Skip to main content Accessibility help

Binge eating disorder: a symptom-level investigation of genetic and environmental influences on liability

  • K. S. Mitchell (a1) (a2), M. C. Neale (a2) (a3) (a4), C. M. Bulik (a5), S. H. Aggen (a2) (a3), K. S. Kendler (a2) (a3) and S. E. Mazzeo (a1) (a2) (a6)...



Recent behavioral genetic studies have emphasized the importance of investigating eating disorders at the level of individual symptoms, rather than as overall diagnoses. We examined the heritability of binge eating disorder (BED) using an item-factor analytic approach, which estimates contributions of additive genetic (A), common environmental (C), and unique environmental (E) influences on liability to BED as well as individual symptoms.


Participants were 614 monozygotic and 410 dizygotic same-sex female twins from the Mid-Atlantic Twin Registry who completed a self-report measure of BED symptoms based upon DSM-IV criteria. Genetic and environmental contributions to BED liability were assessed at the diagnostic and symptom levels, using an item-factor approach.


Liability to BED was moderately heritable; 45% of the variance was due to A, with smaller proportions due to C (13%), and E (42%). Additive genetic effects accounted for 29–43% of the variance in individual items, while only 8–14% was due to C.


Results highlight the relevance of examining eating disorders at the symptom level, rather than focusing on aggregate diagnoses.


Corresponding author

*Address for correspondence to: Dr S. E. Mazzeo, Department of Psychology, Virginia Commonwealth University, PO Box 842018, Richmond, VA 23284-2018. (Email:


Hide All
APA (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn, text-revision). American Psychiatric Association: Washington, DC.
Bulik, CM, Brownley, KA, Shapiro, JR (2007). Diagnosis and management of binge eating disorder. World Psychiatry 6, 142148.
Bulik, CM, Sullivan, PF, Kendler, KS (1998). Heritability of binge-eating and broadly defined bulimia nervosa. Biological Psychiatry 44, 12101218.
Bulik, CM, Sullivan, PF, Wade, TD, Kendler, KS (2000). Twin studies of eating disorders: a review. International Journal of Eating Disorders 27, 120.
Crocker, L, Algina, J (1986). Introduction to Classical and Modern Test Theory. Wadsworth Group: Belmont, CA.
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1997). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinician Version. American Psychiatric Press: Washington, DC.
Grilo, CM, Masheb, RM, Wilson, GT (2001). A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. Journal of Consulting and Clinical Psychology 69, 317322.
Javaras, KN, Laird, NM, Reichborn-Kjennerud, T, Bulik, CM, Pope, HG, Hudson, JI (2008). Familiality and heritability of binge eating disorder: results of a case-control family study and a twin study. International Journal of Eating Disorders 41, 174179.
Keller, MC, Medland, SE, Duncan, LE, Hatemi, PK, Neale, MC, Maes, HHM, Eaves, LJ (2008). Modeling extended twin family data I: description of the cascade model. Twin Research and Human Genetics 12, 8–18.
Kendler, K, Prescott, C (1999). A population-based twin study of lifetime major depression in men and women. Archives of General Psychiatry 56, 3944.
Latner, JD, Clyne, C (2008). The diagnostic validity of the criteria for binge eating disorder. International Journal of Eating Disorders 41, 114.
Lykken, DT, McGue, M, Tellegen, A (1987). Recruitment bias in twin research: the rule of two-thirds reconsidered. Behavior Genetics 17, 343362.
Mazzeo, SE, Landt-Slof, MCTO, Jones, I, Mitchell, KS, Kendler, KS, Neale, MC, Aggen, SH, Bulik, CM (2006). Associations among post-partum depression, eating disorders and perfectionism in a population-based sample of adult women. International Journal of Eating Disorders 39, 202211.
Mazzeo, SE, Mitchell, KS, Bulik, CM, Aggen, S, Kendler, KS, Neale, MC (in press). A twin study of specific bulimia nervosa symptoms. Psychological Medicine.
Mazzeo, SE, Mitchell, KS, Bulik, CM, Reichborn-Kjennerud, T, Kendler, KS, Neale, MC (2009). Assessing the heritability of anorexia nervosa symptoms using a marginal maximal likelihood approach. Psychological Medicine 39, 463473.
Neale, MC, Boker, S, Xie, G, Maes, H (2003). Mx: Statistical Modeling, 6th edn. Richmond, VA; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA.
Neale, MC, Aggen, SH, Maes, HH, Kubarych, TS, Schmitt, JE (2006 a). Methodological issues in the assessment of substance use phenotypes. Addictive Behaviors 31, 10101034.
Neale, MC, Harvey, E, Maes, H, Sullivan, PF, Kendler, KS (2006 b). Extensions to the modeling of initiation and progression: applications to substance use and abuse. Behavior Genetics 36, 507524.
Neale, MC, Lubke, G, Aggen, SH, Dolan, CV (2005). Problems with using sum scores for estimating variance components: contamination and measurement noninvariance. Twin Research and Human Genetics 8, 553568.
Pike, KM, Wilfley, D, Hilbert, A, Fairburn, CG, Dohm, FA, Striegel-Moore, R (2006). Antecedent life events of binge-eating disorder. Psychiatry Research 142, 1929.
Plomin, R, DeFries, JC, McClearn, GE, McGuffin, P (2008). Behavioral Genetics. New York, NY: Worth Publishers.
Reichborn-Kjennerud, T, Bulik, CM, Tambs, K, Harris, JR (2004). Genetic and environmental influences on binge eating in the absence of compensatory behaviors: a population-based twin study. International Journal of Eating Disorders 36, 307314.
Reichborn-Kjennerud, T, Bulik, CM, Kendler, KS, Roysamb, E, Maes, H, Tambs, K, Harris, JR (2003). Gender differences in binge-eating: a population-based twin study. Acta Psychiatrica Scandinavica 108, 196202.
Striegel-Moore, RH, Bulik, CM (2007). Risk factors for eating disorders. American Psychologist 62, 181198.
Striegel-Moore, RH, Franko, DL (2008). Should binge eating disorder be included in the DSM-V? A critical review of the state of the evidence. Annual Review of Clinical Psychology 4, 305324.
Striegel-Moore, RH, Kearney-Cooke, A (1994). Exploring parents' attitudes and behaviors about their children's physical appearance. International Journal of Eating Disorders 15, 377–85.
Sullivan, PF, Eaves, LJ (2002). Evaluation of analyses of univariate discrete twin data. Behavior Genetics 32, 221227.
Van den Berg, SM, Glas, CAW, Boomsma, DI (2007). Variance decomposition using an IRT measurement model. Behavior Genetics 37, 604616.
Wade, TD, Bergin, JL, Martin, NG, Gillespie, NA, Fairburn, CG (2006). A transdiagnostic approach to understanding eating disorders. Journal of Nervous and Mental Disease 194, 510517.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed