Eating Disorders Are More Common in Teens From Lower-Income Families, Not Less, Study Finds

Teenagers from households with lower incomes and less education are more likely to have an eating disorder, a new study co-led by researchers at University College London (UCL) has found, challenging the common assumption that these conditions mainly affect wealthy, well-educated families. The study, published in the International Journal of Eating Disorders and conducted with researchers at Copenhagen University Hospital, reviewed data from 51 studies involving 26,174 adolescents in Western countries across North America, Europe and Australia.

The review included diagnosed anorexia, bulimia and binge eating disorder, alongside early warning signs such as restricting food, fasting, poor body image and feeling pressure to become thinner. Family income showed the strongest and most consistent link: about two-thirds of the studies found that teenagers from lower-income families were more likely to have eating disorder symptoms, and no study found the opposite. Teenagers whose parents had not attended university were around 25% more likely to report eating disorder symptoms than those whose parents had.

Other measures of social and economic background, such as neighbourhood deprivation, parents' jobs, financial difficulties or receiving government benefits, produced far more mixed and inconsistent results. Senior author Dr Nora Trompeter, of UCL's Great Ormond Street Institute of Child Health, said the review shows eating disorders are 'a concern across the socioeconomic spectrum' and that treating them as a condition of affluence risks leaving the adolescents most in need of support undiagnosed and untreated.

The researchers note that most of the studies reviewed involved mainly white adolescents from Western countries, and that they measured socioeconomic status in different ways, making firm conclusions harder to draw. They are calling on clinicians, healthcare professionals and school counsellors to broaden their assumptions about who is at risk of an eating disorder.