What causes an eating disorder: A biopsychosocial perspective

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Eating disorders are complex and severe psychiatric illnesses that can have many causes. The biopsychosocial model considers the interaction of biological, psychological, and social factors that may be contributing to the development of eating disorders like bulimia nervosa, anorexia nervosa, or binge eating disorder. These risk factors affect a patient’s subjective experience, eating disorder symptoms, treatment outcome, and recovery plan.

Last updated on 
January 20, 2022
In this article

Biological risk factors

Biological or genetic risk factors for eating disorder development may include: (1,2)

  • Family history of dieting
  • Family history of overeating
  • Personal history of dieting
  • High parental demands
  • Parental substance use disorder
  • Type I (insulin-dependent) diabetes

Generally, mental health disorders like eating disorders are heritable, which means having a family member with the disorder increases a person’s chance of developing one themself. Heritability rates differ significantly between studies and specific eating disorders, with estimates ranging from 28% to 88%. (3)

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Psychological causes 

Some psychological influences on eating disorders may include: (1,2)

  • Perfectionism
  • Novelty-seeking traits 
  • Neuroticism (tendency to experience negative mood states, including anxiety, fear, anger, depression, and loneliness)
  • Conduct disorder (a behavioral disorder characterized by antisocial behaviors and a disregard for social norms and rules)
  • Physical or sexual abuse
  • High levels of body image dissatisfaction
  • Personal history of an anxiety disorder

Social risk factors 

Some social, environmental, and cultural risk factors that increase the likelihood of developing an eating disorder include: (1,2)

  • Weight-related teasing and bullying
  • Internalizing body image ideals, such as media messaging that glamorizes thin bodies
  • Separation from parent
  • Weight stigma, or discriminating against people of a certain weight and size, typically fat people 
  • Acculturation, or assimilation into Western culture
  • Intergenerational trauma, such as trauma caused by colonization, genocide, and wars

This is by no means a comprehensive list of biopsychosocial risk factors that can  influence the development and progression of an eating disorder. Eating disorders are multidimensional, complex conditions with various causes and presentations.

A biopsychosocial approach to eating disorder treatment

Many eating disorder treatment programs use a biopsychosocial approach to treatment and care, because this model acknowledges all the different factors that can affect a person’s mental health, body image, disordered eating behaviors, and more. 

When you enroll in an eating disorder treatment program, a psychologist or doctor may conduct a biopsychosocial evaluation to assess each of these categories and gather information on various factors, such as: (4) 

  • Patient’s perception of the eating disorder and how it affects them and their family
  • Duration of eating disorder signs and symptoms
  • Description of eating disorder symptoms and triggers
  • Description of eating disorder-related symptoms
  • Current patterns of eating and exercise
  • Weight prior to eating disorder
  • Body image distortion and dissatisfaction
  • Effects of eating disorder on school or work
  • History of familial eating disorders or mental health disorders
  • Motivation for change
  • Past psychiatric history and treatment, if applicable
  • Presence of co-occurring mental health conditions, such as mood disorders
  • History of trauma, neglect, or abuse
  • Personality traits
  • Patient interests, hobbies, and strengths
  • Current relationships with family members
  • Family strengths and weaknesses
  • Willingness of the family to work with the treatment team
  • Educational and occupational history
  • Living situation
  • Community relationships 
  • Pre-existing medical conditions, medications, allergies, etc.
  • Menstrual history
  • A sensitive physical assessment, including weight, height, pulse, blood pressure, temperature, hydration status, oral health, skin health, etc.  

The treatment team will then use this information to create an individualized treatment plan for the patient. Individualized treatment plans are an important facet of any recovery program, since no two patients have the same experience and history. Additionally, a quality eating disorder treatment program will regularly evaluate and modify a patient’s treatment plan according to progress, making it a dynamic and ever-evolving thing. 

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Within Health’s biopsychosocial model

At Within Health, we take a biopsychosocial approach to eating disorder recovery by examining the biological, psychological, and socio-cultural causes behind each patient’s eating disorder, as well as co-occurring psychiatric disorders. We understand that eating disorders don’t arise from one risk factor. Rather, an eating disorder is a result of many factors interacting with one another. 

As part of our approach, we have a multidisciplinary treatment team composed of many different healthcare professionals, such as nurses, doctors, psychiatrists, psychologists, dietitians, and movement specialists, to provide comprehensive and integrated care. The milieu, or treatment community, ensures that patients never feel alone or isolated during recovery and that they feel supported every step of the way.

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.


  1. Hilbert, A., Pike, K. M., Goldschmidt, A. B., Wilfley, D. E., Fairburn, C. G., Dohm, F. A., Walsh, B. T., & Striegel Weissman, R. (2014). Risk Factors Across the Eating Disorders. Psychiatry research, 220(1-2), 500–506. https://doi.org/10.1016/j.psychres.2014.05.054.
  2. National Eating Disorders Association. (n.d.). Risk Factors.
  3. Thornton, L. M., Mazzeo, S. E., & Bulik, C. M. (2011). The Heritability of Eating Disorders: Methods and Current Findings. Current topics in behavioral neurosciences, 6, 141–156. https://doi.org/10.1007/7854_2010_91.
  4. Centre of Excellence in Eating Disorders. (n.d.). Assessment of Suspected Eating Disorders.


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