Eating Disorders and Personality

Some personality traits are associated with particular psychological disorders. In this article, we'll talk about the relationship between personality and eating disorders.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) from the American Psychiatric Association states that “feeding and eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning”. Most people understand the basics of these conditions. But did you know there’s a link between eating disorders and personality?

The prevalence of these disorders has risen over the last twenty years. Although they especially affect young women, health professionals are seeing more and more cases of young male patients.

Eating disorder classifications

In the most recent edition of the DSM, the DSM-5, eating and feeding disorders include:

• Anorexia nervosa.
• Bulimia nervosa.
• Binge eating disorder.
• Avoidant/restrictive food intake disorder (ARFID)
• Rumination disorder.
• Pica.

The first two subtypes are the most common of all eating disorders, which is why we’ll focus solely on anorexia and bulimia.

However, it’s worth mentioning that other feeding and eating disorders have become more common in modern society, such as excess weight and obesity (related to lifestyle and a poor diet), vigorexia, megarexia, permarexia, and drunkorexia.

Characteristics of eating disorders

Scientific literature that discusses eating and feeding disorders stress the multifactorial nature of the conditions. On the other hand, the pressures of conventional beauty standards also play a huge role. They have a profound impact on the maladaptive body image beliefs that are the root cause of these disorders.

Eating disorders and personality traits

The relationship between these two factors suggests that certain traits could play a key role in the origin and progression of eating and feeding disorders. In general terms, research indicates that a neurotic personality is often related to eating disorders.

However, other traits relate to each specific subcategory. For example, many patients with anorexia nervosa also display obsessive behaviors and a desire to be in control. Researchers also highlight inflexible thought patterns, especially those related to maladaptive beliefs. Lastly, people with anorexia nervosa also tend towards dependency and introversion.

On the other hand, bulimia nervosa patients often have a low tolerance for frustration and low impulse control. They also tend to have low self-esteem, are more anxious, and are more “interpersonally sensitive” than those with anorexia (Macias et. al., 2003). Their impulsivity also makes them prone to unpredictable behavior.

Personality disorders and eating disorders

We can’t talk about personality traits without mentioning personality disorders. There’s a high correlation between personality traits and eating disorders. In fact, some studies show it to be as high as 53-93 percent.

Researchers have been able to show that there’s a relationship between anorexia nervosa, avoidance disorder, dependence disorder, and obsessive-compulsive disorder. Bulimia nervosa, on the other hand, is linked to emotional disorders, anxiety disorders, and substance abuse disorders.

Given how complex it is to treat eating disorders, the patient’s personality plays a determining role. The need for control, impulsivity, and lack of mental flexibility make it more difficult for patients to work with therapists and other health professionals.

That’s why it’s important to work on these personality traits in therapy. After all, they play an important role in maintaining cognitive distortions (mental inflexibility), binging and purging (impulsivity), and restrictive diets (need for control).