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Updated: Aug 16, 2026

A Computer-Based Platform for Aiding Clinicians in Eating Disorder Analysis and Diagnosis
Published on: May 10, 2022
Shared transmission of eating disorders and anxiety disorders
Pamela K Keel1, Kelly L Klump, Kathryn B Miller
1Department of Psychology, University of Iowa, Iowa City, Iowa 55242, USA. Pamela-keel@uiowa.edu
Objective:
Eating disorders have high comorbidity with mood, anxiety, and substance use disorders. Using twins from the population-based Minnesota Twin Family Study (MTFS), we examined comorbidity and shared transmission between eating pathology and these disorders.
Method:
Female twins (N = 672), ages 16-18 years, completed structured clinical interviews assessing anorexia nervosa and bulimia nervosa (as described in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV; American Psychiatric Association, 1994]), as well as mood, anxiety, and substance use disorders (as described in the 3rd Rev. ed. of the Diagnostic and Statistical Manual of Mental Disorders [DSM-III-R]). Shared transmission was examined using a discordant monozygotic (MZ) twin design.
Results:
Significant comorbidity was found between eating disorders and major depression, anxiety disorders, and nicotine dependence. Within MZ twin pairs discordant for eating disorders (n = 14), non-eating-disordered cotwins demonstrated increased risk for anxiety disorders compared with controls. Similarly, within MZ twin pairs discordant for anxiety disorders (n = 52), non-anxiety-disordered cotwins demonstrated increased risk for eating disorders compared with controls.
Discussion:
Findings support shared transmission between eating disorders and anxiety disorders. However, the nature of this shared diathesis remains unknown.
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