Are Internationally Adopted Children at Higher Risk for Eating Disorders?

What you need to know

• International adoptees have a higher risk of developing eating disorders compared to non-adopted individuals
• The increased risk extends to other mental health conditions like depression and anxiety
• Adoptive families and healthcare providers should be aware of these risks to support adoptees’ wellbeing

Background on international adoption

Adoption across national borders has become increasingly common since World War II. It’s estimated that over 1 million children have been adopted internationally since then. Countries like Sweden have a particularly high rate of international adoptions.

While adoption provides loving homes for many children, research has shown that adoptees face some increased mental health risks compared to non-adopted individuals. Previous studies have found higher rates of conditions like ADHD, behavioral problems, and suicidal behavior in adoptees. However, less was known about eating disorders specifically in this population.

A large-scale study on eating disorders in adoptees

To examine this issue, researchers conducted a large cohort study using Swedish national population registers. They looked at data on over 2 million individuals born between 1979-2005, including 25,287 international adoptees and over 2 million non-adopted individuals.

The study aimed to determine if international adoptees have a higher risk of developing eating disorders compared to non-adoptees. They also examined rates of other mental health conditions for comparison.

Key findings on eating disorder risk

The results showed that international adoptees did have an elevated risk of eating disorders:

• 21% higher risk of anorexia nervosa
• 60% higher risk of other eating disorders

Importantly, this increased risk remained even after the researchers adjusted for factors like sex, birth year, and maternal education level.

Broader mental health risks

The study found the elevated risk extended beyond just eating disorders. Compared to non-adoptees, international adoptees also had:

• 90% higher risk of major depressive disorder
• 25% higher risk of obsessive-compulsive disorder
• 69% higher risk of anxiety disorders

This suggests the higher eating disorder risk is part of a broader pattern of mental health vulnerabilities in adoptees.

Possible explanations for the findings

The researchers discuss several potential factors that could contribute to these elevated risks in adoptees:

Early life experiences: Many adoptees face adverse experiences early in life, like malnutrition or lack of consistent caregiving. This can potentially impact brain development and future mental health.

Genetic factors: There may be heritable components that increase risk, as biological parents of adoptees may have higher rates of mental health issues.

Identity formation: Adoptees may face unique challenges in developing their identity, especially those who look different from their adoptive families.

Discrimination: International adoptees may experience racism or feelings of not belonging, which could impact mental health.

Family environment: While most adoptive families provide loving homes, there may be stresses related to adoption disclosure or navigating cultural differences.

However, it’s important to note these are largely theoretical explanations. The study wasn’t able to determine the exact causes of the increased risks.

Anorexia and OCD show similar patterns

Interestingly, anorexia nervosa and obsessive-compulsive disorder (OCD) showed lower increases in risk compared to the other conditions examined. The researchers note this could potentially be due to shared genetic factors between anorexia and OCD that have been identified in other studies.

They suggest anorexia and OCD may be more biologically-driven and less influenced by environmental factors related to adoption. In contrast, conditions like depression and anxiety, which showed larger increases, may be more impacted by life experiences.

Strengths and limitations of the study

This study has several key strengths:

• Very large sample size, providing strong statistical power
• Use of high-quality national health registers
• Ability to look at multiple mental health conditions

However, there are also some limitations to consider:

• The study couldn’t determine the causes of the increased risks
• It only included adoptees up to age 34, so very late-onset cases weren’t captured
• There may be some differences in how adoptees access or receive mental health diagnoses

Implications for adoptive families and healthcare providers

While this study highlights increased mental health risks for adoptees, it’s crucial to avoid stigmatization. Many adoptees are happy and healthy, and adoption provides loving homes for children in need.

However, the findings do suggest adoptive families and healthcare providers should be aware of these potential vulnerabilities. This awareness can help ensure proper support and early intervention if issues do arise.

Some key takeaways:

• Adoptive parents may want to be especially attuned to signs of mental health struggles, including disordered eating behaviors
• Pediatricians and family doctors should keep these risks in mind when caring for adopted patients
• Mental health professionals working with adoptees should be knowledgeable about adoption-related issues
• Schools can provide support through counseling services and education on diversity and inclusion

Conclusions

• International adoptees face moderately higher risks of eating disorders and other mental health conditions compared to non-adoptees
• The causes are likely complex, potentially involving both biological and environmental factors
• Awareness of these risks can help families and healthcare providers better support adoptees’ wellbeing
• More research is needed to understand the mechanisms behind these elevated risks and develop targeted support strategies

This study provides important insights into the mental health of international adoptees. While it highlights some increased risks, it also demonstrates the power of large-scale health data to illuminate health patterns in specific populations. Ultimately, this knowledge can lead to better support and care for adoptees and their families.