National Eating Disorders Association

Risk factors for all eating disorders involve a range of biological, psychological, and sociocultural issues. These factors may interact differently in different people, which means two people with the same eating disorder can have very diverse perspectives, experiences, and symptoms. Despite this, researchers have found broad similarities in understanding some of the major risks for developing eating disorders. The factors listed below may be applicable to those with anorexia nervosa, bulimia nervosa, binge eating disorder, or OSFED. Information on ARFID risk factors is listed separately


  • Having a close relative with an eating disorder. Studies of families have found that having a first-degree relative (like a parent or sibling) with an eating disorder increases a person’s risk of developing an eating disorder.
  • Having a close relative with a mental health condition. Similarly, issues like anxiety, depression, and addiction can also run in families, and have also been found to increase the chances that a person will develop an eating disorder.
  • Female sex. Although people of any, all, or no gender can develop an eating disorder, being female increases the risk of developing an eating disorder.
  • History of dieting. A history of dieting and other weight-control methods is associated with the later development of binge eating.
  • Negative energy balance. Burning off more calories than you take in leads to a state of negative energy balance. Although two-thirds of women with anorexia report that their disorder began with deliberate efforts to restrict the amount and/or type of food they were eating in the form of dieting, other causes can include growth spurts, illness, and intense athletic training.
  • Type One (Insulin-dependent) Diabetes. Recent research has found that approximately one-quarter of women diagnosed with Type One diabetes will develop an eating disorder. The most common pattern is skipping insulin injections, known as diabulimia, which can be deadly.


  • Perfectionism. One of the strongest risk factors for an eating disorder is perfectionism, especially a type of perfectionism called self-oriented perfectionism which involves setting unrealistically high expectations for yourself.
  • Body image dissatisfaction. It’s sadly not uncommon to dislike your appearance, but people who develop eating disorders are more likely to report higher levels of body image dissatisfaction and an internalization of the thin ideal. 
  • Personal history of an anxiety disorder. Research has shown that a significant subset of people with eating disorders, including two-thirds of those with anorexia, showed signs of an anxiety disorder (including generalized anxiety, social phobia, and obsessive-compulsive disorder) before the onset of their eating disorder.
  • Behavioral inflexibility. Many people with anorexia report that, as children, they always followed the rules and felt there was one “right way” to do things.


  • Size and weight prejudice. The message that thinner is better is everywhere, and researchers have shown that exposure to this can increase body dissatisfaction, which can lead to eating disorders.
  • Weight-based teasing or bullying. Being teased or bullied about weight is emerging as a risk factor in many eating disorders.
  • Thin ideal internalization. Buying into the message of the socially-defined “ideal body” may increase the risk of an eating disorder by increasing the likelihood of dieting and food restriction.
  • LGBTQ. Non-heterosexual and cis-gender individuals are at higher risk of eating disorders due to stigma, discrimination, and body image distress. Exploring traumas associated with sexuality and/or gender expression may play a crucial role in treatment.
  • Acculturation. People from racial and ethnic minority groups, especially those who are undergoing rapid Westernization, may be at increased risk for developing an eating disorder due to complex interactions between stress, acculturation, and body image.
  • Smaller social networks. Loneliness and isolation are some of the hallmarks of anorexia; many with the disorder report having fewer friends and social activities, and less social support. Whether this is an independent risk factor or linked to other potential causes (such as social anxiety) isn’t clear.


Altman, S. E., & Shankman, S. A. (2009). What is the association between obsessive-compulsive disorder and eating disorders? Clinical Psychology Review, 29, 638-646.

Anderluh, M. B., Tchanturia, K., Rabe-Hesketh, S., & Treasure, J. (2003). Childhood obsessive-compulsive personality traits in adult women with eating disorders: defining a broader eating disorder phenotype. American Journal of Psychiatry, 160(2), 242-247.

Austin, S. Bryn, Sc.D.. 2004. Sexual Orientation, Weight Concerns, and Eating- Disordered  Behaviors in Adolescent Girls and Boys. Journal of the American Academy of Child &  Adolescent Psychiatry, V43.

Bulik, C. M., Sullivan, P. F., Tozzi, F., Furberg, H., Lichtenstein, P., & Pedersen, N. L. (2006). Prevalence, heritability, and prospective risk factors for anorexia nervosa. Archives of general psychiatry, 63(3), 305-312.

Cockell, S. J., Hewitt, P. L., Seal, B., Sherry, S., Goldner, E. M., Flett, G. L., & Remick, R. A. (2002). Trait and self-presentational dimensions of perfectionism among women with anorexia nervosa. Cognitive Therapy and Research, 26(6), 745-758.

Fairburn, C. G., Doll, H. A., Welch, S. L., Hay, P. J., Davies, B. A., & O'Connor, M. E. (1998). Risk factors for binge eating disorder: a community-based, case-control study. Archives of general psychiatry, 55(5), 425-432.

Grucza, R. A., Przybeck, T. R., & Cloninger, C. R. (2007). Prevalence and correlates of binge eating disorder in a community sample. Comprehensive psychiatry, 48(2), 124-131.

Jacobi, C. & Fittig, E. (2010). Psychosocial risk factors for eating disorders. In Agras, W.S. (Ed.), Oxford Handbook of Eating Disorders. Oxford University Press: N.Y.

Jacobi, C., Hayward, C., de Zwaan, M., Kraemer, H. & Agras, W.S. (2004). Coming to terms with risk factors for eating disorders: Application of risk terminology and suggestions for a general taxonomy. Psychological Bulletin, 130, 1, 19-65.

Kaye, W. H., Bulik, C. M., Thornton, L., Barbarich, N., & Masters, K. (2004). Comorbidity of anxiety disorders with anorexia and bulimia nervosa. American Journal of Psychiatry, 161(12), 2215-2221.

Lilenfeld, L. R., Kaye, W. H., Greeno, C. G., Merikangas, K. R., Plotnicov, K., Pollice, C., ... & Nagy, L. (1998). A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Archives of General Psychiatry, 55(7), 603-610.

McClain, Z., & Peebles, R. (2016). Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth. Pediatric Clinics of North America.

Pumariega, A. J. (1986). Acculturation and eating attitudes in adolescent girls: A comparative and correlational study. Journal of the American Academy of Child Psychiatry, 25(2), 276-279.

Stice, E. (2016). Interactive and Mediational Etiologic Models of Eating Disorder Onset: Evidence from Prospective Studies. Annual Review of Clinical Psychology.

Strober, M., Freeman, R., Lampert, C., Diamond, J., & Kaye, W. (2000). Controlled family study of anorexia nervosa and bulimia nervosa: evidence of shared liability and transmission of partial syndromes. American Journal of Psychiatry, 157(3), 393-401.

Treasure, J., & Schmidt, U. (2013). The cognitive-interpersonal maintenance model of anorexia nervosa revisited: a summary of the evidence for cognitive, socio-emotional and interpersonal predisposing and perpetuating factors. Journal of Eating Disorders, 1(1), 1.

Vohs, K. D., Bardone, A. M., Joiner Jr, T. E., & Abramson, L. Y. (1999). Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development. Journal of Abnormal Psychology, 108(4), 695.

Wade, T. D., Bulik, C. M., Neale, M., & Kendler, K. S. (2000). Anorexia nervosa and major depression: shared genetic and environmental risk factors. American Journal of psychiatry, 157(3), 469-471.

Waldron, Jennifer J., Semerjian, Tamar Z., Kauer, Kerrie. 2009. Doing ‘Drag’: Applying Queer- Feminist Theory to the Body Image and Eating Disorders across Sexual Orientation and Gender Identity. In The Hidden Faces of Eating Disorders, Edited by Justine J. Reel & Katherine A. Beals, (63-81).