Excessive eating and piling on the pounds when young could be warning signs that children will develop bulimia as adults, psychiatrists said on Tuesday.

But picky eaters are unlikely to suffer from the binge-and-purge eating disorder.

“We showed that women who in adult life develop bulimia are more likely to have been overweight or were eating too much in childhood…compared to their sisters who didn’t develop an eating disorder,” said Dr. Nadia Micali of the Institute of Psychiatry at King’s College London.

An estimated 5 to 10 percent of women worldwide have bulimia or anorexia nervosa, an illness in which patients are obsessed with being thin and terrified of gaining weight.

There was no difference in childhood eating patterns associated with anorexia nervosa.

In a study presented at the Royal College of Psychiatrists conference in Edinburgh, Micali and her team studied the eating patterns of 154 pairs of sisters to determine whether there were any patterns that could be associated with developing an eating disorder.

There were 71 pairs in which one sister developed bulimia.

Micali and her colleagues asked mothers of the sisters to fill in a questionnaire about their daughters’ early eating habits and their weight at the age of 5 and 10.

The researchers found that if one sister developed bulimia, she was more likely to have been overweight as a child and ate more than her healthy sibling.

“It is not very clear yet if it is just being overweight that puts you at risk, or if you are overweight you then develop concern about the way you look and start dieting and develop bulimia,” Micali told Reuters.

“It is something that has not been clarified yet.”

Unpleasant meals in childhood and not eating enough were not predictive of a later eating problem.

Both bulimia and anorexia usually develop during the teenage years but they can also occur in adults. They are more common in women and can be treated with behavioural therapy and counselling. The earlier the patients are treated, the better the chances for recovery.

Micali said more research is needed to clarify the risk factors but added that parents should be aware that early eating habits and weight could be indications of a later eating disorder.