Adults with acne are 2.4 times more likely to have an eating disorder than people without acne, new research shows.
The study, published in the Journal of the European Academy of Dermatology and Venereology, adds to a growing body of research that shows a significant, yet complex, relationship between eating disorders and dermatological issues.
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The findings indicating that acne may be a predictor of eating disorders held even after the researchers removed the effects of anxiety, depression and body dysmorphic disorder. But in people with existing psychological risk factors, acne might trigger even more concern about appearance and result in overestimating body size or restricting eating, which are theorized to contribute to the development of eating disorders, the researchers wrote.
People's beliefs about how acne flares are related to diet also may contribute to disordered eating behaviors, the researchers wrote.
Eating disorders are on the rise in the United States and can cause significant health issues. A 2023 study showed that hospital visits for children and adolescents with eating disorders more than doubled between 2018 and 2022, from 50,000 to over 100,000.
More than 10,000 Americans die each year from eating disorders, according to the National Association of Anorexia Nervosa and Associated Disorders.
For the recent study, researchers used data from 287,011 adults who had enrolled in the All of Us Research Program between May 31, 2017 and July 1, 2022. They compared nearly 7,400 adults with acne to approximately 207,000 patients without acne.
The lead author of the study, Dr. Jeffrey Cohen, found in a prior study that people with eczema were three times more likely to have binge eating disorder and twice as likely to have anorexia or bulimia. The study highlights the "intricate" relationship between dermatological conditions and mental health, according to the researchers.
The new study was limited by the fact that it did not include a nationally representative sample of people. Also, it only looked at adults with acne, even though acne and eating disorders often afflict adolescents and children.
The study also did not address the impact eating disorders can have on skin. Binging and purging associated with bulimia can harm the skin. It also is hard for acne to clear up while eating disorders persist, according to The Bulimia Project, an organization that provides education, research and resources for people with bulimia.
More research is needed on how to better detect and treat eating disorders among people with acne, the researchers wrote.
People with anorexia may have a powerful fear of gaining weight, even if they are thin. People diagnosed with bulimia have a regular pattern of binging on food and then making themselves vomit. Symptoms of binge-eating disorder vary but may include a feeling of a loss of control around eating and regularly eating large amounts of food.
Treatment for eating disorders may include a combination of talk therapy, medical monitoring and care, medication and nutrition education, according to the Mayo Clinic.