Abstract
Evidence suggests that eating disorders (EDs) are multifactorial, with a complex interplay between genetics and environment. Twin studies have indicated a significant genetic contribution, but non-shared environmental factors also contribute to the variability in their etiology. A scoping review was conducted, finding 32 articles from different databases (PUBMED, EMBASE, and BVS) on twins, with the aim of reviewing the literature that includes information on this interaction in the onset and persistence of ED.The findings revealed that the manifestation of EDs emerges from the interplay between genetic predispositions and environmental influences. Psychosocial factors such as child abuse, family environment, peer pressure, and exposure to sociocultural dynamics that idealize thinness influence the risk of development. Moreover, adverse environmental conditions increase the risk in individuals with genetic predispositions. However, the current literature on EDs in twin populations requires further depth. Most studies focus on underrepresented samples, so research on more diverse cohorts is needed to understand the dynamics of ED diagnosis more precisely. In conclusion, EDs are the product of a complex interplay between genetics and environment. Further research is needed to unravel these dynamics and develop more effective prevention and treatment strategies.
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. www.appi.org
Anaya, C., Burt, S. A., & Klump, K. L. (2022). An investigation of associations between parenting and binge eating across pubertal development in pre-adolescent and adolescent female participants. International Journal of Eating Disorders, 55(12), 1811–1823. https://doi.org/10.1002/eat.23818
Arribas, P., Iranzo-Tatay, C., Rojo-Bofill, L. M., García-Blanco, A., Conesa, L., Plumed, J., Bofill-Moscardó, I., Livianos-Aldana, L., & Rojo-Moreno, L. (2018). Changes in genetic and environmental influences on disordered eating between pre-menarche and postmenarche girls. A twin study. Actas Esp Psiquiatr, 46(5), 192–199. https://pesquisa.bvsalud.org/portal/resource/es/mdl-30338776
Baker, J. H., Brosof, L. C., Munn-Chernoff, M. A., Lichtenstein, P., Larsson, H., Maes, H. H., & Kendler, K. S. (2018). Associations Between Alcohol Involvement and Drive for Thinness and Body Dissatisfaction in Adolescent Twins: A Bivariate Twin Study. Alcohol Clin Exp Res, 42(11), 2214–2223. https://doi.org/10.1111/acer.13868
Baker, J. H., Maes, H. H., Lissner, L., Aggen, S. H., Lichtenstein, P., & Kendler, K. S. (2009). Genetic risk factors for disordered eating in adolescent males and females. Journal of abnormal psychology, 118(3), 576–586. https://doi.org/10.1037/a0016314
Baker, J. H., Johnson, N. K., Munn-Chernoff, M. A., Lichtenstein, P., Larsson, H., Maes, H. H., & Kendler, K. S. (2018). Illicit Drug Use, Cigarette Smoking, and Eating Disorder Symptoms: Associations in an Adolescent Twin Sample. J Stud Alcohol Drugs, 79(5), 720–724. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240011
Berg, K. C., Peterson, C. B., Frazier, P., & Crow, S. J. (2011). Convergence of scores on the interview and questionnaire versions of the Eating Disorder Examination: A meta-analytic review. Psychological Assessment, 23(3), 714–724. https://doi.org/10.1037/a0023246
Bulik, C. M., Wade, T. D., & Kendler, K. S. (2001). Characteristics of monozygotic twins discordant for bulimia nervosa. The International Journal of Eating Disorders, 29(1), 1–10. https://doi.org/10.1002/1098-108x(200101)29:1<1::aid-eat1>3.0.co;2-j
Capusan, A. J., Yao, S., Kuja-Halkola, R., Bulik, C. M., Thornton, L. M., Bendtsen, P., Marteinsdottir, I., Thorsell, A., & Larsson, H. (2017). Genetic and environmental aspects in the association between attention-deficit hyperactivity disorder symptoms and binge-eating behavior in adults: a twin study. Psychological Medicine, 47(16), 2866–2878. https://doi.org/10.1017/S0033291717001416
Couvy-Duchesne, B., O’Callaghan, V., Parker, R., Mills, N., Kirk, K. M., Scott, J., Vinkhuyzen, A., Hermens, D. F., Lind, P. A., Davenport, T. A., Burns, J. M., Connell, M., Zietsch, B. P., Scott, J., Wright, M. J., Medland, S. E., McGrath, J., Martin, N. G., Hickie, I. B., & Gillespie, N. A. (2018). Nineteen and Up study (19Up): understanding pathways to mental health disorders in young Australian twins. BMJ Open, 8(3), e018959. https://doi.org/10.1136/bmjopen-2017-018959
Cunningham, F. G., Leveno, K. J., Dashe, J. S., Hoffman, B. L., Spong, C. Y., & Casey, B. M. (2021). Multifetal pregnancy. In Williams Obstetrics, 26e. McGraw-Hill Education. https://accessmedicine.mhmedical.com/content.aspx?sectionid=263825445&bookid=2977&Resultclick=2
de Paepe, M. (2020). Gestación múltiple: biología de la gemelaridad. In Medicina materno-fetal (8th ed., pp. 68–80). Elsevier España.
Donato, K., Ceccarini, M. R., Dhuli, K., Bonetti, G., Medori, M. C., Marceddu, G., Precone, V., Xhufi, S., Bushati, M., Bozo, D., Beccari, T., & Bertelli, M. (2022). Gene variants in eating disorders. Focus on anorexia nervosa, bulimia nervosa, and binge-eating disorder. Journal of Preventive Medicine and Hygiene, 63(2 Suppl 3), E297–E305. https://doi.org/10.15167/2421-4248/jpmh2022.63.2S3.2772
Fairweather-Schmidt, A. K., & Wade, T. D. (2020). Common genetic architecture and environmental risk factors underpin the anxiety-disordered eating relationship: Findings from an adolescent twin cohort. Int J Eat Disord, 53(1), 52–60. https://doi.org/10.1002/eat.23155
Ferguson, C. J., Muñoz, M. E., Winegard, B., & Winegard, B. (2012). The influence of heritability, neuroticism, maternal warmth and media use on disordered eating behaviors: a prospective analysis of twins. The Psychiatric Quarterly, 83(3), 353–360. https://doi.org/10.1007/s11126-012-9205-7
Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000-2018 period: a systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402–1413. https://doi.org/10.1093/AJCN/NQY342
Gomez-Restrepo, C., Hernandez, G., Jordán-Quintero, M., Rojas-Urrego, A., Santacruz, H., & Uribe-Restrepo, M. (2018). Psiquiatría Clínica. Diagnóstico y tratamiento en niños, adolescentes y adultos. (4th ed.).
Harrell, Z. A. T., Slane, J. D., & Klump, K. L. (2009). Predictors of alcohol problems in college women: the role of depressive symptoms, disordered eating, and family history of alcoholism. Addictive Behaviors, 34(3), 252–257. https://doi.org/10.1016/j.addbeh.2008.10.019
Kendler, K. S., Bulik, C. M., Silberg, J., Hettema, J. M., Myers, J., & Prescott, C. A. (2000). Childhood sexual abuse and adult psychiatric and substance use disorders in women: an epidemiological and cotwin control analysis. Archives of General Psychiatry, 57(10), 953–959. https://doi.org/10.1001/archpsyc.57.10.953
Kendler, K. S., Liu, X. Q., Gardner, C. O., McCullough, M. E., Larson, D., & Prescott, C. A. (2003). Dimensions of religiosity and their relationship to lifetime psychiatric and substance use disorders. The American journal of psychiatry, 160(3), 496–503. https://doi.org/10.1176/appi.ajp.160.3.496
Kendler, K. S., MacLean, C., Neale, M., Kessler, R., Heath, A., & Eaves, L. (1991). The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry, 148(12), 1627–1637. https://doi.org/10.1176/ajp.148.12.1627
Keski-Rahkonen, A., Bulik, C. M., Neale, B. M., Rose, R. J., Rissanen, A., & Kaprio, J. (2005). Body dissatisfaction and drive for thinness in young adult twins. Int J Eat Disord, 37(3), 188–199. https://pesquisa.bvsalud.org/portal/resource/es/mdl-15822080
Khabsa, M., Elmagarmid, A., Ilyas, I., Hammady, H., & Ouzzani, M. (2015). Learning to identify relevant studies for systematic reviews using random forest and external information. Machine Learning, 1–18. https://doi.org/10.1007/s10994-015-5535-7
Klump, K. L., Burt, S. A., McGue, M., & Iacono, W. G. (2007). Changes in genetic and environmental influences on disordered eating across adolescence: a longitudinal twin study. Arch Gen Psychiatry, 64(12), 1409–1415. https://pesquisa.bvsalud.org/portal/resource/es/mdl-18056549
Klump, K. L., McGue, M., & Iacono, W. G. (2002). Genetic relationships between personality and eating attitudes and behaviors. J Abnorm Psychol, 111(2), 380–389. https://pesquisa.bvsalud.org/portal/resource/es/mdl-12003459
Klump, K. L., Suisman, J. L., Burt, S. A., McGue, M., & Iacono, W. G. (2009). Genetic and environmental influences on disordered eating: An adoption study. J Abnorm Psychol, 118(4), 797–805. https://doi.org/10.1037/a0017204
Klump, K. L., Wonderlich, S., Lehoux, P., Lilenfeld, L. R. R., & Bulik, C. (2002). Does environment matter? A review of nonshared environment and eating disorders. International Journal of Eating Disorders, 31(2), 118–135. https://doi.org/10.1002/eat.10024
Korotana, L. M., von Ranson, K. M., Wilson, S., & Iacono, W. G. (2018). Reciprocal Associations Between Eating Pathology and Parent-Daughter Relationships Across Adolescence: A Monozygotic Twin Differences Study. Frontiers in Psychology, 9, 914. https://doi.org/10.3389/fpsyg.2018.00914
Magel, C. A., Lacroix, E., Wilson, S., Iacono, W. G., & von Ranson, K. M. (2024). Shifting goalposts: widening discrepancies between girls' actual and ideal bodies predict disordered eating from preadolescence to adulthood. Development and psychopathology, 1–14. Advance online publication. https://doi.org/10.1017/S0954579424000907
Martin, J. A., Hamilton, B. E., Ventura, S. J., Osterman, M. J. K., Wilson, E. C., & Mathews, T. J. (2012). Births: Final data for 2010. National Vital Statistics Reports, 61(1), 1–72.
Mikhail, M. E., Carroll, S. L., Clark, D. A., O’Connor, S., Burt, S. A., & Klump, K. L. (2021). Context matters: Neighborhood disadvantage is associated with increased disordered eating and earlier activation of genetic influences in girls. Journal of Abnormal Psychology, 130(8), 875–885. https://doi.org/10.1037/abn0000719
Mikhail, M. E., Carroll, S. L., Clark, D. A., O’Connor, S. M., Culbert, K. M., Burt, S. A., & Klump, K. L. (2023). Disadvantage and disordered eating in boys: Examining phenotypic and genotype × environment associations across development. Journal of Psychopathology and Clinical Science, 132(1), 51–62. https://doi.org/10.1037/abn0000791
Munn-Chernoff, M. A., Johnson, E. C., Chou, Y. L., Coleman, J. R. I., Thornton, L. M., Walters, R. K., Yilmaz, Z., Baker, J. H., Hübel, C., Gordon, S., Medland, S. E., Watson, H. J., Gaspar, H. A., Bryois, J., Hinney, A., Leppä, V. M., Mattheisen, M., Ripke, S., Yao, S., Giusti-Rodríguez, P., … Agrawal, A. (2021). Shared genetic risk between eating disorder- and substance-use-related phenotypes: Evidence from genome-wide association studies. Addiction biology, 26(1), e12880. https://doi.org/10.1111/adb.12880
O’Connor, S. M., Burt, S. A., McGue, M., Iacono, W., & Klump, K. L. (2019). Elucidating factors underlying parent-offspring similarity in eating pathology in pre- and early puberty: Exploring the possibility of passive gene-environment correlation. Journal of Abnormal Psychology, 128(7), 658–670. https://doi.org/10.1037/abn0000466
O’Connor, S. M., Burt, S. A., VanHuysse, J. L., & Klump, K. L. (2016). What drives the association between weight-conscious peer groups and disordered eating? Disentangling genetic and environmental selection from pure socialization effects. J Abnorm Psychol, 125(3), 356–368. https://doi.org/10.1037/abn0000132
O’Connor, S. M., Culbert, K. M., Mayhall, L. A., Burt, S. A., & Klump, K. L. (2020). Differences in genetic and environmental influences on body weight and shape concerns across pubertal development in females. J Psychiatr Res, 121, 39–46. https://doi.org/10.1016/j.jpsychires.2019.11.001
O’Connor, S. M., Klump, K. L., VanHuysse, J. L., McGue, M., & Iacono, W. (2016). Does parental divorce moderate the heritability of body dissatisfaction? An extension of previous gene-environment interaction effects. The International Journal of Eating Disorders, 49(2), 186–190. https://doi.org/10.1002/eat.22457
Peters Micah DJ, Godfrey Christina, McInerney Patricia, Munn Zachary, Tricco Andrea C., & Khalil Hanan. (2020). Chapter 11: Scoping reviews. In JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-20-12
Qi, B., Thornton, L. M., Breiner, C. E., Kuja-Halkola, R., Baker, J. H., Lichtenstein, P., Lundström, S., Agrawal, A., Bulik, C. M., & Munn-Chernoff, M. A. (2023). Differential genetic associations between dimensions of eating disorders and alcohol involvement in late adolescent twins. Alcohol Clin Exp Res (Hoboken), 47(9), 1677–1689. https://doi.org/10.1111/acer.15150
Racine, S. E., VanHuysse, J. L., Keel, P. K., Burt, S. A., Neale, M. C., Boker, S., & Klump, K. L. (2017). Eating disorder-specific risk factors moderate the relationship between negative urgency and binge eating: A behavioral genetic investigation. Journal of abnormal psychology, 126(5), 481–494. https://doi.org/10.1037/abn0000204
Rojo-Moreno, L., Iranzo-Tatay, C., Gimeno-Clemente, N., Barberá-Fons, M. A., Rojo-Bofill, L. M., & Livianos-Aldana, L. (2017). Genetic and environmental influences on psychological traits and eating attitudes in a sample of Spanish schoolchildren. Rev. psiquiatr. salud ment, 10(3), 134–142. https://doi.org/10.1016/j.rpsm.2015.05.003
Rutherford, J., McGuffin, P., Katz, R. J., & Murray, R. M. (1993). Genetic influences on eating attitudes in a normal female twin population. Psychological medicine, 23(2), 425–436. https://doi.org/10.1017/s003329170002852x
Sipilä, P., Harrasova, G., Mustelin, L., Rose, R. J., Kaprio, J., & Keski-Rahkonen, A. (2017). “Holy anorexia”-relevant or relic? Religiosity and anorexia nervosa among Finnish women. Int J Eat Disord, 50(4), 406–414. https://doi.org/10.1002/eat.22698
Slane, J. D., Klump, K. L., McGue, M., & Iacono, W. G. (2014). Developmental trajectories of disordered eating from early adolescence to young adulthood: a longitudinal study. Int J Eat Disord, 47(7), 793–801. https://doi.org/10.1002/eat.22329
Smith, K. E., Mason, T. B., Murray, S. B., Griffiths, S., Leonard, R. C., Wetterneck, C. T., Smith, B. E. R., Farrell, N. R., Riemann, B. C., & Lavender, J. M. (2017). Male clinical norms and sex differences on the Eating Disorder Inventory (EDI) and Eating Disorder Examination Questionnaire (EDE‐Q). International Journal of Eating Disorders, 50(7), 769–775. https://doi.org/10.1002/eat.22716
Spanos, A., Klump, K. L., Burt, S. A., McGue, M., & Iacono, W. G. (2010). A longitudinal investigation of the relationship between disordered eating attitudes and behaviors and parent-child conflict: a monozygotic twin differences design. Journal of Abnormal Psychology, 119(2), 293–299. https://doi.org/10.1037/a0019028
Stanford, S. C., & Lemberg, R. (2012). Measuring Eating Disorders in Men: Development of the Eating Disorder Assessment for Men (EDAM). Eating Disorders, 20(5), 427–436. https://doi.org/10.1080/10640266.2012.715522
Suisman, J. L., Burt, S. A., McGue, M., Iacono, W. G., & Klump, K. L. (2011). Parental divorce and disordered eating: an investigation of a gene-environment interaction. Int J Eat Disord, 44(2), 169–177. https://doi.org/10.1002/eat.20866
Sulestrowska, H. (1995). Twin rivalry as an important factor in the development of anorexia nervosa in a 14 year old girl. Psychiatria Polska, 29(2), 193–203. https://www.embase.com/search/results?subaction=viewrecord&id=L25283985&from=export
Treasure, J., Duarte, T. A., & Schmidt, U. (2020). Eating disorders. Lancet (London, England), 395(10227), 899–911. https://doi.org/10.1016/S0140-6736(20)30059-3
Wade, T. D., Bergin, J. L., Martin, N. G., Gillespie, N. A., & Fairburn, C. G. (2006). A transdiagnostic approach to understanding eating disorders. The Journal of nervous and mental disease, 194(7), 510–517. https://doi.org/10.1097/01.nmd.0000225067.42191.b0
Wade, T. D., Bulik, C. M., Heath, A. C., Martin, N. G., & Eaves, L. J. (2001). The influence of genetic and environmental factors in estimations of current body size, desired body size, and body dissatisfaction. Twin Research : The Official Journal of the International Society for Twin Studies, 4(4), 260–265. https://doi.org/10.1375/1369052012489
Wade, T. D., Bulik, C. M., & Kendler, K. S. (2001). Investigation of quality of the parental relationship as a risk factor for subclinical bulimia nervosa. The International journal of eating disorders, 30(4), 389–400. https://doi.org/10.1002/eat.1100
Wade, T. D., Gillespie, N., & Martin, N. G. (2007). A comparison of early family life events amongst monozygotic twin women with lifetime anorexia nervosa, bulimia nervosa, or major depression. International Journal of Eating Disorders, 40(8), 679–686. https://doi.org/10.1002/eat.20461
Wade, T., Martin, N. G., Neale, M. C., Tiggemann, M., Treloar, S. A., Bucholz, K. K., Madden, P. A., & Heath, A. C. (1999). The structure of genetic and environmental risk factors for three measures of disordered eating. Psychological medicine, 29(4), 925–934. https://doi.org/10.1017/s0033291799008740
Wade, T. D., Treloar, S. A., Heath, A. C., & Martin, N. G. (2009). An examination of the overlap between genetic and environmental risk factors for intentional weight loss and overeating. The International Journal of Eating Disorders, 42(6), 492–497. https://doi.org/10.1002/eat.20668
Wade, T. D., Treloar, S. A., & Martin, N. G. (2001). A comparison of family functioning, temperament, and childhood conditions in monozygotic twin pairs discordant for lifetime bulimia nervosa. American Journal of Psychiatry, 158(7), 1155–1157. https://doi.org/10.1176/appi.ajp.158.7.1155
Wade, T. D., Treloar, S., & Martin, N. G. (2008). Shared and unique risk factors between lifetime purging and objective binge eating: a twin study. Psychological Medicine, 38(10), 1455–1464. https://doi.org/10.1017/S0033291708002791
Waszczuk, M. A., Waaktaar, T., Eley, T. C., & Torgersen, S. (2019). Etiological influences on continuity and co-occurrence of eating disorders symptoms across adolescence and emerging adulthood. International Journal of Eating Disorders, 52(5), 554–563. https://doi.org/10.1002/EAT.23040
Wilksch, S. M., & Wade, T. D. (2009). An investigation of temperament endophenotype candidates for early emergence of the core cognitive component of eating disorders. Psychol Med, 39(5), 811–821. https://doi.org/10.1017/S0033291708004261
© Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders.