Research Review: What we have learned about the causes of eating disorders—a synthesis of sociocultural, psychological, and biological research.

Culbert, Kristen M.; Racine, Sarah E.; Klump, Kelly L.

doi:10.1111/jcpp.12441

Cited by 642Eating Disorders and BehaviorsNutrition, Health and Food BehaviorChild Nutrition and Feeding Issues

Research Review: What we have learned about the causes of eating disorders—a synthesis of sociocultural, psychological, and biological research.

Culbert, Kristen M., Racine, Sarah E., Klump, Kelly L.·2015·Journal of Child Psychology and Psychiatry

DOI 10.1111/jcpp.12441

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Abstract

BACKGROUND: Eating disorders are severe psychiatric disorders with a complex etiology involving transactions among sociocultural, psychological, and biological influences. Most research and reviews, however, focus on only one level of analysis. To address this gap, we provide a qualitative review and summary using an integrative biopsychosocial approach. METHODS: We selected variables for which there were available data using integrative methodologies (e.g., twin studies, gene-environment interactions) and/or data at the biological and behavioral level (e.g., neuroimaging). Factors that met these inclusion criteria were idealization of thinness, negative emotionality, perfectionism, negative urgency, inhibitory control, cognitive inflexibility, serotonin, dopamine, ovarian hormones. Literature searches were conducted using PubMed. Variables were classified as risk factors or correlates of eating disorder diagnoses and disordered eating symptoms using Kraemer et al.'s (1997) criteria. FINDINGS: Sociocultural idealization of thinness variables (media exposure, pressures for thinness, thin-ideal internalization, thinness expectancies) and personality traits (negative emotionality, perfectionism, negative urgency) attained 'risk status' for eating disorders and/or disordered eating symptoms. Other factors were identified as correlates of eating pathology or were not classified given limited data. Effect sizes for risk factors and correlates were generally small-to-moderate in magnitude. CONCLUSIONS: Multiple biopsychosocial influences are implicated in eating disorders and/or disordered eating symptoms and several can now be considered established risk factors. Data suggest that psychological and environmental factors interact with and influence the expression of genetic risk to cause eating pathology. Additional studies that examine risk variables across multiple levels of analysis and that consider specific transactional processes amongst variables are needed to further elucidate the intersection of sociocultural, psychological, and biological influences on eating disorders.

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An estimated 13% of young people experience an eating disorder by the age of 20, and 15-47% endorse disordered eating cognitions and behaviours.
“An estimated 13% of young people experience an eating disorder by the age of 20, and 15–47% endorse disordered eating cognitions and behaviours [23].”
From The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people (2023) · cites this paper as [23]
The aetiology of eating disorders is complex; no single risk factor accounts for their manifestation.
“The aetiology of eating disorders is complex; no single risk factor accounts for their manifestation [23].”
From The social media diet: A scoping review to investigate the association between social media, body image and eating disorders amongst young people (2023) · cites this paper as [23]
The period from about 14 to 24 years is critical for the onset of eating disorders.
“This period at the age of c. 14 to 24 years has been named youth by the UN (www.unesco.org) and is critical for the onset of eating disorders (ED) [6].”
From Correlates of interpersonal emotion regulation problems in Loss of Control eating (LOC) in youth: study protocol of the combined online and App based questionnaire, laboratory and randomized controlled online intervention i-BEAT trial (2021) · cites this paper as [6]

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Methylation of the glucocorticoid receptor gene promoter in bulimic women: Associations with borderline personality disorder, suicidality, and exposure to childhood abuse
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Changes in Genetic and Environmental Influences on Disordered Eating Across Adolescence
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A prospective test of the influence of negative urgency and expectancies on binge eating and purging.
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Neural Basis of Impaired Cognitive Flexibility in Patients with Anorexia Nervosa
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Exploring the relationship between negative urgency and dysregulated eating: Etiologic associations and the role of negative affect.
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Predicting bulimic symptoms: An interactive model of self-efficacy, perfectionism, and perceived weight status
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Global DNA hypomethylation and DNA hypermethylation of the alpha synuclein promoter in females with anorexia nervosa
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Puberty moderates genetic influences on disordered eating
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A Longitudinal Analysis of the Role of Biopsychosocial Factors in Predicting Body Change Strategies Among Adolescent Boys
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DNA methylation in individuals with anorexia nervosa and in matched normal‐eater controls: A genome‐wide study
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Shared genetic and environmental risk factors between undue influence of body shape and weight on self-evaluation and dimensions of perfectionism
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The effects of ovarian hormones and emotional eating on changes in weight preoccupation across the menstrual cycle
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Cognitive deficits and biases for food and body in bulimia: Investigation using an affective shifting task
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Food restriction leads to binge eating dependent upon the effect of the brain-derived neurotrophic factor Val66Met polymorphism
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Genetic and environmental influences on thin‐ideal internalization across puberty and preadolescent, adolescent, and young adult development
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Set-shifting and its relation to clinical and personality variables in full recovery of anorexia nervosa.
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Serotonin transporter binding after recovery from bulimia nervosa
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Is the Relationship Between Binge Eating Episodes and Personality Attributable to Genetic Factors?
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“org) and is critical for the onset of eating disorders (ED) [6].”
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Authors: Culbert, K. M., Racine, S. E., & Klump, K. L.
Affiliations: University of Nevada, Las Vegas (US)
Ohio University (US)
Michigan State University (US)
Corresponding author: Culbert, Kristen M.
ORCID: Culbert, Kristen M.
Racine, Sarah E.
Klump, Kelly L.
Venue: Journal of Child Psychology and Psychiatry
Publisher: Wiley
Published: 2015-06-19
Volume: 56
Issue: 11
Pages: 1141-1164
ISSN: 0021-9630 (ISSN-L)
1469-7610
DOI: 10.1111/jcpp.12441
OpenAlex: W1941047028
Cited by: 642
References: 167
Citations by year: 2026: 55 · 2025: 75 · 2024: 91 · 2023: 63 · 2022: 60 · 2021: 63 · 2020: 64 · 2019: 53 · 2018: 48 · 2017: 33 · 2016: 30 · 2015: 7
FWCI: 5.69
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Child Psychology and Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: Hilda and Preston Davis Foundation
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
Keywords: eating disorders, disordered eating, etiology, biopsychosocial model, thin-ideal internalization, media exposure, negative affectivity, perfectionism, negative urgency, inhibitory control, cognitive inflexibility, serotonin, dopamine, ovarian hormones, gene-environment interaction, risk factors, personality traits
MeSH terms: Feeding and Eating Disorders, Humans

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Research Review: What we have learned about the causes of eating disorders—a synthesis of sociocultural, psychological, and biological research.

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