Medical Health Encyclopedia

Living in any economically developed nation on any continent appears to pose more of a risk for eating disorders than belonging to a particular population group. Symptoms remain strikingly similar across high-risk countries.

Income Levels. Oddly enough, within developed countries there appears to be no difference in risk between the rich and the poor. Some studies suggest that those in lower economic groups may be at higher risk for bulimia. But a 2005 study of Latina adolescents found that the risk of eating disorders was actually higher among girls of higher socioeconomic status.

Urban Life. City living is a risk factor for bulimia but it has no effect on the risk for anorexia.

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Intelligence. In one sample, people with eating disorders scored significantly higher than average on IQ tests. People with bulimia, but not anorexia, had higher nonverbal than verbal scores.

Personality Disorders

A 2000 study reported that people with eating disorders tended to share similar personality traits, including low self-esteem, dependency, and problems with self-direction. Researchers have been attempting to determine specific personality disorders or behavioral characteristics that might put people at higher risk for one or both of the eating disorders. Some studies have reported the following personality disorders linked to particular eating disorders:

• Avoidant personalities, mostly seen in anorexia. Such people are generally high functioning, persistent, and perfectionists.
• Dependent personalities, mostly seen in anorexia. This group is usually over-controlled and withdrawn.
• Borderline and histrionic personalities, mostly seen in bulimia. Such individuals are emotionally uncontrolled and impulsive.
• Narcissism is seen in both anorexia and bulimia.

It should be noted that any of these personality traits can appear in either patients with bulimia or anorexia. Some experts believe that the patient's specific personality disorder, rather than whether they are anorexic or bulimic, may be the more important factor in determining treatment choice.