Twin studies of eating disorders: A review

Cynthia M. Bulik, Patrick F. Sullivan, Tracey D. Wade, Kenneth S. Kendler

Research output: Contribution to journalArticlepeer-review

257 Citations (Scopus)


Objective: Twin methodology has been used to delineate etiological factors in many medical disorders and behavioral traits including eating disorders. Although twin studies are powerful tools, their methodology can be arcane and their implications easily misinterpreted. Method: The goals of this study are to (a) review the theoretical rationale for twin studies; (b) provide a framework for their interpretation and evaluation; (c) review extant twin studies on eating disorders; and (d) explore the implications for understanding etiological issues in eating disorders. Discussion: On the basis of this review, it is not possible to draw firm conclusions regarding the precise contribution of genetic and environmental factors to anorexia nervosa. Twin studies confirm that bulimia nervosa is familial and reveal significant contributions of additive genetic effects and of unique environmental factors in liability to bulimia nervosa. The magnitude of the contribution of shared environment is less clear, but in the studies with the greatest statistical power, it appears to be less prominent than additive genetic factors.

Original languageEnglish
Pages (from-to)1-20
Number of pages20
JournalInternational Journal of Eating Disorders
Issue number1
Publication statusPublished - 1 Jan 2000
Externally publishedYes


  • Eating disorders
  • Genetic and environmental factors
  • Twin studies


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