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Eating disorders rarely have a single cause. They develop through a mix of factors, including our relationships, our experiences, and the genes we inherit from our parents.
At ABBI Clinic, we know that trying to understand where an eating disorder has come from can feel overwhelming, especially when there’s no simple answer. This guide walks through what the research shows about genetics and eating disorders and what that means for your treatment and recovery.
Yes, genetics play a significant role. According to the Eating Disorders Genetics Initiative (EDGI), the largest study of its kind, genetics account for an estimated 40-60% of a person’s risk of developing an eating disorder.
It’s called heritability, and it’s a population-level estimate rather than a personal prediction. It tells us how much genetics contributes to risk across large groups of people, not whether any one person will develop an eating disorder. Eating disorders are not strictly passed down through genetics, but a genetic predisposition makes someone more vulnerable to developing one in combination with other factors.
Genetic risk isn’t identical across every eating disorder. Researchers have studied anorexia nervosa, bulimia nervosa, and binge-eating disorder individually, mainly through twin and family studies that compare how often relatives share a diagnosis. Because these studies use different populations and methods, the exact percentages vary, but the overall pattern holds: genetics do matter for all three conditions.
Twin studies estimate that genetics accounts for roughly a third to over half of the risk of developing anorexia nervosa, with one PubMed Central review reporting a range as wide as 33-84% depending on the population studied. Much of this risk is thought to involve genes that affect appetite regulation and the brain’s reward system, including chemical messengers, like serotonin and dopamine, which influence hunger cues and how the brain responds to food and body image.
Genetic factors have been estimated to account for between 28% and 83% of the risk of bulimia nervosa, according to one PubMed Central study. Research also points to genes involved in impulse control and reward processing, which may help explain why bulimia nervosa so often involves cycles of binge eating and compensatory behaviour.
For binge-eating disorder, PubMed Central heritability estimates sit at around 41-57%. As with the other conditions, genetic vulnerability appears to interact with how the brain manages reward and appetite, though research into the specific mechanisms is still developing.
Genetics can make someone more vulnerable to developing an eating disorder, but vulnerability isn’t always the sole influence. Whether that vulnerability develops into an eating disorder or not often depends on a range of external influences, including:
This overlap between genetics and environment also explains why heritability estimates vary so much between studies. Twin and family studies are the main way researchers measure genetic influence, but twins and siblings usually share more than DNA. They often share the same household, the same cultural environment, and sometimes the same difficult experiences, which makes it hard to separate genetic and environmental influence with complete precision.
Our understanding of the genetics of eating disorders has grown considerably in recent years, thanks largely to two strands of research.
The Eating Disorders Genetics Initiative (EDGI) is the largest study of how genes and environment influence eating disorders, funded by the US National Institute of Mental Health. Building on earlier research that established a clear genetic component to anorexia nervosa, EDGI is now extending that work to bulimia nervosa and binge-eating disorder, so our understanding of all three conditions continues to grow.
A separate 2025 study published in Nature Communications analysed health records for more than 67,000 people with eating disorders across Denmark and Sweden. It found that eating disorders share genetic overlap with other conditions, including obsessive-compulsive disorder and autism. This kind of research helps explain why eating disorders so often occur alongside other mental health conditions and why treatment needs to consider the whole picture, not just eating behaviours in isolation.
Understanding the genetic and environmental factors behind an eating disorder shapes how we approach treatment at ABBI Clinic.
Early intervention is one of the clearest findings across this research. The sooner someone receives specialist support, the better their long-term outcomes tend to be, which is why we focus on identifying risk factors, including family history, as early as possible.
We also use this understanding to personalise your care. If you have a family history of an eating disorder, that context helps us build a treatment plan around your specific biological and psychological needs, alongside your personal circumstances. And because ABBI Clinic provides the full range of specialist eating disorder care under one roof, from Day Care to Outpatient support, delivered in person, online, or a mix of both, we can adjust the intensity of your treatment as your needs change, without ever needing to refer you elsewhere.
Not directly. There’s currently no genetic test that can diagnose or predict an eating disorder. What we can do is look at your family history alongside your personal circumstances to understand your level of risk and put the right support in place early.
Not at all. A genetic vulnerability affects the likelihood of developing an eating disorder, not your ability to recover from one. If eating disorders run in your family, we’ll build your treatment plan around that, alongside the same clinically led, evidence-based care we offer every patient.
Because genetics is only part of the picture. Two people with a similar genetic vulnerability can have very different life experiences, and it’s often those experiences, combined with biology, that determine whether
and when an eating disorder develops.
If you’re noticing signs of an eating disorder in yourself or someone you love, you don’t need to work out the cause before reaching out. Our team can help you understand what’s happening and build a treatment plan around you, whatever the underlying factors are.
Fill in the form below or call us, and we’ll guide you through the next steps.
In the UK, there are laws in place that protect and support access to mental health support. Specifically, there is the Mental Health Act, a legal framework that ensures those who require urgent care get the treatment they need and sets clear rules for when and how particular measures can be taken.
At ABBI Clinic, our focus is on providing personalised, research-based eating disorder treatment and support that helps you understand and overcome your eating disorder. It’s worth noting that ABBI Clinic is not able to treat patients who are detained under the Mental Health Act. Legislation isn’t our area of specialism, but we know many of our patients value understanding the government frameworks that can affect their care. With that in mind, this blog helps to explain Section 3 of the Mental Health Act.
Section 3 of the Mental Health Act outlines that a person can be admitted to hospital to be treated for a mental health disorder if the nature of their condition requires it. Specifically, it applies when treatment is necessary for an individual’s health, their safety, or the protection of others.
Section 3 can be used when a person is already known to psychiatric services or if it has been deemed necessary following an initial assessment under Section 2.
A person can be detained under Section 3 for up to six months. This can be renewed by a doctor for a further six months and then for a year at a time.
Outlined in Section 3 of the Mental Health Act are rights that ensure the admission to hospital is fair for everyone. These include rights to the following.
When a person is being detained, they and their nearest relative will have the right to ask for information regarding the detention and discharge. They will also be given information about how to contact an independent mental health advocate who must provide support in helping them understand their rights under Section 3.
A person and their nearest relative can meet with an independent mental health advocate to speak in private about the detention. The IMHA must provide them with support for how to express their views and wishes to health professionals.
IMHAs must provide information about how a person can appeal their detention.
There are several key differences between Section 3 and Section 2 of the Mental Health Act, specifically regarding detention:
| Section | Duration | Purpose. | Can Be Used By | Extendable? |
| 2 | Up to 28 days | To allow for the diagnosis of a mental health condition | Approved mental health professionals | No. After 28 days, the person must be discharged or escalated to Section 3. |
| 3 | Up to 6 months | To allow for the treatment of a mental health condition | Yes. A further 6-month detention can be implemented, followed by yearly extensions if necessary. |
After six months have passed, a person can either have their section extended or be discharged. Discharge can also occur at any time by their doctor, the Mental Health Tribunal, or mental health act managers.
The Mental Health Tribunal is a panel which reviews discharge applications. Made up of a judge, a medical member (psychiatrist), and a lay member (with relevant experience), the panel reviews a person’s mental health, their recovery, up-to-date reports, and the opinion of their doctor before making a decision.
Anyone can seek help and advice from their independent mental health advocate, an approved mental health professional (AMHP) who can provide help and assistance, or online. The NHS and Mind are two of the best resources for further information regarding Section 3.
If you suspect that you or a loved one might be demonstrating the behaviours and signs of an eating disorder and are not currently detained under the Mental Health Act, we are here to help you seek the support you need. Taking that first step can feel daunting, and we want to make it as straightforward as possible.
If you are currently under the Mental Health Act, your existing care team or GP will be best placed to guide you on next steps, or you can contact NHS 111 for further advice.
Fill in the form below, or call us, and we’ll guide you through the next steps.
Since April 2022, large cafes, restaurants and takeaways across England have been legally required to display calorie information on their menus. The policy was designed to support the government’s wider aim of tackling obesity and encouraging healthier food choices, and for many people, this information passes without a second thought. For someone living with an eating disorder, calories on a menu can turn a simple meal out into a source of real anxiety.
At ABBI Clinic, we believe it’s important to look at both sides of this debate: the public health reasoning behind calorie labelling and the impact it can have on people already struggling with their relationship with food.
The intention behind mandatory calorie labelling is straightforward. By giving people access to the same nutritional information in restaurants that they would see on packaged food in a supermarket, the government hoped to make it easier for the public to make informed, healthier choices and help address rising obesity levels nationally.
However, this well-intentioned policy has faced consistent criticism from eating disorder charities and clinicians since it came into force. Beat, the UK’s eating disorder charity, has repeatedly raised concerns that displaying calories in restaurant menus can cause distress for people with an eating disorder, rather than supporting healthier decision-making. A commentary published in the BMJ in 2022 similarly described calorie labelling as a reductionist strategy with the potential to cause collateral damage for people with eating disorders.
For someone without a difficult relationship with food, a calorie count on a menu is easy to ignore. For someone living with an eating disorder, that same number can dominate the entire experience of eating out.
Calorie labels can quickly become the main focus of a meal, rather than one small detail. This can lead to heightened anxiety before, during, and after eating, along with an intense fixation on numbers rather than on the meal itself, the company at the table, or the occasion being celebrated.
Seeing calorie counts can also reinforce unhelpful patterns that are already part of someone’s eating disorder. This might involve leaning towards the lowest-calorie option regardless of appetite or nutritional need, feeling compelled to adjust eating later in the day to “make up” for a meal, or avoiding eating out altogether to sidestep the discomfort of seeing the numbers at all.
One of the most important points often missed in this debate is that calorie labelling doesn’t affect everyone with an eating disorder in the same way. The impact can vary significantly depending on the specific condition someone is living with.
Research, including one study from PubMed Central, suggests that people with anorexia nervosa or bulimia nervosa typically select meals with significantly fewer calories when calorie labels are present, compared with menus that have no labelling at all. For these individuals, calorie labelling can reinforce the restrictive thinking that already underpins their eating disorder.
Interestingly, another PubMed study also found the opposite pattern for people with binge eating disorder, who selected meals with significantly more calories when labels were visible. This highlights that a one-size-fits-all approach to calorie labelling policy may not account for the different ways eating disorders present.
The evidence base in this area is still developing, but the findings so far are worth paying attention to. A recent BMJ Public Health review of calorie inclusion research found that just over half of people with a diagnosed eating disorder who took part in one study felt that calorie labelling made their symptoms worse, and the majority reported that calorie information on menus had caused them difficulty in some way.
A widely cited British Medical Journal-featured study of American restaurant chains also found that calorie labelling led to a small reduction in the average calories consumed, an effect that had disappeared entirely within a year.
If calorie information on menus is something you find difficult, there are practical steps that may help:
If you find that calorie labelling, or eating in general, is affecting your day-to-day life, this may be a sign that it’s worth speaking to a specialist eating disorder service.
The debate around calorie labelling isn’t a simple case of right or wrong. The policy stems from a genuine public health need, but the evidence increasingly suggests that its impact on eating disorders needs far more consideration in how it is designed and delivered.
Offering calorie-free menu options alongside labelled versions, involving eating disorder specialists in future policy reviews, and ensuring public health messaging doesn’t equate lower calories with better health are all steps that could help reduce harm without abandoning the policy’s original aims.
If you suspect that you or a loved one might be demonstrating the behaviours and signs of an eating disorder, we are here to help you seek the support you need. At ABBI Clinic, we have the expertise and compassion to help you heal at every stage of the journey, whatever that looks like for you.
Fill in the form below, or call us, and we’ll guide you through the next steps.
Bulimia nervosa is an eating disorder that can go unnoticed for a long time. Many of the signs of bulimia are subtle rather than obvious, which makes them easier to overlook even by those who are close to someone struggling.
This article sets out the behavioural, physical, and emotional signs of bulimia that are commonly missed, along with practical guidance on approaching a loved one you’re concerned about. Recognising the early signs of bulimia, and knowing how to respond, can make a real difference to the treatment someone receives.
Spotting signs of bulimia in others can be particularly difficult, as many of the behaviours associated with the illness are designed to stay hidden. The changes below are often among the first that friends and family members notice.
Someone experiencing bulimia may develop rigid rules around food, eat unusually large amounts in one sitting, or swing between restricting food and eating much more than intended. These changes are often followed by feelings of distress or a strong urge to compensate, which can include vomiting or the use of laxatives. You may also notice a growing collection of wrappers or missing food, or a reluctance to eat in front of other people.
Frequent trips to the bathroom shortly after meals, particularly if accompanied by running water or music to mask sound, can be a sign of bulimia. Someone may also become secretive about what, when, or how much they are eating and go to greater lengths to eat alone.
Occasions that involve food, such as meals out, celebrations, or family dinners, may increasingly be avoided or cancelled at short notice. Over time, this can lead to broader social withdrawal, as maintaining routines around food becomes harder to manage around other people.
The physical signs of bulimia often develop gradually as a result of repeated cycles of bingeing and vomiting, and they can easily be mistaken for unrelated health issues.
Frequent contact with stomach acid can wear away tooth enamel over time, leading to increased sensitivity, discolouration, or a higher rate of cavities. A persistent sore throat, hoarse voice, or swollen glands can also be a sign worth paying attention to, particularly if it doesn’t have another obvious cause.
Russell’s Sign refers to calluses, scarring, or scrapes on the back of the hand or knuckles, caused by repeated contact with the teeth. Named after the psychiatrist who first documented it, this can be one of the more visible physical signs of bulimia, though it isn’t present in every case.
Weight can fluctuate noticeably, though many people experiencing bulimia stay within an expected weight range, so this sign is often missed or dismissed. Dizziness, fatigue, and light-headedness are also common and can be linked to dehydration or electrolyte imbalances caused by vomiting.
Swelling around the jaw or cheeks, caused by enlarged salivary glands, is another physical sign of bulimia that can develop with repeated vomiting. This swelling may come and go, which can make it harder to notice consistently.
Alongside behavioural and physical signs, bulimia is often accompanied by significant emotional and psychological changes.
A persistent and often overwhelming fear of gaining weight is a common feature of bulimia. This fear can shape daily decisions around food, exercise, and social plans and may not ease even when someone’s weight hasn’t changed.
Bulimia is frequently linked to a distorted perception of body shape or size and self-worth that has become closely tied to weight or appearance. This can show up as frequent negative comments about the body, checking behaviours such as repeated weighing, or avoidance of mirrors and photographs.
Low mood, irritability, and heightened anxiety, particularly around food and mealtimes, are common alongside bulimia. These emotional changes can also be a response to the exhaustion and shame that often accompany the cycle of bingeing and vomiting.
If you’ve noticed several of these signs of bulimia in someone you care about, it’s natural to feel unsure about what to say or do next. A calm, supportive approach makes it easier for the conversation to open a door, rather than close one.
Find a private, unhurried moment away from mealtimes to raise your concerns. Approaching the conversation gently and without an audience gives the other person space to respond honestly, without feeling put on the spot.
Centre the conversation on how the person seems to be feeling, rather than on their weight or appearance. Comments about weight, even well-intentioned ones, can add to feelings of shame and make someone less likely to open up.
Let the person know that support is available and that reaching out for professional help is a sign of strength, not failure. You can offer to help them find the right service or to go with them to a first appointment if that would help.
Early signs of bulimia can include a preoccupation with food, body shape, or weight, eating in secret, disappearing to the bathroom after meals, and mood changes around eating occasions. These early signs are often subtle and may be mistaken for stress or a passing phase, which is why they can be difficult to spot.
Signs of bulimia in others are often easier to notice through a pattern of changes over time, rather than a single moment. Look out for shifts in eating habits, avoidance of meals with others, frequent trips to the bathroom after eating, and signs of low mood or anxiety connected to food.
Yes. Many people experiencing bulimia maintain a weight within an expected range, which is one of the reasons the condition can be so difficult to identify from physical appearance alone.
A diagnosis of bulimia is made by a qualified healthcare professional, based on a full assessment of eating patterns, behaviours, and their impact on physical and emotional wellbeing. If you’re concerned about yourself or someone else, a GP is a good first point of contact.
If you recognise these signs in yourself, reaching out to a GP or a specialist eating disorder service is a positive first step. Support is available at every stage, and recovery is possible with the right treatment plan in place.
If you suspect that you or a loved one might be demonstrating the behaviours and signs of bulimia, we are here to help you seek the support you need. Taking that first step can feel daunting, and we want to make it as straightforward as possible.
Fill in the form below, or call us, and we’ll guide you through the next steps.
