From the Research
The prevalence of personality disorders among individuals with eating disorders is approximately 30-60%, with the most recent and highest quality study suggesting a significant comorbidity rate. This comorbidity rate varies by eating disorder type, with individuals with anorexia nervosa binge-purge subtype and bulimia nervosa typically showing higher rates compared to those with restrictive anorexia nervosa 1. The most common personality disorders observed include borderline personality disorder, avoidant personality disorder, obsessive-compulsive personality disorder, and dependent personality disorder.
Key Findings
- A study published in 2020 found a 65.4% prevalence of feeding and eating disorders (FEDs) in patients with borderline personality disorder (BPD), with the highest prevalence rate reported for other specified feeding and eating disorders (51.3%) and the lowest for bulimia nervosa (6.9%) 1.
- Another study published in 2022 suggested that personality disorders have some impact on treatment outcomes for eating disorders, with Cluster C personality disorders found to negatively impact treatment outcomes for binge eating disorder and attrition rates for anorexia nervosa 2.
- The presence of personality disorders often complicates treatment, leading to poorer outcomes and higher relapse rates in eating disorder recovery, likely due to underlying neurobiological vulnerabilities affecting impulse control, reward processing, and emotional regulation systems.
Clinical Implications
- Clinicians should routinely screen for personality disorders when treating eating disorders, as integrated treatment approaches addressing both conditions simultaneously typically yield better results than treating the eating disorder alone.
- The high comorbidity of personality disorders and eating disorders reflects shared psychological mechanisms, including perfectionism, emotional dysregulation, and interpersonal difficulties, which should be addressed in treatment.
- Further research is needed to fully understand the relationship between personality disorders and eating disorders, including the development of more effective treatment approaches that take into account the complex interplay between these conditions.