Are Eating Disorders Genetic?
Well, the short answer is yes, but….
Why yes, but? I want to say that whether you are here for research, for yourself, or a loved one, we need to first address SHAME and BLAME.
Yes, eating disorders have a genetic component. But what do we mean when we say that?
We mean that there is a genetic predisposition toward the possibility of developing an eating disorder.
Stop. Read that again.
A genetic predisposition…or a higher chance…is NOT the same thing as “This is definitely going to happen.” It only means that there’s a higher chance.
In reality, scientists find it really hard to measure environmental causes. Gone are the days when we could control a human test subject’s environment over the course of their life (and thank goodness for that!) Still, we know that environmental causes play a big factor in the possibility of developing all disorders, not only eating disorders. Unfortunately, it’s hard to get good, solid science down on exactly how big a factor we are talking about.
So, all we have to go off of as scientists are biological genetic material. And as far as the genetic material goes, yes, there’s a possibility of passing on a sensitivity or a predisposition toward the possibility of developing an eating disorder.
(Let’s check in: How are you doing on that shame/blame front? Being kind to yourself is REALLY important as we navigate this information. Remember, this is all this is: information. It is neither morally good or bad. Eating disorders are much the same: neither morally good or bad. So hang in there, and be kind to yourself as you read on.)
Let’s get into some numbers, shall we?
On the topic of Anorexia Nervosa (AN), according to Balik, C; et al, in their study Genetics of Eating Disorders, “Female relatives of individuals with AN are 11 times more likely to develop AN than relatives of individuals without AN.” Although less is known about the genetic factors of Bulimia Nervosa, it appears that BN also shares with AN a rate of about 60 percent when it comes to an increased risk in a family.
The Genetic Link: What Science Says About Anorexia and Bulimia
For decades, eating disorders like anorexia nervosa and bulimia nervosa were believed to stem mainly from environmental factors: media influence, family dynamics, and societal pressures around thinness. But we have no real way to measure these environmental factors, remember? So while those elements certainly play a role, the scientific narrative is expanding. Thanks to advances in genetic research, we now know that biology (specifically our DNA) can play a significant role in the development of eating disorders.
What does the science say?
Twin studies have shown that anorexia nervosa and bulimia nervosa have heritability estimates ranging from 50–80% (Bulik et al., 2006; Trace et al., 2013). This means that genetics may account for more than half the risk of developing these disorders. That’s a big number, but we know (because we are engaging in self-kindness) that this only means that genetics play a role in a predisposition toward these disorders, not that they will definitely cause them to emerge!
In one pivotal study published in The American Journal of Psychiatry, researchers found that identical twins were significantly more likely to both develop anorexia than fraternal twins, suggesting a strong genetic component (Klump et al., 2001). Basically, if one twin has anorexia (or bulimia), the other twin has a higher chance of developing these disorders, leading scientists to believe that these disorders have a genetic component among twins. However, there’s definitely a chance that the environment plays a role. Can you think of ways that the environment can play a role in these disorders? I bet you can.
Key Genetic Findings in Anorexia Nervosa
Recent genome-wide association studies (GWAS) have revealed compelling insights:
A landmark 2019 GWAS (Watson et al., Nature Genetics) identified eight genetic loci associated with anorexia nervosa. Strikingly, many of these were linked not just to psychiatric conditions, but also to metabolic traits like lipid metabolism, BMI regulation, and insulin-glucose balance. In other words, there are eight genetic “factors” that link to comorbidities like psychiatric conditions (schizophrenia), personality traits (like neuroticism), and metabolic traits (like lower insulin-glucose balance). Visit the chart below for more comorbidities!
These findings suggest that anorexia may be a "metabo-psychiatric" disorder, where both psychological vulnerabilities and metabolic predispositions intersect.
Genes such as CADM1, MGMT, and ESYT1 have been associated with neural circuits related to reward processing, anxiety, and impulse control, all of which are implicated in anorexia.
Genetics and Bulimia Nervosa: What We Know
Although bulimia has been studied less extensively from a genetic standpoint, the research still points to important hereditary influences:
Family studies show that first-degree relatives of individuals with bulimia are four times more likely to develop the disorder themselves (Hudson et al., 2006).
A 2017 study published in Psychological Medicine suggested that genetic overlap between bulimia and other psychiatric conditions, such as major depressive disorder, ADHD, and substance use, may indicate shared genetic pathways involving impulse control and emotional regulation (Wade et al., 2017).
Serotonin transporter gene variations (particularly 5-HTTLPR) have been explored for their role in bulimic behaviors, suggesting that individuals with certain genotypes may have increased susceptibility to binge-purge cycles. (Let’s check in…increased susceptibility doesn’t mean it’s going to happen!)
Comorbidities
We’ve talked a bit about comorbidities of Anorexia Nervosa and Bulimia Nervosa, but let’s get into it a bit more. First, comorbid means “occurring along with” or “beside” another disorder. You can think of comorbid disorders as two intersecting circles. They don’t always touch, but sometimes they do. For example, we can have Schizophrenia without Anorexia Nervosa, and we can have Anorexia Nervosa without Schizophrenia, but sometimes, we have both together, and in that case, we call one “comorbid” with the other. Let’s take a look at this chart on comorbidities together. (Please note that this is only a fraction of the comorbidities that go along with eating disorders. If you’d like to research more about comorbidities, please read our next published blog on this topic).
For space, I only included the two most “popular” eating disorders. However, there are many other eating disorders that are worth mentioning. Stay tuned for future blogs on this topic.
This chart shows a few comorbidities of the eating disorders Anorexia Nervosa and Bulimia. This does not include all eating disorders or all comorbidities.
Genetic Counseling
It’s possible that when you come across research for genetic disposition in eating disorders, that you’ll come across the term “genetic counselor” or “genetic counseling.” Let’s break this down a bit, staying the course with our No Shame/No Blame commitment. I know this can be very hard for some of you, so that’s where a genetic counselor may actually be a good fit. Along with ongoing talk therapy (which you can book with me here), genetic counseling can be a great addition as a one or two session add-on to talk therapy.
Let’s talk about what it is and how it can benefit you.
What Is Genetic Counseling?
Genetic counseling is a specialized service that helps individuals and families understand how genetic conditions may affect them. It provides information, support, and guidance on the medical, emotional, and familial aspects of inherited conditions. Genetic counselors are healthcare professionals with training in both medical genetics and counseling.
What Does a Genetic Counselor Do?
A genetic counselor can:
Assess personal and family health history to evaluate genetic risk
Explain how specific conditions are inherited and what that means for the individual
Guide decision-making around whether to pursue genetic testing
Interpret test results and explain their implications
Offer emotional support as clients process complex or uncertain information
Connect clients to specialists or relevant healthcare resources
The Role of Genetic Counseling in Mental Health and Eating Disorders
Although genetic counseling is well established in areas like cancer, prenatal care, and rare diseases, its role in psychiatry and behavioral health is expanding. This includes its relevance to eating disorders like anorexia nervosa and bulimia nervosa. For now, it’s still a good idea to have your own counselor or therapist, as the role of genetic counselors is often limited to specific medical counseling. To book a session with a therapist who specializes in eating disorders (me!) click here.
Relevance to Eating Disorders:
Family Risk Assessment: Eating disorders often run in families. Genetic counselors can help assess whether a person is at increased risk and provide education around early signs and intervention.
Personalized Understanding: When individuals have multiple psychiatric diagnoses (e.g., anxiety, OCD, ADHD), counseling can help clarify overlapping traits and inform care.
Reducing Stigma: Learning that there is a biological and genetic component to eating disorders can reduce self-blame and help shift harmful narratives about willpower or vanity.
Supporting Research: Counselors may help clients participate in genetic research studies that contribute to the understanding of these complex disorders.
Who Might Benefit from Genetic Counseling?
Individuals with a family history of eating disorders or other psychiatric conditions
Families seeking more information about potential inherited risk for their children
People pursuing or considering genetic testing related to mental health
Clinicians and patients looking to integrate genetic information into a comprehensive treatment plan
Ethical and Emotional Considerations
Genetic counseling always involves sensitive, ethical decision-making. Counselors support clients through concerns like:
Uncertainty in test results
Emotional reactions to increased or confirmed genetic risk
Decisions about testing in minors
The potential impact of test results on family dynamics
Importantly, genetic counseling is non-directive. It empowers clients to make their own informed choices, rather than telling them what they should do.
Getting back to compassion: How you can play a role in destigmatizing genetic components to eating disorders.
So, let’s move deeper with our check in. How are you feeling after reading this information?
Can you put your hand on your heart, close your eyes, and do small check in? How are you feeling, truly?
Are you feeling safe? Overwhelmed? Nervous? Anxious? Guilty? Shameful?
And furthermore, what part of you is feeling this way? How old are they? What do they need or want to tell you? Just listen for a minute.
What does this part need from you? It’s ok if this is hard to do, or if it’s feeling painful to do. That’s what therapy helps with: the deeper examination. Remember, I’m available to help you. You can book a session here.
So what if we stopped asking, “Why don’t I/they just eat?”
And instead began asking, “What deeper pain are/am they/I carrying, and how can I/we help me/them feel safe enough to heal?”
For far too long, eating disorders like anorexia nervosa and bulimia nervosa have been misunderstood, minimized, and oversimplified. They’ve been treated as choices, attention-seeking behaviors, or the inevitable result of vanity in a culture obsessed with thinness. But emerging genetic research tells a different story. A story rooted not in blame, but in biology.
Scientific studies now confirm that there are strong hereditary and neurobiological components to eating disorders. We know that certain individuals are born with a genetic predisposition that affects their metabolism, appetite regulation, mood, and how they respond to stress. We know that trauma, perfectionism, impulsivity, and anxiety, traits often intertwined with these conditions, may also have genetic links. And we’re learning that anorexia nervosa, in particular, may be as much a metabolic disorder as it is a psychiatric one.
This matters.
Because when we recognize that these illnesses are not simply “in someone’s head,” we can stop seeing the person as the problem. We can begin to understand that eating disorders are not a failure of willpower or discipline! They are expressions of suffering, shaped by a perfect storm of genetic vulnerability and environmental influence.
And yet, biology is not destiny. Compassion, connection, and community still matter more than ever. No gene guarantees illness. No diagnosis defines a person’s worth.
As clinicians, educators, family members, and community members, we have a responsibility: to meet those affected not with shame, but with understanding. Not with punishment, but with presence. Not with assumptions, but with curiosity.
Let’s listen more closely. Let’s speak more gently. Let’s educate ourselves and others, not just about the symptoms, but about the science, so that no one has to face these disorders in silence or in shame.
Let’s build a world where research informs not just treatment, but how we talk to and about those who are struggling. A world where kindness is clinical. Where compassion is the protocol. Where healing is not just possible, it’s expected, because we’ve removed the barriers of stigma and replaced them with bridges of understanding.
Science gives us clarity.
Kindness gives us courage.
Together, they give us hope. And that is something every person with an eating disorder deserves.
For more information on related topics like How to help your teen cope with stress, click here.
Citations for Genetic Research on Eating Disorders
Watson et al. (2019) – Landmark GWAS on anorexia nervosa
Watson, H. J., Yilmaz, Z., Thornton, L. M., Hübel, C., Coleman, J. R. I., Gaspar, H. A., ... & Bulik, C. M. (2019). Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nature Genetics, 51(8), 1207–1214. https://doi.org/10.1038/s41588-019-0439-2Trace et al. (2013) – Heritability estimates for anorexia and bulimia
Trace, S. E., Baker, J. H., Peñas-Lledó, E., & Bulik, C. M. (2013). The genetics of eating disorders. Annual Review of Clinical Psychology, 9, 589–620. https://doi.org/10.1146/annurev-clinpsy-050212-185546Hudson et al. (2006) – Family aggregation of eating disorders
Hudson, J. I., Hiripi, E., Pope, H. G., & Kessler, R. C. (2006). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348–358. https://doi.org/10.1016/j.biopsych.2006.03.040Klump et al. (2001) – Twin studies on anorexia and bulimia
Klump, K. L., Miller, K. B., Keel, P. K., McGue, M., & Iacono, W. G. (2001). Genetic and environmental influences on anorexia nervosa syndromes in a population-based twin sample. Psychological Medicine, 31(4), 737–740. https://doi.org/10.1017/S0033291701003794Wade et al. (2017) – Genetic overlap in bulimia and comorbidities
Wade, T. D., Gordon, S., Medland, S., & Bulik, C. M. (2017). Genetics of eating disorders. In T. D. Wade (Ed.), Encyclopedia of feeding and eating disorders (pp. 1–8). Springer. https://doi.org/10.1007/978-981-287-104-6_63-1