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by Betty Gorham

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Anorexia nervosa is a complex disorder, one that most believe is influenced by multiple genetic and environmental factors. Complicating matters is the fact that it is difficult to differentiate between early symptoms of anorexia and risk factors. This article will discuss some of the risk factors for the development of anorexia.

Genes: In a recent study, researchers found that anorexia was more prevalent between identical twins, and statistical analyses led to the researchers to conclude that 56% of the liability for developing anorexia is due to genetics, with environmental factors determining the rest (Bulik, Sullivan, Tozzi, Furberg, Lichtenstein, & Pedersen, 2006). It is important to realize, however, that not everyone with a genetic predisposition to anorexia develops it; there is no single "anorexia" gene.

Temperament (which is intimately related to genes): People who become anorexic often were good children. They were eager to please, conscientious, and hard working. Researchers have found high rates of childhood anxiety disorders, negative self-evaluation, and perfectionism among anorexic patients (Kaye, 2004). In addition, those with anorexia especially those with the restrictive subtype of anorexia - prefer simplicity and predictability (Strober, 2004). Anorexia is often seen among highly intelligent and/or high-achievers, and students who are under heavy workloads.

Gender: Since 90 to 95% of those with anorexia are females, being female is a risk factor.

Age: Anorexia is most common in those ages 10 to 25. The most common times of onset are at puberty and during times of transition, such as moving from school to university. However, younger children can also exhibit symptoms of anorexia. There has also been quite a bit of recent press coverage on an increase in anorexia among older women (e.g. 40s, 50s, and 60s).

Culture: Anorexia is believed to be far more common in western societies and among those of higher socioeconomic status. However, it should be noted that anorexia does exist in non-westernized cultures; it is not a "culture-bound" disorder (McDonald, 2004).

Abuse: Those who have suffered traumatic events in their lifetime, such as child abuse and sexual abuse, may be more vulnerable to developing anorexia.

Dieting: This is probably one of the biggest risk factors for developing an eating disorder. An innocent diet can quickly get out-of-hand, especially among those with a genetic predisposition for the development of anorexia. Parents of children with temperaments such as the one described above should be particularly concerned if they notice their child begin to eat less.

References

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, 305-312.

Kaye, W. H. (2004, May). Does dieting help people with anorexia nervosa fit into their genes? Recognition, understanding, and intervention. Presentation at San Diego Children's Hospital Child & Adolescent Psychiatry Grand Rounds.

McDonald, E. J. (2004). Is anorexia nervosa a culture-bound syndrome? Journal of Psychological Inquiry, 9, 94-103.

Strober, M. (2004). Managing the chronic, treatment-resistant patient with anorexia nervosa. International Journal of Eating Disorders, 36, 245-255.

Learn more about this author, Betty Gorham.

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