Understanding Risk Factors for Anorexia
Anorexia has the highest death rate of any mental disorder. Characterized by an extreme form of body dissatisfaction called body image distortion that leads to an extreme limitation on caloric intake, the disorder especially affects young women and can affect both genders at any point of adulthood.
The risk factors that influence whether a person develops anorexia are a dynamic mix of environmental and genetic causes, and it is unclear which factors may overrule others. For instance, if a person has multiple environmental factors indicating a risk for anorexia but is not genetically disposed, it is difficult to determine which factors will be more dominant.
A recent large study of Swedish twins led by Cynthia M. Bulik, Ph.D., of the University of North Carolina at Chapel Hill was published in the March issue of Archives of General Psychiatry. The study focused on the prevalence, heritability and risk factors for anorexia.
The study reviewed a questionnaire sent to the twins in 1972 and 1973 that requested information about demographics, health and social circumstances. The researchers identified the participants that were born between January 1 of 1935 and December 31 of 1958. In a four year period ending in 2002, the twins were given a screening for a range of disorders, including anorexia.
The researchers found that the prevalence of anorexia among the participants was 1.2 percent in women and .29 percent in men. The study estimated that anorexia is 56 percent heritable, with other risk factors attributable to environmental influence. The participants in the study that were born since 1945 had a higher rate of anorexia than older participants.
The participants identified as anorexia-diagnosed had a lower body mass index, exercised more and had a better overall health satisfaction level than those participants without anorexia.
The researchers used the data from the original questionnaires issued in 1972 and 1973 to examine whether certain factors might be associated with a later appearance of anorexia in women. They looked at seven potential predictors: BMI, stomach problems, excessive exercise, perceived stress, an extroverted personality and neuroticism.
Of the seven potential risk factors examined by the researchers, only neuroticism was identified as a risk factor for anorexia nervosa. Neuroticism is characterized by low self-esteem, emotional instability and feelings of depression, anxiety and guilt.
While the contributing factors to development of anorexia nervosa remain complicated and different for each individual, it is important to identify ways to target those at risk for anorexia. Early intervention may provide an opportunity for treatment in a disease that often goes undetected for many years.
