It has been a common misconception about eating disorders that they are diseases affecting those who are overly concerned with their appearance or body image.  It was believed, in fact, that cultural standards around beauty and body were at least partially to blame for the development and proliferation of eating disorders.  However, new research regarding the heritability of eating disorders suggests that they have much less to do with sociological standards of beauty, and have a stronger hereditary basis than was previously considered.

Since the early 2000’s research on heritability of eating disorders had strongly suggested that eating disorders ran in families.  Through research involving twin studies and statistical analysis of epidemiological data, researchers felt fairly certain that the occurrence of eating disorders in families was genetically linked rather than attributed to family dynamics or social conditioning in families.  However, there was no clear indication that a genetic influence was principally responsible.  Yet, new research from the University of Iowa and University of Texas Southwestern Medical Center has found that people with mutations in two different genes – ESRRA and HDAC4 – had a 90 percent and 85 percent chance of developing an eating disorder, respectively.  Those results are certainly too strong to ignore, and in conjunction with an already-accepted understanding of eating disorder heritability, they further point to something happening at the genetic level.

This new research on the genetic component of eating disorders has several important implications.

  • Calling it quits with the blame game – Individuals with eating disorders tend to ascribe blame to themselves for developing an eating disorder. They often feel as if they did something to bring on an eating disorder, or should have been able to prevent it somehow.  Having knowledge that their propensity towards an eating disorder is something not entirely in their control can alleviate the shame and blame they direct towards themselves.
  • Making it a family affair – Families of those with eating disorders have also at times been scrutinized, and it has been suggested that dynamics within the family may have contributed to the development of an eating disorder.  Knowing there are hereditary factors that extend way beyond parenting style lets parents breathe a sigh of relief, knowing  that they didn’t cause an eating disorder.  It also places additional emphasis on education, prevention, and open discussion about eating disorders within families.  If eating disorders run in the family, family members can have conversations about risk factors that may or may not be present for their loved ones, and can plan accordingly.  For example, if there is a hereditary risk factor, parents can be aware of it and be extra sensitive about trying to prohibit children from dieting or other risky food behaviors associated with the illness.
  • Reduced stigma for individuals with eating disorders – Until we develop means to alter our own genetics, we currently understand that genetically-based health conditions are not the fault of an individual for possessing the associated genes.  Individuals with eating disorders will hopefully be more open to talking about something they know to have a genetic basis, making it more normalized, the way we would discuss medical conditions that we know have a strong genetic link.
  • We can honor the complexity of eating disorders and stop offering oversimplified explanations for them. This portrayal of eating disorders as a function of social standards gone wrong does a disservice to the complexity of the issue.  While establishing a genetic connection to eating disorders does not necessarily explain the cause, it adds a layer of complexity and enables us to dig deeper than the surface for helpful explanations and solutions.

There is still work to be done to fine-tune the various roles that biological, sociological and behavioral risk factors play in the development of eating disorders.  But research on a genetic basis is promising, and the significance of those findings offers something decidedly positive for the individuals who face eating disorders and those who seek to support them.


Matt Keck, MFT is the Founder and CEO of Cielo House Comprehensive Eating Disorder Treatment programs.  He works alongside individuals and families to understand and heal from eating disorders.

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