most diagnosed conditions in America. It is important to note, however, that these factors may manifest differently because of each individual’s life experiences. Two people with very different genetics, upbringings, and backgrounds may very well still develop the exact same eating disorder (NEDA, 2017).
One of the most well-studied categories of eating disorder risk factors are those that are biological in nature. Several studies in the current body of research have suggested that certain genetic and/or physiological factors may predispose an individual to be more likely to develop an eating disorder. For example, having an immediate family member with an eating disorder or mental health condition greatly increases one’s risk for developing an eating disorder, particularly in the case of both anorexia nervosa and bulimia nervosa (Mazzeo & Bulik, 2009). Having a mental health condition (such as anxiety or depression) regardless of family history also increases the likelihood of disordered eating tendencies. A history of dieting attempts and long-term negative energy balance (or chronically consuming less calories than your body needs on a daily basis) has been strongly linked with the later development of eating disorders as well.
There can also be specific medical or genetic conditions that may place an individual at a greater likelihood of disordered eating tendencies. It has been shown that up to 25% of females with Type 1 diabetes will develop an eating disorder. This occurrence has been largely attributed to a condition known as “Diabulimia,” where individuals with Type 1 diabetes will purposefully skip insulin injections to induce weight loss. Instances of binge eating disorder have also been observed to be as high as 45% in females with Type 1 diabetes (Kınık et al., 2017).
Importantly, there are a variety of psychological risk factors that may place an individual at a higher risk for the development of an eating disorder. One of the strongest psychological risk factors for the development of an eating disorders is a self-reported history of perfectionism and setting unrealistically high standards for oneself in multiple areas of life. A personal history of “behavioral inflexibility,” or an extreme need to “follow the rules” as both an adult and as a child is also associated with higher instances of disordered eating. Additionally, it has been found that up to two-thirds of people with an anorexia nervosa diagnoses showed signs of an anxiety disorder such as generalized anxiety or obsessive-compulsive disorder before their eating disorders manifested. This suggests that having an anxiety disorder is another psychological factor which may cause an individual to develop a disordered eating pattern (NEDA, 2017).
Social factors can also play a large role in the development of eating disorders and are arguably the type of risk factor that may be the most widely varied in terms of breadth and extent. Countless aspects can shape one’s social experiences and subsequent risk of eating disorder development. Weight stigma, bullying that’s related to weight, and cultural fixation of the “thin ideal”—or the concept that smaller bodies are inherently better—are all prominent risk factors that aggravate the likelihood of an eating disorder developing. Social isolation and poor familial or social support also have a strong correlation with eating disorder risk, which may be linked to mental health disorder predisposition as well. Furthermore, the Westernization of modern media—and the subsequent onslaught of media promoting traditional Western beauty standards—is shown to have sparked an increase in eating disorder prevalence not only in America, but in countries all around the world (NEDA, 2017).
It is important to be aware of the factors that may lead a person to developing an eating disorder so that these conditions can be detected, assessed, and successfully treated before they become life-threatening. Eating disorders, in general, have some of the highest mortality rates of all mental health and substance abuse conditions. Eating disorders with earlier intervention tend to have more favorable long-term outcomes, which is why it is important to understand which populations may be more at risk for developing these conditions.
References:
- Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402–1413. https://doi.org/10.1093/ajcn/nqy342
- Kınık, M. F., Gönüllü, F. V., Vatansever, Z., & Karakaya, I. (2017). Diabulimia, a Type I diabetes mellitus-specific eating disorder. Turkish Archives of Pediatrics/Türk Pediatri Arşivi, 52(1), 46–49. https://doi.org/10.5152/TurkPediatriArs.2017.2366
- Mazzeo, S. E., & Bulik, C. M. (2009). Environmental and genetic risk factors for eating disorders: What the clinician needs to know. Child and Adolescent Psychiatric Clinics of North America, 18(1), 67–82. https://doi.org/10.1016/j.chc.2008.07.003
- Risk Factors. (2017, February 21). National Eating Disorders Association. https://www.nationaleatingdisorders.org/risk-factors
- Rodgers, R. F., Lombardo, C., Cerolini, S., Franko, D. L., Omori, M., Fuller‐Tyszkiewicz, M., Linardon, J., Courtet, P., & Guillaume, S. (2020). The impact of the COVID‐19 pandemic on eating disorder risk and symptoms. The International Journal of Eating Disorders, 10.1002/eat.23318. https://doi.org/10.1002/eat.23318
- Ward, Z. J., Rodriguez, P., Wright, D. R., Austin, S. B., & Long, M. W. (2019). Estimation of Eating Disorders Prevalence by Age and Associations With Mortality in a Simulated Nationally Representative US Cohort. JAMA Network Open, 2(10), e1912925. https://doi.org/10.1001/jamanetworkopen.2019.12925