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Girls whose mothers, fathers and grandparents are highly educated may have an increased risk of developing an eating disorder, a new study suggests – particularly if the girls themselves do well in school.
The study, which followed more than 13 000 females born in Sweden between 1952 and 1989, found that as parents' or grandmothers' education increased, so did girls' risk of being hospitalised for anorexia or another eating disorder.
Similarly, the risk climbed in tandem with the girls' own grades in high school, researchers report in the American Journal of Epidemiology.
The vast majority of girls in the study were never treated for an eating disorder, regardless of family education and grades; 55 out of 13,376 were hospitalised during the study period.
Still, the findings suggest that girls from families with higher academic achievement are at relatively greater risk, according to the researchers, led by Dr Jennie Ahren-Moonga of the Karolinska Institute in Stockholm.
Girls feel more pressure
It's possible, the researchers write, that these girls feel more pressure from family to succeed – which for some could translate into an obsession with controlling their eating and body weight.
In addition, higher-achieving girls may be more likely to have certain personality traits, such as perfectionism, that make them relatively more vulnerable to eating disorders. Such demands likely play an "important role" in eating disorder development, Ahren-Moonga told Reuters Health in an email.
"This is even more relevant," she noted, "when combined with low self- esteem, as the feeling of not being able to live up to expectations plays a crucial role in both anorexia nervosa and bulimia nervosa."
The researchers based their findings on data from a large health study of multiple generations of Swedish families. They focused on the generation of females born between 1952 and 1989, tracking their rate of hospitalisation for eating disorders through 2002.
Risk factors: educated parents, higher grades
Overall, girls whose parents went to college had about twice the risk of being treated for an eating disorder as those whose parents had only an elementary-school education. The risk was six times higher among girls whose maternal grandmothers had a college education, compared with those whose grandmothers went only to elementary school.
Similarly, girls with the highest grades at age 15 had twice the risk of hospitalisation as girls with the lowest grades.
The study doesn't prove that greater education and school achievement lead to eating disorders in some girls. But it does point to a group of girls who may be at relatively greater risk.
All parents, Ahren-Moonga said, should be aware of the potential signs of an eating disorder – such as when a child begins to skip meals, routinely goes to the bathroom after a meal or loses weight for no clear reason. Spotting and treating eating disorders early, she noted, improves the chances of a full recovery.
(Reuters Health, September 2009)
