How personality traits can impact eating disorders

An eating disorder can develop due to a combination of risk factors, including your genetics, emotional factors, cultural influences and personality traits.  

Personality traits describe how a person tends to think, feel, and behave on an ongoing basis. They are believed to have a strong genetic component and are also influenced by our upbringing and life experiences. 

While it is possible to modify certain risk factors in the development of an eating disorder (such as body dissatisfaction, engaging in dieting and the extent to which one internalizes appearance and body ideals), there are certain personality traits that can increase one’s likelihood of developing an eating disorder. These traits can also influence the maintenance and treatment of eating disorders [1]. 

An eating disorder is never a choice, and understanding the various risk factors that contribute can help in prevention, early intervention and recovery. 

“Researchers argue that understanding disordered eating behaviour in the context of an individual’s broader pattern of thinking, feeling, and regulation of emotions, may improve the identification and treatment of eating disorders and disordered eating.” – Gilmartin, Gurvich, Sharp. (2022). 

In this blog, we explore how various personality traits can impact eating disorders and provide advice to cope and get support. 

Neuroticism  

Neuroticism is a personality trait that is often is associated with negative emotions. People with this trait may be more likely to experience anxiety, self‐consciousness, fear, guilt, shame, irritability, emotional instability, and depression [2]. They may also experience persistent worrying , find it hard to manage emotions and feel frustrated, panicked or hopeless in emergencies or stressful situations.  

In a 2024 study [3], it was found that neuroticism was the personality trait that most likely leads to generalised anxiety and dieting. People with high levels of neuroticism can experience disordered eating, including binge-eating, emotional eating and dieting [4] and neuroticism can strongly contribute to the co-occurrence of depression, anxiety and suicidal risk in people with anorexia nervosa or bulimia nervosa [5]. 

“[Our findings] suggest that interventions targeting hopelessness… may improve clinical outcomes. For people who are feeling hopeless, therapies can focus on challenging negative beliefs and thoughts, teaching coping skills to manage stress and setbacks, and setting achievable goals to foster a sense of hope and agency.” –Dr Zuo Zhang, first author of the study and postdoctoral researcher at the Social, Genetic & Developmental Psychiatry Centre at King’s IoPPN 

Perfectionism  

Perfectionism is a strong risk factor for the development and maintenance of body dissatisfaction and eating disorders, particularly bulimia nervosa and anorexia nervosa. [6]

People with perfectionism often hold themselves to excessively high standards and put themselves under extreme pressure to meet these standards. This may manifest into feelings about their body weight, shape and appearance, and some may turn to disordered eating behaviours in an attempt to control some part of their lives to: 

• achieve a ‘perfect’ body aligned with the thin, fit or muscular body ideals 
• maintain a ‘perfect’ or ‘clean’ diet and exercise regime    
• avoid weight gain   

This can be made even more difficult by constant exposure to stereotypical and unattainable beauty/appearance ideals that are present in mainstream media. Our society tells us the body is a problem to be fixed and that success and self-worth is found through achieving a certain body size or looking a certain way. This is false and only serves to profit off your insecurities.  

People with perfectionism may also experience evaluative concerns, which involves experiencing extreme negative reactions to mistakes or perceived failure, performance doubts, harsh self-scrutiny and concern over criticism.  

For advice on overcoming unhealthy perfectionism, click here 

“Learning how my eating disorder was influenced by my personality traits, such as perfectionism, helped me to realise the eating disorder wasn’t my fault or a choice I was making.”  – Person with a lived experience of Anorexia. 

Where does this leave us? 

Personality traits like neuroticism and perfectionism bring both strengths and challenges. It’s important to note that if you observe these traits within yourself or your loved one, it does not mean you are guaranteed to develop an eating disorder. No single cause of eating disorders has been identified – it’s rather a combination of biological, psychological and sociocultural factors that can contribute to an eating disorder developing.  

Early intervention has shown to improve recovery outcomes, so as soon as you notice something concerning with your or a loved one’s relationship to food, exercise and the body, seek professional support. 

It’s important to discuss how your feeling, what you’re thinking and any personal context or history with your healthcare professional so they can be aware of the varying factors that may influence your eating behaviour. For clinicians, it is essential to support individuals with any challenges associated with personality features alongside the eating disorder. [7]   

We’re here to help 

• Butterfly’s National Helpline provides confidential and free counselling, support and information 7 days a week (8am-midnight AEST/AEDT) for anyone in Australia who is concerned about eating disorders or body image concerns.  Call 1800 ED HOPE (1800 33 4673), chat online or email support@butterfly.org.au  
• Find an eating disorder healthcare professional – search our Referral Database for healthcare professionals that specialise in eating disorders. 
• Find out more about how we help  

Not sure if what you’re experiencing is an eating disorder? 

Use Butterfly’s online, confidential screening tool to help you know if you are experiencing symptoms of an eating disorder.  

While this tool won’t give you a diagnosis, it will let you know if you should seek further professional help. You can print off your results to take to the GP, psychologist or other healthcare professional to start the conversation about appropriate treatment and support.  

Click here  

Learn more 

• Centre for Clinical Interventions – self-help resource for perfectionism  
• Butterfly podcast episode – In depth on perfectionism with Tracey Wade  

References

• [1] Wonderlich, S. A., Lilenfeld, L. R., Riso, L. P., Engel, S., & Mitchell, J. E. (2005). Personality and anorexia nervosa. International Journal of Eating Disorders, 37, S68–S71. https://doi.org/10.1002/eat.20120 
• [2] Widiger, T. Oltmanns, J. (2017). Neuroticism is a fundamental domain of personality with enormous public health implications. World Psychiatry Journal. 16 (2). Pp. 144-145. Online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428182/#wps20411-bib-0001 
• [3] Zhang, Z. et al. (2024) Distinct personality profiles associated with disease risk and diagnostic status in eating disorders. Journal of Affective Disorders 360. Pp146-155. Online: https://www.sciencedirect.com/science/article/pii/S0165032724008760?via%3Dihub#bb0125 
• [4] Gilmartin, T. Gurvich, C. Sharp, G. (2022). The relationship between disordered eating behaviour and the five factor model personality dimensions: A systematic review. Journal of Clinical Psychology .78 (9). Pp1657-670. Online: https://onlinelibrary.wiley.com/doi/10.1002/jclp.23337 
• [5] Zhang, Z. et al. (2024)
•  [6] National Eating Disorder Collaboration, n.d. Perfectionism as a risk factor. NEDC e-Bulletin. 45. Online: https://nedc.com.au/eating-disorder-resources/find-resources/show/issue-45-perfectionism-as-a-risk-factor  
• [7] Fairburn CG, Cooper Z, Doll HA, O’Connor ME, Bohn K, Hawker DM, et al. Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. Am J Psychiatry. 2009;166(3):311–9