Eating disorders have long been thought of as a problem affecting well-off, well-educated families. A new review published in the International Journal of Eating Disorders involving more than 26,000 teenagers suggests this stereotype is not just wrong, it may be actively dangerous, leaving some of the most vulnerable young people slipping through the cracks.
The study led by researchers at University College London (UCL) in collaboration with Copenhagen University Hospital, has pulled together data from 51 separate studies carried out across North America, Europe and Australia, and found that teenagers from lower-income, lower-education households are actually more likely to show signs of an eating disorder.
Challenging the Stereotype
For decades, eating disorders have been linked with wealth and privilege. But researchers argue that this assumption can mean teenagers from poorer backgrounds get overlooked by doctors, teachers and counsellors who assume the problem lies elsewhere.
Senior author Dr Nora Trompeter (UCL Great Ormond Street Institute of Child Health) said: “Eating disorders are often stereotyped as a problem of affluence but this review shows that this is not the full picture. Our review has found that teenagers from lower-income, lower-education households are actually more likely to show signs of disordered eating, not less. This tells us that disordered eating is a concern across the socioeconomic spectrum, and prevention and treatment efforts need to reach families facing financial and social disadvantage, who may currently be overlooked.”
What the Review Assessed
The review examined both diagnosed eating disorders (anorexia, bulimia and binge eating disorder) and early warning signs of disordered eating. These earlier signs include things like restricting food, fasting, having a poor body image, and feeling under pressure to be thinner. Looking at both means the research captures young people already struggling as well as those at risk of developing a full-blown disorder.
The clearest pattern came with family income: about two-thirds of the studies found that teenagers from lower-income families were more likely to have symptoms of an eating disorder. Parental education also mattered, and teenagers whose parents had not been to university were around 25% more likely to report eating disorder symptoms than those whose parents had.
Other measures (like neighbourhood deprivation, parents’ jobs, financial difficulties, or whether a family received government benefits) painted a more mixed picture. The researchers point out that these can be harder to measure consistently across studies and may not reflect family circumstances in the same way.
Why This Matters
If eating disorders are seen as something that mainly affects wealthy, high-achieving teenagers, then the signs may simply be missed in young people from different backgrounds. That could mean no screening and problems could spiral when they could have been caught early.
Dr Trompeter said: “Eating disorders don’t discriminate by income or education. If anything, the evidence points the other way, and treating them as a ‘privileged’ condition risks leaving adolescents most in need of support undiagnosed and untreated.”
The researchers are now urging clinicians, GPs, school nurses, counsellors and others working with young people to rethink who they consider at risk. Spotting disordered eating earlier in teenagers from lower-income or lower-education homes could make a huge difference to their recovery.
Dr Trompeter added: “Challenging outdated stereotypes could help reduce missed diagnoses and ensure that those young people who are most in need receive timely treatment.”
Caveats
As with any big review, there are limits. Most of the studies focused on teenagers living in Western countries, so the findings may not translate directly to other populations. The way different studies measured socioeconomic status also varied widely, making it hard to compare results neatly.
Still, the overall message is clear: eating disorders are not confined to a particular type of family or background, and treating them as if they are risks letting down the young people who most need help.
Trompeter, N. et al. (2026). Research Update: A Systematic Review of the Relationship Between Eating Disorder Symptoms and Parental Socioeconomic Status (SES) Among Adolescents. International Journal of Eating Disorders.