Conclusions

In this comprehensive review of research, the factors most closely associated with eating disorders in females were identified as: depression, sexual abuse, substance abuse, anxiety disorders, early pubertal onset, and the personality traits of perfectionism and impulsivity. No causal relationships were identified, but sexual abuse and anxiety disorders often preceded the eating disorder. Findings reported in this review indicate the need for further research to determine the interrelationship of these factors to each other and to various eating disorders. Although the rates of all these factors were elevated in both anorexics and bulimics, certain factors were more associated with one sub-type than the other. Sexual abuse and substance abuse were associated with bulimia and purging behaviors. Rates of both substance abuse and depression were higher among girls experiencing early maturation. Anxiety disorders and depression were more common among women with anorexia and bulimia nervosa; however, OCD and perfectionistic personality were more common in anorexics.

Opportunities for application of these findings encompass research, education, and practice in nursing, health, and counseling professions. Identification of these associated factors and current findings about them can inform professional education and policy development in screening, monitoring, and facilitating treatment for eating disorders. Much of this information can also be useful to educate individuals, families and the public in the early recognition of those in whom these factors may appear to be present. As the development of new eating disorders continues among women worldwide, education is the key to prevention and treatment of these potentially deadly disorders.

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