Identifying Childhood Risk Factors for Anorexia Nervosa

Identifying early risk factors for development of eating disorders is important for understanding the etiology and for formulating strategies for prevention. Dasha E. Nicholls, MBBS, MD and Russell M. Viner, MBBS, PhD, of University College, London, used data from the 1970 British Cohort Study, which included information reported at birth, and at 5, 10, and 30 years of age, to identify associations between suggested childhood risk factors and self-reported lifetime anorexia nervosa (AN) at 30 years of age (J Am Acad Child Adoles Psychiatry 2009; 48:791).The British Cohort Study is a continuing longitudinal study of infants born between April 5-11, 1970 in England, Scotland, Wales, and Northern Ireland.

The two researchers did not find evidence to support a role for many childhood risk factors previously suggested for AN. Independent factors that did predict lifetime self-reported AN were: female sex, infant feeding problems, maternal depression symptoms in early childhood and a history of under-eating during early childhood. Protective factors were high self-esteem in late childhood and higher maternal body mass index. Prenatal events or gestational age, birth weight, separations from the mother, childhood emotions disorders, parenting style, and sleep problems, did not play any role in the later development of AN. The authors note that the main limitation of their study is the self-report history of AN, and accept that under-reporting and over-reporting might result in some bias.