Fighting with food and yourself: what science knows about RPP

Eating disorders (EDS) have long been considered a problem of adolescents and young women. In popular culture, the image of a person with RPP was usually associated with extreme thinness, anorexia, and the modeling industry. However, modern research shows that the real picture is much more complicated. Today, doctors are recording an increase in the number of cases among men, adults, and even women during menopause. Moreover, experts are increasingly calling RPP one of the most dangerous mental disorders due to the high risk of chronic course and mortality. About the prerequisites, causes and risk groups — in the material of Izvestia.

Why is RPP Becoming One of the Most Overlooked Mental Health Issues

Eating disorders are a group of mental illnesses in which a person's attitude to food, weight, and their own body becomes pathological. The most well-known forms are considered to be anorexia nervosa, bulimia nervosa and compulsive overeating. However, experts identify other forms, including atypical disorders, which can be no less dangerous to health.

A few decades ago, the main reason for the RPP was considered to be the pressure of social standards of beauty. But modern research in psychiatry and neuroscience shows that this is only part of the problem. Today, scientists consider RPP to be the result of a complex interaction of genetics, brain function, emotional regulation, and the external environment.

A major review in Nature Neuroscience has shown that eating disorders have a significant biological component. Researchers have found genetic links between anorexia and a number of metabolic, nervous system, and mental health conditions. The authors emphasize that we are not talking about the existence of a single "anorexia gene", but about a combination of hereditary factors that increase a person's vulnerability to the disease.

Scientists pay special attention to the brain's reward system. Research shows that in some people, food restriction or weight loss begins to be perceived by the brain as a source of psychological reinforcement. As a result, dangerous behavior receives a kind of "encouragement" at the neurobiological level. This is one of the reasons why it can be difficult for a person to stop even when they already realize the harm to their health.

In addition to biological factors, anxiety, depression, perfectionism, low self-esteem, and chronic stress play a major role. Many patients describe the development of RPP as an attempt to regain control of life during a period of emotional crises. Food, weight, and restrictions are beginning to be perceived as the only area that a person can fully control.

Who is most likely to experience eating disorders

Women are still the main risk group. However, current evidence shows that eating disorders have long ceased to be exclusively a "women's problem." According to Harvard Medical School, a significant proportion of women experience symptoms of RPP already in adulthood. Many cases go unnoticed because patients do not conform to the common stereotype of a person with anorexia or bulimia.

Particularly noticeable in recent years has been the growing attention of researchers to eating disorders in men. For a long time, RPP was considered a predominantly female problem, which is why many cases among men simply did not come to the attention of doctors and scientists. However, current evidence shows that such disorders are much more common than previously thought.

According to a review by Deutsches Otzteblatt International, the lifetime prevalence of anorexia among men is estimated at about 0.2%, bulimia at 0.6%, and compulsive overeating at about 1%. The authors emphasize that the real figures may be higher due to systematic underdiagnosis and insufficient treatment of men for help.

The researchers note that one of the main reasons remains stigma. Many men do not perceive their own symptoms as signs of a mental disorder, as society still associates RPP primarily with women. The review emphasizes that such beliefs make it difficult both to diagnose and to start treatment on time.

An additional complication is that male eating disorders often manifest themselves differently from female ones. If women are more likely to strive for weight loss and thinness, then men can focus on gaining muscle mass, strict nutrition control, excessive training and the so-called "dry" physique with a minimum percentage of fat. Because of this, the symptoms often go unnoticed even by specialists.

Why Researchers are increasingly talking about middle-aged women

One of the most discussed studies in recent years has been the work of scientists from Florida International University, published in 2026. It is dedicated to a group of patients who for a long time practically did not come to the attention of specialists — women aged 45 to 65 years.

Scientists have found that the risk factors in middle age differ from the causes typical for adolescents. While young girls often face issues of self-identification and appearance, women after the age of 45 experience divorce, loss of parents, empty nest syndrome, age-related body changes and menopause. All this can significantly affect the attitude towards one's own body and food.

Researchers pay special attention to menopause. According to the results of the study, experiencing severe menopausal symptoms is associated with a higher risk of developing RPP. Figure changes, redistribution of adipose tissue, and a sense of distance from the social ideal of youth can increase dissatisfaction with appearance.

Maria Baso Perez also warns that the popularity of weight loss drugs and the so-called Ozempic era may further increase pressure on women, creating new risks for the formation of unhealthy attitudes towards nutrition and the body.

How stress and anxiety affect the development of RPP

Almost all modern research points to a close relationship between eating disorders and emotional disorders. Many patients with OCD simultaneously experience anxiety disorders, depression, obsessive-compulsive symptoms, and chronic stress. In some cases, it is anxiety that appears earlier and becomes one of the risk factors for future illness.

Experts explain this by the fact that eating behavior often begins to perform an emotional function. Limiting food, counting calories, overeating, or purifying behavior can temporarily reduce internal tension and create a sense of control. However, over time, this mechanism becomes fixed and turns into a stable pathological behavior model.

Perfectionism plays an additional role. Studies show that many patients with anorexia have a pronounced tendency to make harsh demands on themselves and react painfully to mistakes or failures. Nutrition control becomes a continuation of the desire for absolute control over one's own life.

Psychiatrists point out that without working with emotional causes, treatment of RPP is often less effective. That is why modern therapy programs usually include not only restoring nutrition, but also helping to manage anxiety, stress, and self-esteem.

How social media has changed the situation

Over the past 10 years, social media has become one of the most actively studied risk factors. The researchers note that constantly comparing oneself with idealized images on the Internet can increase dissatisfaction with one's own body. Teenagers and young people are particularly vulnerable, for whom appearance plays an important role in shaping self-esteem.

Recommendation algorithms pose an additional problem. After watching several weight loss videos, users begin to receive significantly more similar content, including extreme diets, fasting tips, and materials romanticizing painful thinness. Modern research in the field of artificial intelligence shows that such content can enhance the symptoms of RPP and support pathological attitudes. That is why scientists are increasingly calling on platforms to actively identify and limit the distribution of materials related to dangerous eating behavior.

A separate area of research is related to the so—called orthorexia, an obsessive desire to eat exclusively "properly" and "cleanly." Some researchers note that the modern culture of a healthy lifestyle sometimes blurs the line between health care and an eating disorder.

All nerves were eaten up: Russian schoolchildren began to suffer from anorexia and bulimia more often

Experts told us how to recognize RPP in a child.

Why treatment of RPP remains a difficult task

Late diagnosis remains one of the main problems. Many people have been hiding their symptoms for years, even from close relatives. This is especially common among adult women and men who believe that they must cope with their difficulties on their own. An additional problem is caused by long waiting lists for treatment. In some countries, patients may wait many months for specialized care. NHS reports in the UK show that adult patients sometimes wait more than a year to start therapy.

Modern treatment usually includes several areas at the same time: psychotherapy, nutrition restoration, medical supervision, work with anxiety and family support. Cognitive behavioral therapy, family-oriented programs, and long-term follow-up after completion of basic treatment are considered the most effective.

Experts emphasize that early detection remains the main factor in successful recovery. The earlier a person receives help, the lower the risk of severe complications, chronic disease and repeated relapses.

What researchers are saying today

Modern science is gradually abandoning the old notion of eating disorders as a problem exclusively for young girls. Research shows that RPP can occur at almost any age and affect people of any gender.

The main conclusion of recent years is that eating disorders are formed under the influence of many factors at the same time — from genetics and brain function to social networks, life crises and cultural pressures. That is why experts are increasingly talking about the need for early screening and a broader understanding of what these diseases actually look like.

The sooner a person receives help, the higher the chance of full recovery. And the more society moves away from stereotypes about who "can" or "can't" face RPP, the more likely it is to notice the problem before it begins to threaten health and life.