Does Anorexia Impair One’s Ability to Relate Socially?

Historically, research has indicated that those suffering from anorexia nervosa often live isolated lives and are socially inhibited. Patients with anorexia typically display impaired social interactions, which is implicated in the development of the eating disorder.

Perhaps the decline in energy from lack of nutrition causes the person with anorexia to focus all resources on oneself to survive and thus external relationships decline in importance. There is also thought that abnormal neurobiological changes influence a person’s ability to interact socially.

The question remains: Why do some still suffer from poor social adjustment before significant weight loss occurs and after weight restoration?

Comparing Patterns

The January, 2013 issue of the International Journal of Eating Disorders features an article titled: Perception of Affect in Biological Motion Cues in Anorexia Nervosa.

It addresses the question of whether body movement social cues are misread by sufferers of anorexia. Specifically researched are non verbal body motions. It is already noted that individuals with anorexia often have difficulty accurately identifying facial expressions.

The 64 study participants were divided into three groups:

  1. Those with anorexia (21)
  2. Those fully weight restored after anorexia (20)
  3. Those with no history of anorexia or eating disorders (23).

All of the participants completed tests consisting of:

  • The Eating Disorder Examination (EDE)
  • Eating Disorder Examination Questionnaire (EDE-Q)
  • Brief Symptom Inventory (BSI)
  • Autism-Spectrum Quotient (AQ)
  • Group Embedded Figures Test (GEFT)
  • Wechsler Abbreviated Scale of Intelligence (WASI) and the Pointlight Walkers (Pointlight)

Woman blowing bubblesResults demonstrated that those with anorexia were less accurate in reading body language as an indicator of emotion. Particularly interestingly, sadness was more difficult for the anorexic participants to perceive while anger was easier to observe.

The authors suggest that biologically, all humans are designed to survive and that reading anger is a more essential survival tactic than reading sadness.

Anger could be an indicator of impending or actual threat to one’s survival, while sadness may be a less essential social cue to read for imminent survival.

The authors also propose that all humans suffer from impaired motion perception social indicators, when the body is stressed from starvation.  Therefore, it may not be a genetic predisposition of those with anorexia to suffer from impaired abilities to read various social cues, but rather the normal reaction of any human enduring starvation.

More recent research in the area of anorexia and social interaction has demonstrated that individuals with anorexia tend to be hyposensitive to their own actions in the face of a remarkable attentional response toward the actions by others.

Help With The Therapeutic Aspect

Therapeutically, these findings may be useful to clinicians as we seek to educate families and loved ones regarding the impact of starvation on the social perceptions of the individual suffering from anorexia.

It may suggest that assumptions of non verbal communications between family members that are typically easily decipherable, may need to be closely observed by the clinician and brought to the attention of the individual with anorexia.

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Also, it may be helpful for the family therapist to share the biological cause of this social impairment and thus encourage family members to use their words to communicate their feeling states more than just relying on body language.

Woman smilingImplications for findings such as these may also help in improving psychological treatments for eating disorders that have been aimed at redirecting patients’ attention from anxiety-provoking thoughts, including attentional bias modification treatments (ABMT).

ABMT have been used successfully to retune attentional bias in patients with anorexia, especially in those individuals who exhibit significant attentional bias in social interactions.

Finally, it may be a subtle motivational point for the individual struggling with anorexia, by encouraging the individual to consider that their relationship skills and communication capacity may very well increase with weight restoration.


Jacquelyn EkernAbout the author: Jacquelyn Ekern, MS, LPC founded Eating Disorder Hope in 2005, driven by a profound desire to help those struggling with anorexia, bulimia and binge-eating disorder. This passion resulted from her battle with, and recovery from, an eating disorder. As president, Jacquelyn manages Ekern Enterprises, Inc. and the Eating Disorder Hope website. In addition, she is a fully licensed therapist with a closed private counseling practice specializing in the treatment of eating disorders.

Jacquelyn has a Bachelor of Science in Human Services degree from The University of Phoenix and a Masters degree in Counseling/Psychology, from Capella University. She has extensive experience in the eating disorder field including advanced education in psychology, participation and contributions to additional eating disorder groups, symposiums, and professional associations. She is a member of the National Eating Disorder Association (NEDA), Academy of Eating Disorders (AED), the Eating Disorders Coalition (EDC) and the International Association of Eating Disorder Professionals (iaedp).

Jacquelyn enjoys art, working out, walking her golden retriever “Cowgirl”, reading, painting and time with family.
Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without support from our generous sponsors.


[1]: International Journal of Eating Disorders 46:1 12-22 2013
[2]: Dalmaso, M. et al. Altered social attention in anorexia nervosa during real social interaction. Sci. Rep. 6, 23311; doi: 10.1038/srep23311 (2016).

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on on June 12, 2017..
Edited And Updated By: Crystal Karges, MS, RDN, IBCLC.
Reviewed By: Jacquelyn Ekern, MS, LPC on June 12, 2017.
Published on 

Although Eating Disorder Hope was founded by Jacquelyn Ekern, this organization would not be possible without the support from our generous sponsors.

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