A total of 40 married and 22 unmarried female patients with eating disorders were studied in order to investigate the relationship between eating disorders and marriage. Eating disorders developed in 14 patients before marriage (premarital onset) and in 26 patients at the time of or after marriage (postmarital onset). The postmarital-onset group was characterized by a significantly higher age at onset, but was similar in age and duration of illness to the group of 22 unmarried patients. However, the various clinical features of the three groups did not differ. Four premarital-onset patients showed exaggerated clinical features after marriage, but the other patients showed no change in clinical features after marriage. In the postmarital-onset group, eating disorders were triggered in 18 patients (69%) by marital problems, separation or divorce. In contrast, eating disorders were triggered by dieting in order to lose weight in 8 patients (57%) in the premarital-onset group and 12 patients (55%) in the unmarried group. These results suggest that marital conflict plays an important role in the development and continuation of eating disorders in married women.