["European Eating Disorders Review, Volume 34, Issue 3, Page 612-626, May 2026. ", "\nABSTRACT\n\nObjective\nThis research aimed to explore what women with lived experience of anorexia nervosa (AN) perceive as causal or contributing factors involved in the development of their AN.\n\n\nMethod\nSixteen participants were interviewed about their perceptions of the development of their AN. Interviews were analysed using thematic analysis.\n\n\nResults\nParticipants described a strong role of relational factors in the perceived development of AN, including perception of unmet emotional needs, feelings of non‐belonging, or significant emotional‐relational injury, social difficulties, and exposure to conditional worth messaging about the body or eating. Relational factors were described in connection with internal factors of poor self‐worth, disrupted emotion regulation ability, and emotional distress, which further linked to AN's development as an emotional coping strategy. Moreover, participants identified that experiences of prolonged or severe emotional distress had preceded AN symptoms, but opportunities for early prevention/intervention were missed.\n\n\nConclusions\nThese findings highlight relational factors, internal factors and emotional distress as potential targets for prevention and early intervention in AN, via improved screening for at‐risk individuals, early intervention for emotional distress, and better support for families in building healthy emotion regulation skills. Additionally, the data indicates that working with emotional and relational wounds may be important treatment targets.\n\n"]