Perfectionism and Eating Disorders: A PRISMA Systematic Review of Achievement Striving and Maladaptive Standards in Academic Contexts

Perfectionism is a complex construct with multiple facets, which can be manifested either in an adaptive or maladaptive tendency, influencing behaviors and cognitions. Maladaptive perfectionism has been consistently linked to several psychopathological outcomes, including eating disorders. In academic settings, high personal standards, fear of negative evaluation, and excessive self-criticism may increase vulnerability to disordered eating behaviors among students. This review aims to examine the relationship between perfectionism and eating disorders in student populations, with a particular focus on the distinction between adaptive and maladaptive dimensions of perfectionism. To this end, a systematic review of the literature was conducted following PRISMA guidelines, using predefined inclusion and exclusion criteria and selecting original studies investigating perfectionism and eating-related outcomes in high school and university students. Articles were selected from PubMed and Google Scholar using search strings composed of words identified using the PEO method. Ten studies were included in the final review. Overall, the evidence shows a consistent association between perfectionism and disordered eating, although the strongest and most consistent effects were observed for maladaptive perfectionism. By contrast, adaptive perfectionism did not always function as a risk factor and, in some cases, appeared to be neutral or even protective. Several studies also highlighted the role of moderating variables, such as self-esteem, perfectionistic self-presentation, perceived incompetence, adherence to food rules, and family communication patterns. In conclusion, the literature suggests that perfectionism alone may not be sufficient to explain eating symptoms, but the interaction with other psychological variables has significant implications for eating disorders.