{
  "abstract": "Background: Eating disorder treatment is most successful when delivered at first onset, underscoring the importance of early intervention. Genetic factors may contribute to earlier onset, but molecular genetic research into symptom onset and severity remains limited.\n\nAims: We investigated (1) age at onset of behavioural symptoms and low weight, including sex differences, (2) the SNP-based heritability and cross-trait polygenic associations of symptoms, onset, and severity.\n\nMethod: Participants (n = 24,973) of genetically-derived European ancestry were from the NIHR BioResource, including the Genetic Links to Anxiety and Depression Study, Eating Disorders Genetics Initiative UK, and COVID-19 Psychiatry and Neurological Genetics Study. Symptoms were assessed with the ED100K questionnaire. We described sex-stratified onset of binge eating, low weight, self-induced vomiting, laxatives, diuretics, excessive exercise, and fasting. SNP-based heritability was estimated using GCTA-GREML. We tested associations with 26 polygenic scores (PGS), which were calculated using SBayesRC.\n\nResults: Symptom median onset ranged from 16-20 years: vomiting (16), fasting and excessive exercise (17), binge eating (18), laxatives (19), diuretics (20), and low weight (20). Males were disproportionately likely to report adult onset. In females, behavioural symptoms and low weight showed substantial heritability (SNP-based h2 = 0.31–0.78), but onset and cognitive symptoms appeared to be less heritable. PGS analyses identified distinct pathways: in females, higher childhood obesity PGS was linked to earlier binge eating onset (~7 months), and higher educational attainment PGS to earlier low weight onset (~6 months).\n\nConclusions: Eating disorder symptoms begin in adulthood as frequently as adolescence, challenging stereotypes and underscoring investment needed in adult services, particularly for men. While symptoms were strongly heritable, onset and cognitive symptoms showed limited genetic contribution. Symptom-level PGS analyses highlight distinct biological and developmental pathways. Larger sample sizes and more accurate phenotyping are needed.",
  "abstract_shown": true,
  "affiliations": [
    "Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK",
    "UK National Institute for Health and Social Care Research (NIHR) Biomedical Research Centre for Mental Health, South London and Maudsley Hospital, London, UK",
    "Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom",
    "Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany",
    "National Centre for Register-based Research, Aarhus University, Aarhus, Denmark",
    "Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, German Red Cross Hospitals Westend, Berlin, Germany"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 15,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Helena L. Davies",
      "orcid": "0000-0002-9419-1009"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Abigail R. ter Kuile",
      "orcid": "0000-0002-7869-3754"
    },
    {
      "affs": [
        0
      ],
      "name": "Zain-Ul-Abideen Ahmad",
      "orcid": "0000-0002-6940-8851"
    },
    {
      "affs": [
        0
      ],
      "name": "Sang Hyuck Lee"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Rujia Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jessica Mundy",
      "orcid": "0000-0001-5513-8902"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Jonathan Coleman",
      "orcid": "0000-0002-6759-0944"
    },
    {
      "affs": [
        3
      ],
      "name": "Carlotta Sampels"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Saakshi Kakar",
      "orcid": "0000-0003-1677-1857"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Emily Kelly"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Chelsea Mika Malouf"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Gursharan Kalsi",
      "orcid": "0000-0002-5156-7176"
    },
    {
      "affs": [
        0
      ],
      "name": "Moritz Herle",
      "orcid": "0000-0003-3220-5070"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Gerome Breen",
      "orcid": "0000-0003-2053-1792"
    },
    {
      "affs": [
        0,
        1,
        4,
        5
      ],
      "name": "Christopher Hübel",
      "orcid": "0000-0002-1267-8287"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c58jkxpnbw02b.bib",
  "cited_by": 0,
  "doi": "10.1192/bjp.2026.10763",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619679/?tool=EBI",
  "id": "c58jkxpnbw02b",
  "issns": [
    "0007-1250",
    "1472-1465"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC7619679",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "heading",
      "Article"
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      "3203|Eating Disorders and Behaviors"
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  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7619679/pdf/?tool=EBI",
  "pmcid": "PMC7619679",
  "pmid": "42841245",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/c58jkxpnbw02b.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Eating Disorders and Behaviors",
      "subfield": "psychiatry"
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  "title": "Mapping the genetic landscape of the age at onset and severity of eating disorder symptoms",
  "title_text": "Mapping the genetic landscape of the age at onset and severity of eating disorder symptoms",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:20:43Z",
  "url": "https://research.draconitic.com/paper/c58jkxpnbw02b",
  "venue": "The British journal of psychiatry : the journal of mental science",
  "versions": []
}