Investigating Relationships Between Genetic Risk, Childhood Maltreatment, and Eating Disorders in Women

Genetic and environmental factors contribute to eating disorder risk, yet their interplay is poorly understood. We examined whether childhood maltreatment and polygenic scores for anorexia nervosa (PGS-AN) and binge-eating broad (PGS-BEB) are associated with eating disorders. We also examined the interactions between childhood maltreatment and PGSs in predicting eating disorders.

This nested case-control study used data from up to 63,989 mothers in the MoBa (Norwegian Mother, Father and Child Cohort Study). Mothers reported on their own experiences of 4 childhood maltreatment types: long-term humiliation or degradation, threats to self or someone close, physical abuse, and sexual abuse. Diagnoses of AN, bulimia nervosa (BN), binge-eating disorder (BED), purging disorder (PD), and binge-eating spectrum disorders (BESP) were obtained using self-report data from 5 time points and population health registers.

The prevalence of AN, BN, BED, PD, and BESP was 2.19%, 4.15%, 10.39%, 0.60%, and 12.96%, respectively. All childhood maltreatment types were strongly associated with elevated eating disorder likelihood (with odds ratios [ORs] ranging from 1.71 to 3.29) as were eating disorder PGSs (with ORs ranging from 1.05 to 1.31). There were no multiplicative interaction effects between childhood maltreatment and PGSs. Small additive interactions were observed between PGS-AN and PGS-BEB and degradation/humiliation for BN and BESP in exploratory analyses.

Eating disorder PGSs and childhood maltreatment are associated with higher odds of eating disorders. Furthermore, we found tentative evidence of small additive interaction effects between polygenic liability and childhood maltreatment, suggesting that their combined influence further elevates the risk of some eating disorders.