Hoarding Symptoms in Eating Disorders: An Observational Cross-Sectional Study

Abstract

Objective: Hoarding behaviors have been reported in eating disorders (EDs), particularly those characterized by binge eating; however, research on this comorbidity is scarce. This cross-sectional observational study investigated hoarding symptoms in a community-based sample of individuals with lifetime ED diagnoses (N = 5927).

Method: Participants were grouped by ED history: anorexia nervosa (AN) only, AN and another ED (AN Mixed), bulimia nervosa (BN) only, binge-eating disorder (BED) only, and both BN and BED (BN-BED). Hoarding symptoms were compared across these groups and to published data from cohorts with hoarding disorder (HD), obsessive-compulsive disorder (OCD), and nonclinical controls, using independent t tests. Logistic regression was used to examine the odds of screening positive for hoarding, and correlations assessed associations between hoarding and ED symptoms.

Results: Hoarding symptoms were prominent across all ED groups. They were most prevalent in BN-BED and least prevalent in AN. The ED cohort showed lower hoarding symptoms than the HD cohort, but generally higher symptoms than the OCD cohorts. All ED groups showed significantly higher hoarding symptoms than one control cohort, with BN, BED, and BN-BED also exceeding a second control cohort. Positive correlations emerged between hoarding and ED symptoms.

Discussion: Individuals with EDs, especially featuring binge eating as a core symptom, appear to be at higher risk for hoarding symptoms. Screening for hoarding in ED patients could be beneficial. Further research is needed to examine the potential co-occurrence of hoarding symptoms and EDs and explore factors that may contribute to this relationship.

Keywords: anorexia nervosa; binge eating; binge‐eating disorder; bulimia nervosa; eating disorder genetics initiative; eating disorders; hoarding.