Biological risk factors of anorexia
Eating disorders like AN, binge eating disorder (BED), and bulimia nervosa (BN) were once thought to be primarily sociocultural conditions caused primarily or only by the influences in someone's environment. However, science is increasingly uncovering the many ways genetics and biology can influence developing eating disorders.1
Genetic anorexia nervosa risk factors
Research has indicated that anorexia nervosa is at least somewhat heritable—or, in other words, able to be genetically passed down. Studies found that those who had relatives with AN were more likely to struggle with the condition and that AN and BN both appear in clusters amongst biologically related individuals.
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Further studies on twins indicated that genetics accounts for anywhere from 58% to 76% of the odds of developing anorexia nervosa. Genetics can also come into play when it comes to
other risk factors of anorexia, with issues like weight concerns, body dissatisfaction, and weight preoccupation also found to be at least moderately heritable.
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Age-related risk factors of anorexia
Eating disorders can impact people of any age, but anorexia nervosa traditionally has the youngest average age of onset of these disorders, at 18.9 years old.2 Still, many people may struggle with the condition even before then.
Puberty has long been considered a risk factor for developing eating disorders. This period of life carries many potential triggers for developing these behaviors, including several simultaneous social and biological changes.3
Increased body dissatisfaction, higher levels of body fat, and hormonal changes are all considered puberty-related anorexia risk factors on the biological side. For pubescent girls, specifically, the start of menstruation and the slew of hormonal and genetic changes it brings on may be a particular risk.3
Psychological anorexia nervosa risk factors
Though eating disorders often have a very physical impact, the conditions are technically classified as mental health disorders—and for good reason. At the core of nearly all eating disorders are underlying mental health concerns.
Personality traits as anorexia risk factors
Several studies have tied certain personality traits, emotional proclivities, and other psychological factors to AN.
Issues like perfectionism, negative self-evaluation, and neuroticism—or emotional instability—have all been found in high rates in those who struggle with anorexia nervosa.4 Chronic low self-esteem is so frequently tied to AN and other eating disorders it's even been considered a prerequisite to developing these conditions.7
Other research has shown certain genetically inheritable personality traits can also be risk factors of anorexia, including high levels of stress reactivity and harm avoidance, a term that incorporates a cluster of personality traits, such as shyness, excessive worry, pessimism, and fearfulness.1
Anorexia and common co-occurring conditions
Anorexia nervosa has also been found to
commonly co-occur with a number of other mental health conditions.
Substance use disorders, bipolar disorders, major depressive disorders, and anxiety disorders have all been found to commonly present in those with AN. In particular,
obsessive compulsive disorder (OCD) seems to have a strong tie with anorexia nervosa, and some studies also suggest a significant overlap between AN and
autism spectrum disorder.
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While the presence of these conditions does not mean someone has AN, it can present as a risk factor for anorexia or for developing an eating disorder.
Environmental anorexia risk factors
AN was initially thought of as a cultural condition, and many of the same factors that were first connected to the disorder are still thought of as anorexia nervosa risk factors.
Bullying and trauma
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history of exposure to adverse or traumatic events has been identified as an anorexia risk factor.
4 Experiencing sexual abuse and trauma, in particular, has been tied to the development of AN and other eating disorders.
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Those who were victims of bullying were also found to be at an increased risk for anorexia nervosa, regardless of body weight, shape, or size.
9 Unfortunately, the rise of the internet and social media has likely contributed to the spread of this type of behavior.
Media and cultural expectations
Mass media, pop culture, and cultural ideals around beauty have long been associated with the development of eating disorders.
Before the internet even took hold, studies connected disordered eating behaviors and thoughts to issues like increasingly thinner models and actresses and
widespread promotion of dieting products and programs, especially in media directed at women.
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Interestingly, studies have suggested that media images and beauty ideals may play more of a role in developing an eating disorder for middle-aged or older women, as most cultural ideas about physical appearance are centered around youth, causing women to harbor significant body dissatisfaction until after age 70 or even beyond that point.
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Today, the internet and social media, in particular, make these images even more inescapable. Studies are still being done on this newest iteration of the phenomenon. Still, it's likely that the increased exposure to these images and ideas—even on an internet that supports the body acceptance movement and other more positive ideals—will continue to contribute to unhelpful thoughts and behaviors.
Careers and recreational pursuits
The pursuit of specific careers or pastimes may also serve as an anorexia risk factor, likely through the pressure put on certain athletes or professionals to look a certain way or achieve a certain body weight or shape.
One study found that dancers have a three times higher risk of suffering from eating disorders compared to their peers.
11 Another showed that both female and male athletes had an
elevated risk of anorexia-related behaviors or thoughts, particularly those participating in sports that emphasized leanness.
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One Australian study concluded that actors and actresses may represent an at-risk population for developing anorexia nervosa, though it found that more research on the subject was needed.
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Finding help for anorexia nervosa
Anorexia nervosa is a serious mental health condition that can be dangerous or even deadly if left untreated. If you recognize these anorexia nervosa risk factors or signs and symptoms of anorexia in yourself or a loved one, it's essential to seek out help.
Your primary care physician, therapist, or another trusted medical professional is a great place to start. These experts can help you secure an official eating disorder diagnosis, which is often needed to pursue further treatment, or otherwise help guide you in the next best steps.
Remote treatment at Within
We understand that eating disorders don't discriminate by age, race, gender, or anything else and that each case is as different as the person experiencing it. Our team of multidisciplinary experts helps craft unique treatment plans for each patient, and our program can be followed entirely online.
Regardless of where you look for help, the most important thing is pursuing it. It's often the first step on the road to recovery.
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