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The Conversation: Perfectionists more likely to develop bulimia

- November 2, 2018

Perfectionists are rarely satisfied with their performance or appearance and engage in harsh self-criticism when their efforts fall short. Perfectionists are also more likely to develop the eating disorder bulimia nervosa, according to new research. (Shutterstock)
Perfectionists are rarely satisfied with their performance or appearance and engage in harsh self-criticism when their efforts fall short. Perfectionists are also more likely to develop the eating disorder bulimia nervosa, according to new research. (Shutterstock)

This article was originally published on , which features includes relevant and informed articles, written by researchers and academics in their areas of expertise and edited by experienced journalists.

is Professor and Director of Clinical Training in the Department of Psychology and Neuroscience at

Bulimia nervosa is a common and life-threatening eating disorder. AV¾ãÀÖ²¿ 275,000 Canadian girls and women will . They will by vomiting, fasting or exercise.

Most sufferers of bulimia are female. AV¾ãÀÖ²¿ two per cent of them die every decade. And around a fifth of those deaths about . Uncovering the multiple factors leading to bulimia nervosa is therefore very important, especially as the causes are largely unknown.

As a professor in AV¾ãÀÖ²¿â€™s department of psychology and neuroscience, I research personality traits and eating disorders. As a clinical psychologist, I also assess and treat eating disorders and associated problems, including perfectionism.

My lab just published the most complete investigating the link between the personality trait of perfectionism and bulimia nervosa to date. Our results clearly show perfectionists have higher odds of developing bulimia and are at greater risk for developing the disease as time passes.

Building on this research, therapists may be able to improve treatments for some bulimic clients by focusing on their underlying perfectionism as well as their symptoms.

Harsh self-criticism


Perfectionism involves striving relentlessly for flawlessness and holding unrealistically high standards for oneself and others.

Perfectionists are rarely satisfied with their performance and .

Perfectionism is linked to relationship problems, disconnection and sadness. (Shutterstock)

To get a more comprehensive picture of whether perfectionism leads people to develop bulimia nervosa, we conducted a thorough literature search that identified 12 longitudinal studies involving a total of 4,665 participants.

We then analyzed results from these 12 studies using statistical means. Most of our participants were female (86.8 per cent) and included adolescents, undergraduates and adults from the community, with an average age of 19 years.

We showed perfectionism predicted increases in bulimia nervosa, even after controlling for baseline levels of the condition. This suggests perfectionists are at risk for developing more bulimia nervosa as time passes.

In fact, our results indicate perfectionism is centrally important to the personality of people who go on to develop bulimia.

Previous research has already shown that external pressure from family, friends and media can contribute to the disease by . But the link between perfectionism and bulimia has never before been extensively explored.

A dog-eat-dog world


Perfectionism is linked with . Perfectionists may turn to food to cope with sadness brought on by their lack of connection to other people.

Symptoms of bulimia (e.g., binge eating) may also offer perfectionists a .

It’s a dog-eat-dog world today. We have controlling and hyper-competitive helicopter parents. And in society at large, . Rank and performance matter more than ever. These are conditions where perfectionism is likely to develop. So, we may see more and more perfectionism-linked cases of bulimia nervosa emerge.

Our results suggest treating perfectionism as early as possible may help to stop the development of bulimia nervosa. It is time to go beyond entirely symptom-focused treatments. Building on our research, clinicians may want to assess and to treat both bulimic symptoms (e.g., vomiting) and underlying perfectionism (e.g., self-criticism).

Bulimia nervosa usually . AV¾ãÀÖ²¿ 25 per cent of people with the condition develop . And such as tooth decay and depression.

Clearly, more research is needed to understand and defeat this disease.The Conversation

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AV¾ãÀÖ²¿ is a founding partner of The Conversation Canada, a new-to-Canada online media outlet providing independent, high-quality explanatory journalism. Originally established in Australia in 2011, it has had more than 85 commissioning editors and 30,000-plus academics register as contributors. A full list of articles written by AV¾ãÀÖ²¿ academics can be found on .