Eating Disorders & Body Dysmorphia and Narcissism as Sex Differentiated Expressions of a ‘Mate Value Hyper-Enhancement Syndrome’

Eating Disorders & Body Dysmorphia and Narcissism as Sex Differentiated Expressions of a ‘Mate Value Hyper-Enhancement Syndrome’

What is considered attractive and desirable in men and women differs substantially: while female attractiveness to men is largely based on physical appearance, male attractiveness to women is largely based on status, intelligence, and wealth (Regan et al. 2000)(Neto et al. 2012). Various personality traits and psychiatric disorders influence behaviors related to mating, such as behaviors that enhance one's own sexual attractiveness and behaviors that affect a person's approach to mating (e.g., a short term vs long term strategy), and explains why certain traits have been selected for, including ones typically considered pathological that nevertheless confer mating advantages (Del Giudice 2014)(Cloudfindings 2024). Eating disorders (specifically motivated by appearance and weight loss goals) and body dysmorphia are highly female typical disorders which are characterized by an obsessive preoccupation with perceived inferiority largely in physical attractiveness and attempts at ameliorating this perceived inferiority, as well as avoidance and low self esteem due to this perceived inferiority (Cloudfindings 2022). Pathological narcissism is a male-typical disorder (Grijalva et al. 2015) which is characterized by an obsessive preoccupation with status, achievement, intelligence, and attractiveness, with hypersensitivity to criticism and perceived slights to ones status, and behavior oriented at enhancing one's own status (Cloudfindings 2024). It is easily noticed that the disorders both involve similar cognitions and behaviors related to attractiveness, but eating disorders correspond to female attractiveness, and narcissism to male attractiveness. In this post, I argue that both eating disorders & body dysmorphia and narcissism are sex differentiated expressions of a shared syndrome of pathologically (but not necessarily maladaptive) increased mate-value enhancement behaviors and cognitions.

Relationships Between EDs, BD, and Narcissism

Multiple studies have shown that eating disorder cognitions and behaviors have a strong positive relationship with pathological narcissism (Cloudfindings 2022)(Szymczak et al. 2023)(Campbell & Waller 2010). Such a relationship has also been found for body dysmorphia and narcissism (Cloudfindings 2022)(Ghanbari & Kiamarsi 2023). Cloudfindings (2022) investigated the structure of attitudes experiences and cognitions characteristic of eating disorders and body dysmorphia, and found three dimensions underlying them: competitiveness, reflecting tendencies to compare one's own attractiveness to others and feel the need to compete with them and a paranoid and antagonistic attitude towards those perceived as attractive; low self esteem, reflecting avoidant and submissive behaviors as a result of perceived interiority and unattractiveness; and sexual status seeking, reflecting the tendency to be motivated toward being attractive - especially to highly desirable mates and to be seen as more sexually desirable than others. It was found that competitiveness related to vulnerable narcissism and borderline traits, low self esteem to vulnerable narcissism, borderline traits, and low histrionic traits, and sexual status seeking to grandiose and vulnerable narcissism as well as histrionic and borderline traits. Histrionic and grandiose narcissistic traits are associated with high extraversion, borderline and vulnerable narcissistic traits to high neuroticism, and grandiose and vulnerable narcissism to low agreeableness (Cloudfindings 2023). Using the data from Cloudfindings (2022) I conducted a principal components analysis on the ED/BD variables and psychiatric disorder variables [Table 1] [Figure 1]. Extraversion, agreeableness, and neuroticism were roughly plotted based on where their associated psychiatric disorder traits loaded on the components [Figure 1]. Based on this analysis, sexual status seeking is most closely related to high extraversion, competitiveness to high neuroticism and to a lesser extent low agreeableness, and low self esteem to low extraversion and high neuroticism. This was further tested by extracting three factors from the pathological trait scales corresponding to agreeableness, extraversion, and neuroticism, which appeared to be successful, then testing the correlations to the ED/BD factors - sexual status seeking and competitiveness related to low agreeableness, sexual status seeking to high extraversion and competitiveness & low self esteem to low extraversion, and all three to high neuroticism [Table 2]. High extraversion, low agreeableness, and high neuroticism have been identified as the core three personality traits that pathological narcissism maps onto (Crowe et al. 2019). With the ED/BD factors, while they did not perfectly map onto the extracted three personality traits (it would be useful to investigate this with a measure made to measure the big five traits as opposed to crude extraction from other scales), they correlated with agreeableness, extraversion, and neuroticism similar to narcissism. While this is speculative, competitiveness may reflect narcissistic antagonism, sexual status seeking agentic/exhibitionistic narcissism, and low self esteem narcissistic hypersensitivity.

Table 1

	PC1	PC2	PC1 (varimax)	PC2 (varimax)
Vulnerable Narcissism	0.91	-0.05	0.76	0.51
Grandiose Narcissism	0.61	0.29	0.32	0.60
Drive for Thinness	0.67	-0.15	0.63	0.28
Sexual Status Seeking	0.66	0.47	0.25	0.77
Competitiveness	0.71	-0.41	0.82	0.10
Low self esteem	0.41	-0.75	0.78	-0.35
BPD	0.71	0.06	0.53	0.47
HPD	0.30	0.77	-0.23	0.79

Figure 1

Table 2

	Agreeableness factor	Extraversion factor	Neuroticism factor
Vulnerable narcissism	-0.74	-0.01	0.67
Grandiose narcissism	-0.92	0.21	0.19
BPD	-0.55	-0.1	0.82
HPD	-0.17	0.92	0.32
Sexual status seeking	-0.42	0.33	0.43
Competitiveness	-0.37	-0.29	0.36
Low self esteem	-0.19	-0.35	0.27

Overlaps and Differences Between EDs/BD and Narcissism

EDs/BD and narcissism overlap in many areas which are closely relevant to the mechanistic (high levels of shame, competitiveness, attachment insecurity, celebrity worship), evolutionary (higher sociosexuality, higher selectiveness for highly desirable mates) characteristics, and behavioral consequences of EDs/BD and narcissism (cosmetic surgery, exercise addiction, increased and more problematic social media use, high importance attributed to appearance, family, and economic goals) [Table 3]. 

Table 3

Eating disorders / body dysmorphia	Narcissism	Citation
Associated with cosmetic surgery	Associated with cosmetic surgery	Sahraian et al. (2021)
Associated with celebrity worship	Associated with celebrity worship	Maltby et al. (2010) Ashe et al. (2005)
Associated with exercise addiction	Associated with exercise addiction	Trott et al. (2020) Bruno et al. (2014)
Associated with higher in sociosexuality	Associated with higher sociosexuality	Rammsayer & Troche (2013) Cloudfindings (2022) Valentova et al. (2019)
High levels of shame	High levels of shame	Troop et al. (2008) Sarno et al. (2020)
More selective for highly desirable mates	More selective for highly desirable mates	Cloudfindings (2022) Tajmirriyahi et al. (2021)
Competitive behaviors and attitudes	Competitive behaviors and attitudes	Cloudfindings (2022) Luchner et al. (2011)
Associated with higher, more problematic social media use	Associated with higher, more problematic social media use	Wilksch et al. (2019)  Hinojo-Lucena et al. (2019)  Andreassen et al. (2017)
Higher importance and standards attributed to maintaining physical appearance, familial goals, economic goals	Higher importance attributed to maintaining physical appearance, familial goals, economic goals	Gunnard et al. (2011) Roberts & Robins (2000)
Associated with attachment insecurity	Associated with attachment insecurity	Troisi et al. (2006) Zhang et al. (2024)

There are also notable sex relevant similarities and differences between these phenotypes [Table 4]. EDs/BD are more prevalent in women, associated with female-dominated communities (“pro-ana”, “pro-mia”) which encourage ED/BD thinking and behavior, are associated with having a more feminine personality, a submissive interpersonal style, and having experiences of being victimized. Narcissism is more prevalent in men, associated with male-dominated communities (“incel”, “manosphere”) which encourage BD-like thinking and behavior, associated with being more masculine overall, a dominant interpersonal style, and victimizing others. These findings point to an association with masculinity-femininity, as well as dominance and submissiveness. I propose two main reasons for this, the first being a lack of recognition of a “grandiose” dimension of ED/BD symptoms, due to differences in how EDs/BD and narcissism are framed and conceptualized - ‘sexual status seeking’ may reflect the “grandiose” dimension of ED/BD pathology - EDs are typically measured only by behavior and cognitions directly related to eating rather than more general underlying cognitions and attitudes underlying ED behavior - which could mask more dominant and grandiose presentations of ED/BD pathology. The second reason which has already been mentioned is that EDs/BD are focused on female-typical attractiveness and narcissism is focused on male-typical attractiveness - this likely could have contributed to the characterization of the disorders as separate entities, and psychological feminization-masculinization likely confers some differential risk for the disorders through changes that promote body-focused self criticism (for example, anorexia is associated with altered sensory processing which may contribute to a distorted body image; Crespi & Dinsdale 2019) as opposed to status-focused self criticism. It is not unheard of for major or even core components of psychiatric disorders to have been unrecognized for long periods of time, such has been the case for self disorders in schizophrenia (Parnas 2011), as well as narcissistic vulnerability in narcissistic personality disorder (Miller et al. 2013), so it would not be far fetched to suggest that such has been the case to a degree with the characterization of EDs/BD. Stigma toward evolutionary psychology could have also played a role in the separation of these disorders as evolutionary explanations could be interpreted as offensive or demonizing. 

Table 4

Eating disorders / body dysmorphia	Narcissism	Citation
3.8:1 female-male ratio of prevalence	1.6:1 male-female ratio of prevalence	Marie et al. (2019) Stinson et al. (2009)
Associated with “pro-ana”, “pro-mia” culture, which is characterized by hyper-competitive and dysmorphic like beliefs about attractiveness, those that partake often encouraging dysmorphic beliefs and ED behaviors in eachother	Associated with “manosphere” and “incel” culture, which is in part largely characterized by hyper-competitive and dysmorphic-like beliefs about attractiveness, which those who are apart tend to reinforce amongst eachother	Boero & Pascoe (2012) Broyd et al. (2023) Selmer et al. (2023) Zapcic (2024)
Associated with femininity	Adaptive narcissism associated with masculinity, femininity associated with lower pathological narcissism	Mayer et al. (2001) Watson et al. (1987)
Submissive interpersonal style	Dominant interpersonal style	Hartmann et al. (2010) Ruiz et al. (2001)
Associated with being victimized	Associated with victimizing others or both victimizing others and being victimized	Lie et al. (2019) Fanti & Hentich (2015)

Overall, there is strong evidence to suggest that eating disorders & body dysmorphia and narcissism largely represent the same underlying disorder, that are differentiated by sex-dependent indicators of attractiveness which are pursued. There may be a link between a compulsive eating disorder subtype, obsessive compulsive personality disorder, and narcissism, however I will not discuss that in this current post.

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2. Neto et al. (2012) Sex and culture similarities and differences in long-term partner preferences

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5. Cloudfindings (2022) Latent Structure of Body Dysmorphia, Eating Disorder Symptoms, and Self Esteem Problems in Heterosexual Women, and Their Association with Cluster B Personality Traits

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12. Sahraian et al. (2021) Body Dysmorphic and Narcissistic Personality Disorder in Cosmetic Rhinoplasty Candidates

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14. Ashe et al. (2005) Are celebrity-worshippers more prone to narcissism? A brief report

15. Bruno et al. (2014) Unraveling Exercise Addiction: The Role of Narcissism and Self-Esteem

16. Trott et al. (2020) A comparative meta-analysis of the prevalence of exercise addiction in adults with and without indicated eating disorders

17. Rammsayer & Troche (2013) The relationship between sociosexuality and aspects of body image in men and women: A structural equation modeling approach

18. Troop et al. (2008) Shame in women with a history of eating disorders

19. Sarno et al. (2020) Shame behind the corner? A daily diary investigation of pathological narcissism

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33. Selmer et al. (2023) Sociosexuality and incel ideology: Does a mismatch between sexual practice and sexual intentions predict extreme misogynist views?

34. Zapcic (2024) “An Alpha Wouldn't Spare an Emotion on a Woman”: A directed qualitative analysis of dark triad outcomes in women's relationships with Red Pill men

35. Boero & Pascoe (2012) Pro-anorexia communities and online interaction: Bringing the pro-ana body online

36. Mayer et al. (2001) Sexual orientation and eating psychopathology: the role of masculinity and femininity

37. Watson et al. (1987) Narcissism, sex roles, and self-functioning

38. Hartmann et al. (2010) Interpersonal problems in eating disorders

39. Ruiz et al. (2001) Distinguishing narcissism and hostility: Similarities and differences in interpersonal circumplex and five-factor correlates

40. Lie et al. (2019) Is bullying and teasing associated with eating disorders? A systematic review and meta‐analysis

41. Fanti & Henrich (2015) Effects of self-esteem and narcissism on bullying and victimization during early adolescence

42. Parnas (2011) A disappearing heritage: the clinical core of schizophrenia

43. Miller et al. (2013) Grandiose and Vulnerable Narcissism and the DSM–5 Pathological Personality Trait Model

44. Crespi & Dinsdale (2019) Autism and psychosis as diametrical disorders of embodiment