















































International Journal of Social and Educational Innovation (IJSEIro) 

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EATING DISORDERS IN ADOLESCENTS 

 

Remus RUNCAN 

„Aurel Vlaicu” University of Arad, Romania. 

 

 Marius MARICI 1 

„Ștefan cel Mare” University of Suceava,  Romania 

 

Abstract 

The aim of this study is to review and synthesize peer-reviewed research from 

scientific journals and books pertaining to eating disorders in adolescents. Our analysis will 

focus on both typical and atypical eating disorders, including their specific comorbidities, 

culture-related diagnostic issues, emotional issues, functional consequences, gender 

distribution, medical consequences, onset, psychosexual effects, symptoms, treatment, and 

cure. Additionally, we will examine the factors and predictors involved in their aetiology. 

This study is a crucial step towards advancing Romanian research on eating disorders in 

adolescents. By thoroughly examining the existing literature, we hope to identify gaps in 

knowledge and areas for future investigation. Ultimately, our goal is to contribute to the 

development of effective prevention and treatment strategies for this vulnerable population. 

 

Keywords: adolescents, anorexia, binge eating, bulimia, eating disorder; 

 

1. Introduction 

 

1.1. Eating Disorders 

There are three typical eating disorders or polysymptomatic syndromes – anorexia, 

binge eating disorder, and bulimia. They are defined by ‘maladaptive attitudes and behaviors 

around eating, weight, and body image, including as well nonspecific disturbances of self-

image, mood, impulse regulation, and interpersonal functioning’ (Steiger, Bruce & Israël, 

2003, p. 173).  

There are also five atypical eating disorders or other specified feeding or eating 

disorders: atypical anorexia nervosa, atypical binge eating disorder, atypical bulimia nervosa, 

 
1 Correspondent author: marius.marici@usm.ro / +40-747-494-707; 



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night eating syndrome and purging. The latter is defined as ‘feeding and eating disorders that 

cause clinically significant distress or impairment in social life, but does not meet the full 

criteria for typical [eating disorders]’ (Galmiche et al., 2019, p. 1402). Atypical Anorexia 

Nervosa is a type of anorexia nervosa where the individual meets all the criteria for the 

disorder except for being underweight. Binge-Eating Disorder of low frequency and/or 

limited duration is characterized by recurrent episodes of binge eating, but less frequently 

than the typical diagnosis of binge-eating disorder. Bulimia Nervosa of low frequency and/or 

limited duration is similar to binge-eating disorder, but with the addition of purging behaviors 

such as vomiting or laxative use. Purging Disorder is characterized by purging behaviors 

without binge eating. (DSM-5, 2013; Zam, Saijari & Sijari, 2018) Singh (2013) presented a 

rare form of eating disease – pica, which refers to ‘a tendency or craving to eat substances 

other than normal food [such as ashes, clay, mud, or plaster], occurring during childhood or 

pregnancy, or as a symptom of disease’ (Lexico, n.p.). Eating disorders are commonly 

diagnosed and treated mental health conditions. These disorders affect a significant portion of 

the population and can have serious consequences if left untreated. (Steiger, Bruce & Israël, 

2003) 

 

1.2. Anorexia (nervosa) 

Anorexia (nervosa) has been defined by English language dictionaries as ‘lack or loss 

of appetite for food (as a medical condition); an emotional disorder characterized by an 

obsessive desire to lose weight by refusing to eat’ (Lexico, n.p.). Anorexia nervosa is a 

serious eating disorder characterized by an unhealthy obsession with dieting and thinness, 

resulting in significant weight loss. Despite the individual's drastic weight loss, they continue 

to perceive themselves as overweight and fail to recognize the severity of their condition. 

(Strickland, 2001) Anoerxia is an eating disorder whose main feature is ‘appetitive 

overcontrol’, a ‘relentless pursuit of thinness and a morbid fear of the consequences of eating 

(usually expressed as a dread of weight gain or obesity)’ (Steiger, Bruce & Israël, 2003, p. 

173). It is a disorder defined as ‘a refusal to maintain body weight at a minimally normal 

weight for age and height; an intense fear of gaining weight. This fear, present even in an 

emaciated condition, may be denied, but it is demonstrated by an intense preoccupation with 

thoughts of food, irrational worries about gaining weight, and rigorous exercising programs, 

with severe restriction of total food intake in order to prevent weight gain; a disturbance of 

body conceptualization. Parts of the body such as the thighs and abdomen are experienced as 

being excessively large; evaluation of the self is mainly in terms of body weight and shape; 



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and the denial of illness or the underweight condition is a hallmark symptom of this disorder; 

amenorrhea or cessation of menstrual cycles’ (Halmi, 2004, p. 63).  

In terms of comorbidity, anorexia is associated with alcohol-use, alexithymia, anxiety, 

bipolar, celiac disease, depressive, obsessive-compulsive, other substance-use disorders, and 

type 1 and type 2 diabetes mellitus (Ward et al., 1995; Karwautz et al., 2008; Young-Hyman 

& Davis, 2010; DSM-5, 2013; Nowakowski, McFarlane & Cassin, 2013; Runcan, 2020). 

Culture-related diagnostic issues: in post-industrialized, high-income countries (e.g., 

‘Australia, European countries, Japan, New Zealand, the United States’), (DSM-5, 2013). 

When it comes to emotions, the typical anorexic individual is often a strong-willed adolescent 

who uses their aversion to food as a misguided way of exerting control over their life due to a 

lack of control in other areas. Unfortunately, the functional consequences of anorexia can 

lead to social isolation and a failure to reach their full academic or career potential. (DSM-5, 

2013) Anorexia has an increased prevalence in girls starving themselves to attain a 

fashionable boyish figure, with 1 of every 100 adolescent girls having anorexia nervosa 

(Rolls, Fedoroff, & Guthrie, 1991). In terms of medical consequences anorexia is associated 

with: abnormal levels of several neurotransmitters (which might be further associated with 

depression), amenorrhea, bluish hands and feet, constipation, fear of fatness, heart failure, 

infertility, kidney failure, lanugo (growth of fine body hair), loss of muscle mass, low body 

weight, lower blood pressure, lower body temperature, osteoporosis, perception of distortion 

of body shape, slowed metabolism, slowed reflexes, slower pulse, weakened heart (Rolls, 

Fedoroff, & Guthrie, 1991). Anorexia usually appears first in childhood (Schulherr, 2008). 

Anorexia is associated with an arrest of sexual development, which is a psychosexual effect 

in adolescents. Usually when anorexia installs it is associated with a pattern of binging and 

purging, compulsive exercising, continuation of weight loss despite thinness, dieting in 

secret, exaggerated fear of gaining weight, persistent feeling of being fat even after weight 

loss, loss of menstrual periods, preoccupation with calories, cooking, food, or nutrition, 

significant weight loss, and sleep disorders. The treatments and cure for anorexia refer to: 

hospitalization, medication, nutritional counselling, and psychotherapy for the individual and 

family group. 

Zonnevylle-Bender et al. (2004) compared emotional functioning of adolescent 

anorexia nervosa patients with two control groups (an internalizing psychiatric outpatient 

group and a healthy control group).  

The study conducted by the authors revealed that individuals with anorexia nervosa 

and those who were psychiatric outpatients with depressive and/or anxiety disorders 



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exhibited significant deficits in emotional functioning when compared to the healthy control 

group. Specifically, the anorexia nervosa group demonstrated the most significant impairment 

in emotional functioning. The results of the emotional tasks showed that both psychiatric 

groups performed worse than the healthy control group in their ability to process visual 

emotional information. Additionally, the psychiatric outpatients with depressive and/or 

anxiety disorders group had more difficulty in memorizing responses to auditory emotional 

stimuli than the anorexia nervosa and healthy control group. Furthermore, the psychiatric 

outpatients with depressive and/or anxiety disorders group processed auditory emotional 

information at a slower pace than the healthy control group. It is worth noting that no 

differences were found between the three groups on non-emotional, cognitive tasks. 

Overall, these findings suggest that individuals with anorexia nervosa and those with 

depressive and/or anxiety disorders experience significant deficits in emotional functioning, 

particularly in their ability to process emotional information. Emotional intelligence, empathy 

and alexithymia are socio-emotional difficulties encountered by anorexia nervosa during 

adolescence, difficulties heightened by anxiety and depression (Rome et al., 2003; Peres et 

al., 2018; Runcan, 2020). 

 

1.3. Binge Eating Disorder 

Definition: binge eating has been defined by English language dictionaries as ‘the 

consumption of large quantities of food in a short period of time, typically as part of an eating 

disorder’ (Lexico, n.p.). Binge eating is a term used to describe the act of consuming a 

significant amount of food within a short period of time, often accompanied by a feeling of 

being unable to control one's eating habits (Strickland, 2001).  

Comorbidity: alexithymia, anxiety disorders, bipolar disorders, celiac disease, 

depressive disorders, substance use disorders, and type 1 and type 2 diabetes mellitus (Ward 

et al., 1995; Karwautz et al., 2008; Young-Hyman & Davis, 2010; DSM-5, 2013; 

Nowakowski, McFarlane & Cassin, 2013; Runcan, 2020). Culture-related diagnostic issues: 

It is noteworthy that this phenomenon is observed with comparable frequency across various 

industrialized nations, including Australia, Canada, European countries, New Zealand, and 

the United States. Emotional issues: feeling of disgust with oneself, of distress, of 

embarrassment by how much he/she eats, of guilt (DSM-5, 2013). Functional consequences: 

Binge eating has been found to be linked with higher healthcare utilization when compared to 

individuals with a similar body mass index (BMI). Additionally, it can lead to the 

development of obesity, a decrease in health-related quality of life and life satisfaction, an 



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increase in medical issues and mortality rates, a higher risk for weight gain, and difficulties 

with social role adjustment. (DSM-5, 2013) Gender distribution: The gender ratio is 

significantly less imbalanced in individuals with binge-eating disorder compared to those 

with bulimia nervosa. This suggests that the prevalence of the disorder is more evenly 

distributed among males and females in the former, while the latter is more commonly 

observed in females. (DSM-5, 2013) Indicative of: borderline personality (“mental illness 

characterized by erratic and impulsive self-destructive behaviour and an intense fear of 

abandonment” (Ford-Martin, in Gale, 2001, p. 88), and bulimia (Strickland, 2001). Medical 

consequences: Abdominal pain, electrolyte imbalances, and intestinal damage can lead to 

serious health complications such as cardiac arrest, muscle weakness, and vomiting. Onset: in 

adolescence (Schulherr, 2008). Psychological effects: depression. Specific behaviours: binge 

eating, often followed by fasting, purging, or vomiting, is a common symptom of an eating 

disorder. This behavior is often accompanied by a deep-seated fear of gaining weight or 

becoming fat. (Rolls, Fedoroff & Guthrie, 1991) Symptoms: binge eating, also known as 

uncontrollable eating, is characterized by the consumption of large quantities of food within a 

short and defined time frame. This behavior is often followed by purging, which can take the 

form of abusing diuretics or laxatives, engaging in excessive exercise, fasting, or inducing 

vomiting. Treatment and cure: binging can be a result of various underlying psychological 

factors such as stress, anxiety, or depression. By identifying and addressing these root causes, 

patients can gain a better understanding of their behavior and learn to manage their impulses. 

Behavior modification techniques can also be helpful in breaking the cycle of binging. This 

may include setting achievable goals, practicing mindfulness, and developing healthy coping 

mechanisms. Triggers: hunger, interpersonal stressors, negative mood, thoughts about weight 

and shape (Black Becker, 2004). 

 

1.4. Bulimia (nervosa) 

Definition: bulimia (nervosa) has been defined by English language dictionaries as 

‘an emotional disorder characterized by a distorted body image and an obsessive desire to 

lose weight, in which bouts of extreme overeating are followed by fasting or self-induced 

vomiting or purging’ (Lexico, n.p.) Bulimia nervosa is a serious eating disorder that is 

defined by three primary symptoms. These include recurrent episodes of binge eating, 

inappropriate compensatory behaviors, and an extreme preoccupation with body weight.  

(Black Becker, 2004) 



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Comorbidity: alexithymia, anxiety disorders, bipolar and depressive disorders, celiac 

disease, low self-esteem, borderline personality disorder, substance use, and type 1 and type 2 

diabetes mellitus (Ward et al., 1995; Karwautz et al., 2008; Young-Hyman & Davis, 2010; 

DSM-5, 2013; Nowakowski, McFarlane & Cassin, 2013; Runcan, 2020). Culture-related 

diagnostic issues: in the majority of industrialized nations, such as Australia, Canada, various 

European countries, Japan, New Zealand, South Africa, and the United States, there is a 

common trend. Emotional issues: experiencing intense feeling of guilt and shame over 

binging, feeling out of control, and realizing the abnormality of the eating pattern. 

Functional consequences: severe role impairment in the social-life domain (DSM-5, 2013). 

Gender distribution: far more common in females than in males (Rolls, Fedoroff & Guthrie, 

1991; DSM-5, 2013). Medical consequences: abdominal pain and electrolyte imbalances can 

potentially lead to serious health complications such as cardiac arrest or weakness. Onset: in 

late adolescence (Schulherr, 2008). Physiological causes: a defective satiety mechanism. 

Psychological effects: depression swings, mood swings. Specific behaviours: bulimia is a 

disorder characterized by a tendency to engage in crash diets, consume high-calorie junk food 

(such as candy bars, cookies, and ice cream) in secret, eat until experiencing stomach aches, 

drowsiness, or external interruptions, and experience weight fluctuations within a 4.5 kg 

range. Additionally, individuals with bulimia may engage in binge eating followed by fasting, 

purging, or vomiting, and experience a fear of gaining weight. (Rolls, Fedoroff & Guthrie, 

1991) Symptoms: eating uncontrollably (binging) large amounts of food (e.g., a loaf of bread, 

several boxes of cookies) in a short and well-defined time period (at least twice a week and 

twice or more times a day), and then purging by abusing diuretics or laxatives, dieting, 

exercising, fasting, vomiting; alcohol abuse, bloating, dental problems, drug abuse, heartburn, 

irregular periods, swollen cheeks. Treatment and Cure: Anti-depressant medication, such as 

anticonvulsants, diphenylhydantoin (such as Dilantin), and tricyclic antidepressants, can be 

used to alleviate symptoms of depression. Additionally, individual and/or group 

psychotherapy can be employed to investigate the patient's unconscious motivations for 

binging, in combination with behavior modification techniques to help cope with the disease. 

Nutritional counselling is also an important aspect of treatment, as it can help patients 

develop healthy eating habits and maintain a balanced diet. In severe cases, hospitalization 

may be necessary to provide intensive care and support. 

Ward et al. (1995) have found that when diabetes is combined with an eating disorder, 

adolescents become doubly disabled. This is a particularly challenging situation for 

adolescents because type 1 diabetes requires a significant lifestyle adjustment, even with the 



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advancements in medical technology. This chronic disease prevents individuals from living a 

carefree life. Additionally, eating disorders bring about a host of disorder-specific 

disadvantages (Grylli et al., 2002). 

According to Quick, Byrd-Bredbenner & Neumark-Sztainer (2013), research indicates 

that young individuals with chronic illnesses that necessitate a dietary component, such as 

celiac disease, cystic fibrosis, inflammatory bowel disease, irritable bowel syndrome, and 

type 1 diabetes mellitus, may be susceptible to developing disordered eating habits that can 

escalate into a full-blown eating disorder during their treatment. 

 

2. Material and Method 

 

Given the complexity of eating disorders, we have consulted acta (of psychiatrics), 

books (on eating disorders), dictionaries, encyclopaedias (of behavioural sciences and 

psychology), handbooks (of eating disorders and psychology), journals (of behaviours, body 

image, care / therapeutics / treatment, clinical nutrition, eating disorders, health psychology, 

health, medicine, nutrients, nutrition, paediatrics, paediatric psychology, prevention, 

psychiatry, psychosomatics, scientific research, and weight disorders), manuals (of mental 

disorders), reviews (on eating disorders). 

The search of the articles and books related to eating disorders was done using a 

specific search related controlled vocabulary.  

 

3. Results 

 

Literature has investigated both factors involved in the aetiology of eating disorders 

and predictors of eating disorders. 

 

3.1. Factors Involved in the Aetiology of Eating Disorders 

Biological, developmental, familial, psychological, and sociocultural factors are 

involved in the aetiology of eating disorders (Rolls, Fedoroff & Guthrie, 1991). 

Biological factors (Connan & Stanley, 2003): 

- Endocrine changes along the hypothalamic-pituitary-gonadal axis; 

- Genetic predisposition (Winchester & Collier, 2003): there is a 55% concordance 

rate of monozygotic twins for an eating disorder with only a 7% concordance rate 

for dizygotic twins; 



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- Serotonin (a brain neurotransmitter regulating appetite, mood, pain, and sleep) 

alteration by dieting in women but not in men, a biological difference that could 

explain why eating disorders are more common in women than in men. 

Developmental factors: 

- After puberty, girls have twice as much fat as boys and grow away from the lean 

female ideal (hence more dissatisfaction with their body and dieting as a way to 

take control), while boys acquire more lean muscle and develop toward the 

accepted male ideal. 

Familial factors: 

- Families of individuals with anorexia nervosa often exhibit characteristics such as 

being achievement-oriented, enmeshed, overprotective, and rigid. These traits can 

hinder the development of autonomy and foster dependency in the affected family 

member. Additionally, families of both anorexics and bulimics tend to place 

excessive emphasis on appearance, diet, food, physical fitness, and weight. There 

is also a higher likelihood of a family history of alcoholism, affective disorders, 

and eating disorders in first-degree relatives. In contrast, families of bulimics tend 

to be less structured than those of anorexics. Emotional distance, increased overt 

conflict, neglect, and rejection are common in these families. It is important to 

note that these generalizations do not apply to all families of individuals with 

eating disorders and should not be used to stereotype or stigmatize them. 

Psychological factors  

- Individuals with anorexia nervosa often exhibit traits such as compliance, 

impaired autonomy, limited spontaneity, and perfectionism. Both anorexics and 

bulimics struggle with conflicts of autonomy and identity, low self-esteem, and a 

sense of ineffectiveness. Additionally, both groups tend to display obsessive 

personality traits, such as being preoccupied with calorie counting and mental 

imaging of food. Bulimics, on the other hand, are more likely to have a history of 

childhood maladjustment and have been obese or had an obese mother. They are 

often extroverted and active, but may have a history of trouble with the law, such 

as theft, and problems with alcohol abuse. Furthermore, bulimics often have a 

history of unstable mood and attempted suicide, which suggests a deficit in the 

regulation of affect and control. (Kaltiala-Heino et al., 1999; Serpell & Troop, 

2003; DSM-5, 2013) 

 



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Sociocultural factors  

- Certain professions prioritize appearance and weight over performance, requiring 

individuals to maintain a specific weight. Modelling, acting, and professional 

sports are some of the industries that place a significant emphasis on physical 

appearance. In these fields, maintaining a certain weight is often considered 

crucial for success. Other professions that require weight maintenance include 

athletics such as jockeys, runners, and wrestlers, as well as dancing and jockeying. 

- However, this emphasis on weight can lead to negative consequences such as the 

greater incidence of bulimia in boarding schools and college dorms of competitive 

and stressful schools and campuses where dating is emphasized. The 

internalization of values and beliefs that equate thinness with attractiveness and 

success is a prevalent issue in our society. This phenomenon refers to the process 

by which individuals adopt societal norms and expectations regarding body image 

and internalize them as personal beliefs. This can lead to weight dissatisfaction, 

weight concern, and dieting. 

- Social pressure also plays a role in the idealization of the thin female form and 

pressures on women to compete and perform well while still being attractive and 

feminine. Additionally, social status can contribute to the prevalence of anorexia 

and bulimia among upper-class and middle-class 12-25-year-old females in 

developed countries. (Kaltiala-Heino et al., 1999; Nasser & Katzman, 2003; 

Sundgot-Borgen, Skarderud & Rodgers, 2003; DSM-5, 2013) 

Rome et al. (2003, 100) identified as risk factors for the development of an eating 

disorder the following: 

- Affective alcoholism or illness in first-degree relative; 

- Ballet, gymnastics, modelling, visual sports; 

- Body-image dissatisfaction; 

- Family history of eating disorder or obesity; 

- History of compulsive exercise, excessive dieting, frequently skipped meals; 

- Low self-esteem; 

- Parental eating behaviour and weight; 

- Personality traits (e.g., perfectionism); 

- Physical or sexual abuse. 

 



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Schmidt (2003) identified several factors that contribute to the development of eating 

disorders. These include genetic and environmental factors, as well as life events and societal 

pressures.  

- Genetically, there is evidence that certain genes related to dopamine, weight control, 

feeding, and energy expenditure, as well as serotonin, may increase the risk of developing an 

eating disorder. Additionally, there is a heritability of both behavioral and attitudinal 

symptoms, such as binge eating, dietary restraint, and self-induced vomiting. 

- Environmental factors also play a role, with childhood adversity, childhood abuse, 

childhood maltreatment, and maladaptive maternal behavior among the risk factors. Perinatal 

risks, such as birth problems, and attachment patterns, such as insecure or unresolved 

attachment status, also contribute to the risk model. 

- Life events, such as acute or chronic stressors and crises perceived as shameful or 

disgusting, can also precipitate the development of an eating disorder. Puberty is another 

critical period when physical and psychosocial challenges must be navigated. 

- Finally, societal pressures, particularly in the Western world, where there is a sharp 

contrast between the availability of calorific, cheap, and highly palatable foods and the 

excessive value placed on dietary restraint and slimness, can contribute to the development of 

eating disorders. The daily bombardment of images of emaciated supermodels and other thin 

role models can also institute the norm among young women. 

- It is important to note that there is a unique versus shared genetic risk, such as body 

mass index, that can also contribute to the development of eating disorders. By understanding 

these factors, we can better identify and treat individuals who may be at risk for developing 

an eating disorder. 

Zeeck et al. (2011) investigated everyday emotions and the relationship between 

binge eating, the desire to eat, and emotions and found that, from 24 emotions (anger, 

boredom, contempt, disappointment, disgust, enjoyment, exhaustion, fear, guilt, helplessness, 

hope, hurt, interest, jealousy, loneliness, longing, power, powerlessness, relaxation, sadness, 

satisfaction, shame, surprise, tenseness), anger, feelings of loneliness, disgust, exhaustion or 

shame lead to binge eating behaviour with the highest probability. 

Wooldridge & Lytle (2012) advanced the idea that there are four – biological 

(malnutrition, osteoporosis, pre-morbid obesity, puberty), cultural and gender-related (body 

image, homosexuality, weight-related teasing), familial (excessive parental expectations, 

greater achievement, conflict and control orientation, less autonomy, less independence), and 

psychodynamic (conflict about sexual identity, loss of sexual drive, over-involvement of 



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caretakers, perfectionism) – not just one factor involved in male anorexia nervosa. Holland & 

In 2016, Tiggemann highlighted the significant influence that social networking sites have on 

body image and disordered eating outcomes. This impact is primarily driven by seeking 

negative feedback through status updates and the uploading and viewing of photos. 

Appearance-based social comparison plays a crucial role in mediating these outcomes. 

According to Lacoste (2017), family issues and past experience with sexual abuse explain the 

transition to anorexia in female adolescents. 

In 2018, Marzilli, Cerniglia & Cimino conducted a comprehensive analysis of the 

factors contributing to the development of binge eating disorder. Their research identified 

several key risk factors, including biological, environmental, and psychological factors. 

Biological risk factors, such as familial genetic predisposition and epigenetic processes, play 

a significant role in the development of binge eating disorder. These factors can increase an 

individual's susceptibility to the disorder and make it more difficult to manage. 

Environmental risk factors, including early adverse experiences, parental influences on 

childhood eating behavior, parental psychopathology, and traumatic experiences in the 

parents, can also contribute to the development of binge eating disorder. These factors can 

create a stressful and unstable environment that may lead to disordered eating behaviors. 

Psychological risk factors, such as personality traits of perfectionism and impulsivity, 

negative affect or depressive symptoms, weight and eating concerns, and body 

dissatisfaction, can also increase an individual's risk of developing binge eating disorder. 

These factors can lead to negative self-image and a preoccupation with food and weight, 

which can contribute to the development of disordered eating behaviors. 

 

3.2. Predictors of Eating Disorders 

In 2006, Haines et al. conducted a study to determine whether weight-related teasing 

had any impact on the development of disordered eating behaviors among adolescents. The 

study found that weight teasing during adolescence predicted disordered eating behaviors at a 

5-year follow-up. Interestingly, the patterns of these associations differed by gender. Boys 

who were teased about their weight were more likely to initiate binge eating with loss of 

control and unhealthy weight control behaviors, while girls who were teased were more likely 

to become frequent dieters. In a more recent study conducted by Tan et al. in 2022, weight 

teasing was investigated in association with various health risk behaviors in adolescents. 

These behaviors included binge eating, lack of healthy dietary behavior, lack of physical 

activity, sedentary behaviors, sleep disturbance, and unhealthy dietary behavior. 



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In 2011, Day et al. conducted a study to investigate the specific risk factors associated 

with the development of early-onset bulimia nervosa and subclinical bulimia nervosa. The 

study identified certain correlates, such as parental depression during the same period as the 

onset of eating pathology, as well as markers like ethnicity, age, and weight. Additionally, the 

study found that early menarche, parental obesity, and parental psychiatric disorder were all 

risk factors for the development of bulimia nervosa. 

In 2015, Micali et al. conducted a study that focused on predicting eating disorders. 

The study identified various risk factors, including body dissatisfaction, body mass index, 

self-esteem, maternal eating disorders, and economic disadvantage. Interestingly, the study 

found that these risk factors varied according to gender. 

Finally, in 2018, Zam, Saijari, and Sijari identified several signals that may indicate 

the presence of an eating disorder. These signals include body weight, fatal illnesses, 

obsessions with food, and shape. 

 

4. Conclusions 

 

After conducting a thorough investigation of various references, several conclusions 

can be drawn regarding eating disorders in adolescents. Firstly, there are three typical eating 

disorders and five atypical eating disorders that are prevalent in this age group. It is worth 

noting that eating disorders are among the most frequently diagnosed and treated mental 

disorders.  

Typical eating disorders have specific comorbidities, culture-related diagnostic issues, 

emotional issues, functional consequences, gender distribution, medical consequences, onset, 

psychosexual effects, symptoms, and treatment and cure. For instance, anorexia nervosa 

involves emotional functioning and socio-emotional issues, while binge eating has its own 

triggers such as hunger, interpersonal stressors, negative mood, and thoughts about weight 

and shape. Additionally, bulimia nervosa combined with diabetes requires a change in 

lifestyle. 

The aetiology of eating disorders is complex and involves biological, developmental, 

familial, psychological, and sociocultural factors. Predictors of eating disorders include body 

weight, fatal illnesses, obsessions with food, different risk factors, and shape and weight-

related teasing. 

It is possible to reduce the risks of eating disorders by changing cultural ideals that 

connect thinness and beauty to self-worth and happiness. This can be achieved by helping 



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children and adolescents establish healthier attitudes and eating behaviours, and learn to 

value themselves and others for intrinsic qualities, rather than extrinsic qualities focusing on 

appearance. 

 

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