Family History of Education Predicts Eating Disorders across Multiple Generations among 2 Million Swedish Males and Females

Abstract

PurposeTo investigate which facets of parent and grandparent socio-economic position (SEP) are associated with eating disorders (ED), and how this varies by ED subtype and over time.MethodsTotal-population cohort study of 1,040,165 females and 1,098,188 males born 1973–1998 in Sweden, and followed for inpatient or outpatient ED diagnoses until 2010. Proportional hazards models estimated associations with parental education, income and social class, and with grandparental education and income.Results15,747 females and 1051 males in our sample received an ED diagnosis, with rates increasing in both sexes over time. ED incidence in females was independently predicted by greater educational level among the father, mother and maternal grandparents, but parent social class and parental income showed little or no independent effect. The associations with education were equally strong for anorexia nervosa, bulimia nervosa and ED not-otherwise-specified, and had increased over time. Among males, an apparently similar pattern was seen with respect to anorexia nervosa, but non-anorexia ED showed no association with parental education and an inverse association with parental income.ConclusionsFamily history of education predicts ED in gender- and disorder-specific ways, and in females the effect is observed across multiple generations. Particularly given that these effects may have grown stronger in more recent cohorts, these findings highlight the need for further research to clarify the underlying mechanisms and identify promising targets for prevention. Speculatively, one such mechanism may involve greater internal and external demands for academic success in highly educated families.

Significant Locus and Metabolic Genetic Correlations Revealed in Genome-Wide Association Study of Anorexia Nervosa

“…Third, congruent with our results, positive associations been anorexia nervosa and educational attainment have been reported (30) and have been conjectured to reflect greater internal and external demands for academic success in highly educated families. Our results, in contrast, suggest that genetic factors may partially account for these reported associations.…”

Intellectual functioning of adolescent and adult patients with eating disorders

“…As intelligence is strongly associated with education levels, our findings might reflect higher than average education levels of ED patients. Family history in education is an established risk factor for ED . We did not find any difference in IQ between the AN, BN and EDNOS groups.…”

School Achievement and Risk of Eating Disorders in a Swedish National Cohort

“…This is consistent with a smaller Swedish study that reported an association between high parental education and eating disorders among females but not males, 13 whereas another Swedish study reported a modest association with AN among males. 15 The present study suggests that parental education only partly explains the observed associations between school achievement and eating disorders among females. Other unmeasured familial factors may contribute to this association, such as familial values, role modeling, or personality traits.…”