Adolescents who grew up in households facing financial hardship and lower parental education are more likely to experience eating disorder symptoms, according to new findings from the Avon Longitudinal Study of Parents and Children (ALSPAC).1 The study highlights how socioeconomic deprivation in early childhood is associated with disordered eating, body dissatisfaction, and weight and shape concerns during adolescence—while also underscoring that affected teens may face greater challenges in receiving timely diagnoses and access to treatment.
This prospective cohort study is published in JAMA Network Open.
A UK cohort study finds socioeconomic deprivation in early life is tied to greater eating disorder symptoms in adolescence, with barriers to care. | Image credit: estradaanton – stock.adobe.com
“More severe financial hardship was associated with increased risk of disordered eating, weight and shape concerns, and body dissatisfaction,” wrote the researchers of the study. “Lower parental educational attainment was strongly associated with increased odds of offspring’s disordered eating in adolescence.”
Research on socioeconomic status (SES) and eating disorders highlights the complex ways in which social and family factors shape mental health risks. A Danish study found that higher parental SES is associated with increased risk of anorexia nervosa, with weaker associations for bulimia and eating disorders not otherwise specified.2 These contrasting findings suggest that different eating disorders may have distinct socioeconomic patterns. Importantly, eating disorders occur across the SES spectrum, underscoring the need for equitable access to detection and treatment regardless of background.
The current study analyzed data from the ALSPAC, a UK-based population cohort that recruited pregnant women in the Avon region with expected delivery dates between April 1991 and December 1992.1 Maternal reports collected from pregnancy through 47 months postpartum provided information on socioeconomic indicators, including parental income, education, occupation, and financial hardship, while area-level deprivation was determined using national statistics linked to residential postcodes.
The final sample included 7824 children who were alive at age 1 with complete exposure data, retaining 1 twin at random in twin pairs. Eating disorder symptoms, including disordered eating behaviors, weight and shape concerns, and body dissatisfaction, were assessed at ages 14, 16, and 18 years. Data analysis was conducted between October 2022 and November 2024 to examine associations between early-life socioeconomic factors and adolescent eating disorder outcomes.
A consistent association was identified between childhood socioeconomic deprivation and increased risk of eating disorder symptoms in adolescence. Each 1-point increase in financial hardship was linked to higher odds of disordered eating (OR, 1.06; 95% CI, 1.04-1.10), greater weight and shape concerns (coefficient, 0.02; 95% CI, 0.01-0.04), and higher body dissatisfaction (coefficient, 0.22; 95% CI, 0.06-0.37).
Additionally, lower parental education further amplified risk, with adolescents from these households nearly twice as likely to show disordered eating behaviors (OR, 1.80; 95% CI, 1.46-2.23).
However, the researchers noted several study limitations. First, higher attrition among participants from lower socioeconomic backgrounds may have biased results, particularly the income–disordered eating link observed only at age 14, which could reflect earlier onset or missing data. Second, the data were collected from the 1990s to the 2000s, so findings may not fully reflect today’s economic context. Third, missing parental occupation (10%) and education (3%) data may have introduced bias, and measures of restrictive eating may not have captured severe behaviors typical of anorexia nervosa. Finally, while maternal mental health was considered, the study could not fully adjust for potential genetic confounding.
Despite these limitations, the researchers believe these findings underscore that socioeconomic disadvantage in early childhood plays a significant role in the development of disordered eating and related concerns during adolescence.
“Identifying and addressing existing barriers that might prevent young people from deprived backgrounds from accessing eating disorder services should be [a] research and policy priority,” wrote the researchers. “Provision of comprehensive medical training might facilitate identification of a broader spectrum of eating disorder presentations in primary care, particularly in populations who are more likely to be missed.”
References
1. Hahn JS, Flouri E, Harrison A, et al. Family socioeconomic position and eating disorder symptoms across adolescence. JAMA Netw Open. 2025;8(8):e2527934. doi:10.1001/jamanetworkopen.2025.27934
2. Koch SV, Larsen JT, Plessen KJ, et al. Associations between parental socioeconomic-, family-, and sibling status and risk of eating disorders in offspring in a Danish national female cohort. Int J Eat Disord. 2022;55(8):1130-1142. doi:10.1002/eat.23771