Are Eating Disorders Contagious? The Bad and the Good News
If negative peer influence can increase risk, maybe the flip side is also true.
Updated May 22, 2026 | Reviewed by Monica Vilhauer Ph.D.
This is a question that was asked of me at a recent school event. I'll admit, my first instinct was to smile, charmed by the phrasing and touched by the genuine curiosity behind it. Of course not, I thought. Eating disorders aren't infectious the way viruses are. You can't catch one from a sneeze.
But as I sat with the question a little longer, I realized I had completely missed what was actually being asked, and what a remarkably insightful question was being asked.
Although eating disorders aren't contagious in the infectious sense, they do spread. They move through social networks, quietly and powerfully, in ways that mirror contagion more closely than most people realize.
A large study of over 700,000 teenagers found that having just one classmate diagnosed with an eating disorder increased a student's own risk by 9%. Having more than one raised that risk to 18%, within the first year alone. These aren't trivial numbers. They tell us something important about how eating disorders travel through communities, and it is something that I am seeing in my practice now, more than ever.
The mechanism is social influence, and adolescents are especially vulnerable to it. Research shows that college students whose friends engage in disordered eating and negative body talk report significantly higher rates of eating pathology themselves. The behaviors and beliefs of the people around us shape our own, often without our awareness. Restrictive eating gets normalized, and body criticism becomes a common mode of conversation. Over time, what began as one person's struggle can become a shared framework.
Social media has accelerated this process dramatically. Digital platforms provide constant body comparison and appearance-focused content with algorithms designed to hold attention . The American Academy of Pediatrics has identified this as a contributing factor in the rising rates of eating disorders, particularly among young people who spend the most time online and who are most vulnerable to developing eating disorders.
But here's the part I was most eager to share with that thoughtful student: the same dynamic works in reverse.
If negative peer influence can raise risk, positive peer influence can lower it. Resilience , body acceptance, and healthy eating attitudes are protective, and they spread too. Peer-led programs like The Body Project, which challenge the thin ideal and promote self-affirmation through group discussion, have demonstrated a 46% reduction in bulimia nervosa onset and a 62% reduction in purging disorder onset over two to four years in high-risk young women. These programs work precisely because they harness the same power of social influence, but in a protective direction through group-based critique of unrealistic body standards and promotion of body appreciation.
This means that the adults in young people's lives have real power here to support healthy social networks. We can start with ourselves. We can model self-acceptance, not as a performance, but as a genuine practice. That means being mindful of how we talk about food, weight, and bodies, our own and others', in front of young people. We are not projects to be fixed, and the more we live that belief, the more the people watching us will begin to internalize it too.
We can talk openly about eating disorders, not with panic , but with honesty. They are diseases, serious and common. They are also treatable. Reducing stigma means treating these illnesses the way we treat any other medical condition: with information and compassion. And when we notice warning signs, such as food restriction, rigidity around eating, withdrawal, or distorted body talk, we don't wait. Early intervention matters enormously, both for the individual and for the effect that message can send within their peer group.
But perhaps most importantly, adults can deliberately create the conditions for positive contagion to spread. Programs like The Body Project don't happen on their own; they require schools, clinicians, and parents to prioritize them, fund them, and make space for them: a coach who builds a team culture around performance and nourishment rather than weight; a school counselor who advocates for eating disorder education ; a parent who reaches out when they notice a child's friend is struggling. These aren't small gestures. They are the exact ways that protective social norms and messages travel.
That student's question, the one that made me smile at first, turned out to be one of the best I've received, because the answer is more complicated, and more hopeful, than a simple no.
Alho J, Gutvilig M, Niemi R, et al. Transmission of Mental Disorders in Adolescent Peer Networks. JAMA Psychiatry. 2024;81(9):882–888. doi:10.1001/jamapsychiatry.2024.1126
MacIntyre RI, Howard LM, Ciaralli SR. Social help or harm? An egocentric network analysis of college peer influence on body dissatisfaction and eating pathology. Body Image. 2026 Feb 20;57:102055. doi: 10.1016/j.bodyim.2026.102055. Epub ahead of print. PMID: 41722348.
D'Adamo L, Ghaderi A, Rohde P, Gau JM, Shaw H, Stice E. Evaluating whether a peer-led dissonance-based eating disorder prevention program prevents onset of each eating disorder type. Psychol Med. 2023 Nov;53(15):7214-7221. doi: 10.1017/S0033291723000739. Epub 2023 Apr 11. PMID: 37039122; PMCID: PMC10564960.
Breithaupt L, Eickman L, Byrne CE, Fischer S. REbeL peer education: A model of a voluntary, after-school program for eating disorder prevention. Eat Behav. 2019 Jan;32:111-116. doi: 10.1016/j.eatbeh.2016.10.010. Epub 2016 Oct 27. PMID: 27825587.
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Lauren Hartman, MD, is a double board-certified pediatrician and adolescent medicine specialist with nearly 20 years of experience treating children, adolescents, and young adults, with particular expertise in eating disorders.
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