With a blend of contributing factors such as past experiences and personality, anorexia is more complicated than you might think.

Anorexia nervosa is an eating disorder involving weight loss, food restriction, and sometimes compulsive exercise.

Body image distress and fear of weight gain often drive these behaviors, but the condition goes deeper than that.

Biological and environmental factors can:

  • make you more likely to develop anorexia
  • trigger behaviors related to anorexia
  • get in the way of healing and recovery

In addition, the following factors can contribute to anorexia:

  • genetics
  • brain chemistry
  • family behaviors
  • other mental health conditions
  • past trauma
  • social attitudes about weight

Learning about the risk factors and causes of anorexia can help people at many stages of recovery gain a better understanding of their condition. It can often be a validating process.

Whether you’re still figuring out if you have an eating disorder or you’re far along on your path to recovery, learning about the roots of anorexia could be a step toward healing.

Environmental and social factors play a large role in who develops anorexia.

Eating disorders are often connected to having a history of trauma, especially childhood sexual trauma.

Research suggests that people with eating disorders are also more likely to have experienced:

  • physical abuse
  • emotional abuse
  • teasing and bullying
  • parental divorce
  • loss of a family member

Some other environmental risk factors of anorexia are:

  • bullying, especially about weight
  • childhood adversity or trauma
  • isolation and loneliness
  • being in environments with high pressure to have a smaller body (like modeling and ballet)
  • history of family or generational trauma
  • living in a culture that promotes small bodies as ideal

One study in women with anorexia found that 13.7% met criteria for post-traumatic stress disorder (PTSD). Most of the women with PTSD reported that their first traumatic event happened before they’d developed anorexia.

The most common traumatic events were connected to sexual trauma.

Other research suggests that childhood bullying can predict eating disorder symptoms in both kids who bully and kids who experience bullying.

Sometimes anorexia can be triggered when a person who has other anorexia risk factors spends a lot of time in situations where the pressure to have a small body is very strong.

Certain personality traits are more common in people with anorexia.

Anorexia has been linked to:

  • body dissatisfaction and frequent thoughts about an “ideal” appearance
  • perfectionism
  • anxiety disorders such as social anxiety disorder, generalized anxiety disorder, and obsessive-compulsive disorder (OCD)
  • history of dieting or other weight-control methods
  • autistic features
  • rigid ideas, beliefs, or plans

Some research estimates that anywhere from 8 to 37% of people with an eating disorder could be autistic.

One study found the chances of autism were more than 15 times greater in people with anorexia than in those without.

Researchers also looked at the link between eating disorder symptoms and cognitive inflexibility. Cognitive flexibility is the ability to think about something in a new way, such as finding a new way to solve a problem.

People with cognitive inflexibility may have a harder time adapting to unexpected conditions. They might stay more focused or get stuck on one issue longer.

The study found that eating disorder symptoms and social anxiety were both tied to cognitive inflexibility. And when researchers took social anxiety out of the picture, the link between eating disorder symptoms and cognitive inflexibility stayed strong.

Perfectionism could also play a major role in anorexia, both before and after recovery. Researchers suggest that perfectionism in people with anorexia could be related to self-doubt.

For decades, people believed social, cultural, and family behaviors were the main cause of anorexia. But anorexia can run in families, and twin studies suggest genetics play an important role.

Genetic risk factors of anorexia include:

  • having a family member with an eating disorder
  • having a family member with a mental health condition
  • living with type 1 diabetes

Your chance of developing anorexia is much higher if a close family member has it. If you have a parent, sibling, or child with anorexia, your risk of developing it could be 10 times greater than that of someone who doesn’t have a relative with the condition.

Living with type 1 diabetes is also a key risk factor for anorexia. Research suggests rates of eating disorders are higher in people with type 1 diabetes.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies restricting insulin as a purging behavior. If someone is restricting both food and insulin, they could meet the criteria for anorexia nervosa with purging behaviors.

Eating disorders can impact anyone of any age, gender, socioeconomic status, or race. But some people may have more risk factors that increase their chances of having anorexia.

Women are about 2 to 3 times more likely to develop anorexia than men. But rates of anorexia in men may be underreported due to stigma.

Teens and young women in their early 20s seem to have a higher risk of anorexia than other age groups.

Another risk factor is having a mental health issue, such as:

  • OCD
  • anxiety
  • depression
  • a mood disorder

Many people with anorexia are also on the autism spectrum.

Social and cultural pressures to have a small body can also be risk factors for eating disorders. For example, anorexia is more common in Western culture and in people recently exposed to Western culture.

Low self-esteem is another known risk factor for anorexia.

A healthcare professional can diagnose anorexia. To get a diagnosis, you might talk to:

  • a pediatrician
  • a family practitioner
  • a psychiatrist

This might involve a physical exam and a mental health evaluation. If you want to learn more about anorexia symptoms first, here’s one good place to start.

The DSM-5 has these guidelines for diagnosing anorexia nervosa:

  • weight loss that impacts your health and well-being
  • strong fear of gaining weight
  • body image distortion
  • view of body weight and shape that affects your self-esteem
  • lack of recognition that the weight loss is taking a toll on your health

Anorexia can impact people of any body size.

People with atypical anorexia might be considered average or overweight according to the BMI. But the weight loss they’ve experienced can cause the same health impacts as it would in someone with a smaller body who has anorexia.

So what causes anorexia? It’s caused by a complex interaction of your environment and genetics. Social situations and personality could play especially big roles in whether someone has anorexia.

If you think you have anorexia, you’re not alone. Treatment centers, counseling, family therapy, and other methods can help you build a good relationship with food and your body.

You can learn more about anorexia treatment options here.