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A Narrative Review of Sex Differences in Eating Disorders: Is There a Biological Basis?
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Journal Article
A Narrative Review of Sex Differences in Eating Disorders: Is There a Biological Basis?
2021
Overview
Eating disorders and their core symptoms (eg, binge eating, body weight/shape concerns) disproportionately affect females, and these sex-differentiated effects become prominent during and after puberty. Although psychosocial influences such as heightened sociocultural pressures for thinness in girls and women contribute to this sex imbalance, biological factors could also play an important role.
This narrative review summarizes evidence of biological factors underlying the sex-differentiated prevalence of eating pathology as well as within-sex variability in risk.
There are sex differences in the pubertal emergence of genetic effects on eating pathology (adrenarche in males; gonadarche in females), and at least some genetic contributions to eating pathology seem to vary between the sexes. Furthermore, sex steroid hormones (eg, testosterone, estradiol, progesterone) are leading contributors to differential risk for eating pathology in males and females across the life span. Emerging data suggest that between-sex and within-sex variability in risk might occur via hormone-driven modulation (activation/deactivation) of genetic influences and neural responsiveness to food-related cues.
There is a biological basis to heightened risk for eating pathology in females, relative to males, as well as unique biological influences within each sex. Findings from this review highlight the importance of studying both sexes and considering sex-specific biological mechanisms that may underlie differential risk for eating pathology
•Some genetic effects on eating pathology vary between the sexes.•Sex steroids impact sex-specific genetic and phenotypic effects on eating pathology.•Testosterone exerts protective effects that reduce eating pathology in males.•Lower estradiol enhances genetic and phenotypic eating pathology risk in girls/women.•Neural responses to palatable food differ between the sexes, possibly via estradiol.
Publisher
Elsevier Inc,Elsevier Limited
