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  • Risk Factors for Eating Disorders

    A risk factor is something that increases your likelihood of getting a disease or condition. It is possible to develop eating disorders with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing eating disorders. If you have a number of risk factors, ask your doctor what you can do to reduce your risk.
    A number of factors can play a role in your risk of developing an eating disorder. Emotional stress, generated by significant life events, often precedes the onset of an eating disorder in susceptible individuals.
    The following factors have been found to increase the risk of developing an eating disorder:

    Gender

    Females are much more likely than males to develop an eating disorder. An estimated 5%-15% of people with anorexia or bulimia are male, and an estimated 35% of those with binge eating disorder are male.

    Socioeconomic Factors

    People living in economically developed nations appear to have a higher risk for developing eating disorders. Studies suggest that, within economically developed countries, the risk for bulimia may be higher among lower socioeconomic groups.

    Age

    Eating disorders are most prevalent in people (usually girls and young women) between the ages of 12-25. Although, eating disorders can occur in children and older adults.

    Genetics and Biochemical Factors

    Studies suggest that abnormalities in brain pathways involving the neurotransmitter serotonin persist after recovery from certain eating disorders. These findings lead to speculation that serotonin and other similar chemical substances within the brain may have a causative role in anorexia. Further studies are needed. Some genes have also been found to be associated with eating disorders in certain people. Further research may bring new insights into the causes and treatments of these disorders.

    Athletics and Certain Professions

    Athletes, such as dancers, jockeys, gymnasts, runners, wrestlers, and cheerleaders, tend to be at a higher risk for eating disorders. Many coaches and teachers encourage thinness to achieve a competitive edge. They may advocate calorie counting and inappropriate loss of body fat. There is also a higher risk of eating disorders in models, actresses, entertainers, sorority members, and socialites, all of whom may experience social pressures to be thin.

    Early Puberty

    Girls who experience early puberty are more at risk for developing an eating disorder. Since they mature physically faster than their peers and have an increase in normal body fat, they may feel isolated and under greater pressure to restrict their food intake.

    Personality Factors

    Certain personality factors seem to increase a person’s risk of developing an eating disorder. People with eating disorders tend to be perfectionists who have high expectations of themselves and others. In spite of being high achievers, they may have low self-esteem and identity problems. They are prone to dichotomous thinking (ie, seeing everything as good or bad, a success or a failure). This thinking carries over to issues about weight, where thin is good and thinnest is best.
    Fear of change and difficulty coping with stress are common in people who have eating disorders. They may also fear criticism, avoid sexuality, or act out impulsively. Among people with eating disorders, there are high rates of personality disorders (eg, borderline personality disorder , avoidant personality disorder, obsessive-compulsive personality disorder , and narcissism.

    Emotional Disorders

    People with mood disorders (eg, major depressive disorder, obsessive-compulsive disorder , anxiety disorders are at greater risk for developing an eating disorder. In fact, between 40%-96% of all people with eating disorders also have mood disorders.

    Family Influences

    Negative influences within a family can play a role in eating disorders. Some studies suggest that eating disorders are more prevalent in people where one or both parents are overprotective, detached, critical, rigid, or ineffective at resolving conflict.
    A person may be more at risk for developing an eating disorder if she has parents who have psychiatric disorders or who abuse alcohol or other addictive substances. Research suggests that daughters of mothers who have a history of eating disorders may be at higher risk for an eating disorder. Eating disorders are also more common in families where there is pressure to be thin.

    Social and Cultural Pressures

    Beauty standards in Western culture focus on youth and thinness. Images of thin, beautiful, successful people are constantly portrayed in the media. These and other pressures, such as pressures from appearance-obsessed peers and romantic partners, lead to higher rates of eating disorders in people in Western culture.

    History of Abuse

    Researchers are investigating the link between childhood abuse and the development of eating disorders. Some studies have found an association between women who have been sexually abused and bulima.

    References

    American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Text Revision. Washington, DC: American Psychiatric Association; 2000.

    Bulimia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated March 2010. Accessed April 6, 2010.

    Eating disorders statistics. The Alliance for Eating Disorders Awareness website. Available at: http://www.eatingdisorderinfo.org/Resources/EatingDisordersStatistics.aspx . Accessed April 6, 2010.

    Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61:348-358.

    Johnson JG, Cohen P, Kotler L, Kasen S, Brook JS. Psychiatric disorders associated with risk for the development of eating disorders during adolescence and early adulthood. J Consult Clin Psychol. 2002;70:1119-1128.

    Myers D. The relationship between sexual abuse and eating disorders. Vanderbilt University, Psychology Department website. Available at: http://www.vanderbilt.edu/ans/psychology/health%5Fpsychology/PSY297.html . Accessed April 6, 2010.

    National Eating Disorders Association website. Available at: http://www.nationaleatingdisorders.org/p.asp?WebPage%5FID=337 .

    The numbers count: mental disorders in America. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml#Eating . Updated August 10, 2009. Accessed April 6, 2010.

    Steiner-Adair C, Sjostrom L, Franko DL, et al. Primary prevention of risk factors for eating disorders in adolescent girls: learning from practice. Int J Eat Disord. 2002;32:401-411.

    Yager J, Devlin MJ, Halmi KA, et al. Practice Guideline for the Treatment of Patients with Eating Disorders. 3rd ed. American Psychiatric Association website. Available at: http://www.psych.org/psych%5Fpract/treatg/pg/EatingDisorders3ePG%5F04-28-06.pdf . Accessed April 12, 2007.

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