Perfectionism Linked to Eating Disorders

Concern Over Making Mistakes May Increase Risk

From the WebMD Archives

Feb. 5, 2003 -- People who have difficulty dealing with personal mistakes may be more likely to develop a serious eating disorder such as anorexia and bulimia, according to a new study.

In one of the largest studies to date on the issue, researchers found that perfectionism appears to increase the risk of developing eating disorders, but not other psychiatric problems, such as depression, alcoholism, anxiety disorder, or phobias.

"Until recently, it hasn't been clear whether the link between perfectionism and eating disorders is unique, or if perfectionism is also associated with the development of other psychiatric problems, such as anxiety disorders, depression, and substance abuse," says researcher Cynthia M. Bulik, PhD, of the Virginia Institute for Psychiatric and Behavioral Genetics at Virginia Commonwealth University, in a news release.

"These findings tell us that there may be something unique about perfectionism that sets up a person for being at risk for anorexia and bulimia nervosa," says Bulik.

The study, published in the February issue of the American Journal of Psychiatry, involved more than 1,000 female twins aged 25-65 and used standardized tests and interviews to evaluate links between perfectionist traits and psychological problems.

Researchers say perfectionism is a personality style in which a person is overly critical of his or her own performance. Perfectionists also tend to have an excessive need for approval and are greatly concerned about making mistakes. They differ from high achievers who are driven by a goal to achieve, whereas perfectionists are driven by a fear of failure.

The study found that negative reactions to mistakes and the tendency to view mistakes as personal failures were the perfectionist traits most significantly associated with anorexia and bulimia among the women, and were the only aspects of perfectionism not linked to other mental disorders.

Anorexia is an eating disorder characterized by starvation and compulsive exercising, and bulimia is an excessive concern over body weight that leads to periods of binge-eating and subsequent self-induced vomiting or laxative abuse.

Researchers say their findings may help parents and loved ones spot the warning signs of an eating disorder before they develop.

"Most patients and their patients say that perfectionism goes back to before they developed an eating disorder," says Bulik. "Young girls who are highly perfectionistic and punish themselves unduly for perceived failures can be helped to learn how to give themselves a break and set more realistic goals. This could also help them develop more realistic body image standards as well and perhaps prevent them for developing such extreme weight-loss behaviors."

SOURCE: American Journal of Psychiatry, February 2003 • News release, Virginia Commonwealth University.