Chasing Perfect: How Perfectionism Fuels Eating Disorders in Adults

Perfectionism and eating disorders in adults: how the pressure to be perfect fuels disordered eating. Discover dietitian support for health, healing, and recovery

Can being a perfectionist really cause eating problems?

Yes. Research shows that perfectionism is one of the strongest psychological traits linked to eating disorders in adults. A large review of 25 studies with over 10,000 participants found a clear connection between perfectionism and eating behaviours like bingeing, purging, and restrictive dieting [1]. Perfectionism often comes with self-criticism, fear of failure, and the belief that nothing is ever good enough [2,3]. When these thought patterns mix with pressures about appearance or self-worth, they can drive unhealthy eating habits and body image concerns [4].

Q2: What does perfectionism look like in everyday life?

Perfectionism can show up as constantly worrying about mistakes, doubting your decisions, feeling pressure to meet others’ expectations, or believing your worth depends on your achievements or appearance [2,3]. In eating, this can appear as strict food rules, obsessive calorie tracking, over-exercising, or comparing your body to others [1,4].

Q3: Are there different types of perfectionism, and do they affect eating differently?

Yes. Socially prescribed perfectionism, where you feel others expect you to be perfect, is strongly linked to binge eating and bulimia. People may use food to cope with stress or self-criticism [5]. Self-oriented perfectionism, where you set high standards for yourself, is often associated with restrictive eating and anorexia. In this case, dieting or exercising becomes a way to feel in control or prove personal discipline [6].

Q4: Aren’t eating disorders mostly a teenage problem?

Not at all. Eating disorders are increasingly recognised in adults. Perfectionism often becomes stronger and more ingrained with age [7]. Adults face unique pressures from work, parenting, and relationships, which can intensify perfectionistic tendencies. Many people carry these patterns from childhood into adulthood without ever addressing them, increasing the risk of long-term disordered eating [1].

Q5: How does perfectionism make eating disorders harder to treat?

Perfectionism creates rigid, all-or-nothing thinking. For example, someone might feel like a total failure after breaking a strict diet and spiral into bingeing or self-punishment [4]. Focusing only on food behaviours without addressing perfectionism often leads to relapse. Treating the underlying thought patterns is key to long-term recovery [1].

Q6: What kinds of therapy help with perfectionism and eating disorders?

Cognitive behavioural therapy (CBT) designed for perfectionism helps challenge black-and-white thinking, reduce fear of mistakes, and build self-compassion [8]. Mindfulness and self-compassion therapies teach people to respond to setbacks with kindness instead of criticism, breaking cycles of perfectionism and disordered eating [9]. Addressing perfectionism alongside eating behaviours helps make recovery more sustainable [1].

Q7: What’s the main message for people struggling with perfectionism and eating issues?

Perfectionism is not just a personality quirk—it is a serious risk factor for eating disorders. The good news is that it is treatable. You don’t have to be perfect to be healthy, worthy, or accepted. Understanding and changing the beliefs driving perfectionism can support recovery, promote self-compassion, and help create lasting change beyond food and body image [1,2,4,8,9].

References

1. Stackpole R, Greene D, Bills E, Egan SJ. The association between eating disorders and perfectionism in adults: A systematic review and meta-analysis. Eat Behav. 2023;51:101769. doi:10.1016/j.eatbeh.2023.101769

2. Shafran R, Cooper Z, Fairburn CG. Clinical perfectionism: A cognitive-behavioural analysis. Behav Res Ther. 2002;40(7):773–91.

3. Frost RO, Marten P, Lahart C, Rosenblate R. The dimensions of perfectionism. Cognit Ther Res. 1990;14(5):449–68.

4. Bardone-Cone AM, Wonderlich SA, Frost RO, Bulik CM, Mitchell JE, Uppala S, et al. Perfectionism and eating disorders: Current status and future directions. Clin Psychol Rev. 2007;27(3):384–405.

5. Hewitt PL, Flett GL. Dimensions of perfectionism in unipolar depression. J Abnorm Psychol. 1991;100(1):98–101.

6. Boone L, Soenens B, Luyten P. An empirical typology of perfectionism in early-to-mid adolescents and its relation with eating disorder symptoms. Behav Res Ther. 2014;52:137–42.

7. Egan SJ, Wade TD, Shafran R, Antony MM. Perfectionism as a transdiagnostic process: A clinical review. Clin Psychol Rev. 2011;31(2):203–12.

8. Lloyd S, Schmidt U, Khondoker M, Tchanturia K. Can psychological interventions reduce perfectionism? A systematic review and meta-analysis. Behav Cogn Psychother. 2015;43(6):705–31.

9. Kelly AC, Carter JC. Self-compassion training for binge eating disorder: A pilot randomized controlled trial. Psychol Psychother. 2015;88(3):285–303.