What Causes Eating Disorders?

Individuals coping with eating disorders, both sufferers and family members, frequently wonder "What causes eating disorders?" Family members, especially parents, often ask, "Did I cause my daughter (or son) to develop an eating disorder?" While the causes are not definitely known, specialists in the field point to a number of factors that appear to contribute to the development of anorexia nervosa and bulimia nervosa. Some of these factors include:

1- Cultural Pressures for Thinness: In the United States, as in most industrialized nations, we live in a society that is obsessed with body shape and weight. Over the decades from the early 1960's through the late 1970's and continuing through today, societal values with regard to the ideal female body shape changed radically. Remember the movie stars of the 1950's, for example Marilyn Monroe? As the millennium turned, these movie stars would likely be seen as OBESE by current Hollywood standards.

Women, and increasingly men, are bombarded with images of the ideal body shape. Whether it is the glamorization of anorexia nervosa, "heroin chic," or the cut look of the health club, an image is presented in magazines, on television, and in the movies of bodies that very few people, outside of the modeling and acting businesses, actually have or might be expected to have. This cultural pressure appears to lead to excessive dieting and attempts at self-starvation by some young people. When self-starvation gets out of control it can lead to anorexia nervosa or rebound binges and bulimia nervosa.

2- Low Self-Esteem: Excessive attempts at dieting, self-starvation, rebound binges and purging tend to occur among those individuals who feel they MUST meet the societal standard for thinness. Low self-esteem can be one reason that drives that determination. Low self-esteem can be caused by many things: persistent bad experiences in school or with peers; early, possibly biological depression or anxiety; extreme shyness; physical, sexual or emotional abuse; or problematic family environment.

3- Co-occuring Conditions: We know that a number of other mental health related conditions often occur in individuals with eating disorders, and it is quite possible that they may contribute to the development of eating disorders. These conditions include depression, obsessive compulsive disorder, alcoholism and substance abuse, post-traumatic stress disorder from physical or sexual abuse, and impulse control problems.

4- Participating in Certain Activities or Professions: While choice of activity or profession doesn't cause eating disorders, we know that being in certain fields and participating in certain activities increase the risk. Fields and activities that encourage low body weight or emphasize appearance seem to put some individuals at greater risk. Acting, modeling and professional dancing are fields whose female members show higher than expected rates of eating disorders. Participation in certain sports that emphasize body weight and/or shape may also increase risk. These include gymnastics, ballet dancing, figure skating, rowing and (for males) wrestling.

In the early days of the eating disorders epidemic, as in earlier days in mental health treatment in general, many professionals tended to "blame the family." Families of eating disordered individuals were often seen in treatment showing certain characteristic ways of dealing with their symptomatic child. Often, families would be highly intrusive, watching every morsel of food that their anorexic child would eat, and insistently urging their child to eat more. Decades of data show us that anorexia nervosa is one of the most deadly conditions in all of mental health practice. Between 5% and 30% of anorexic individuals succumb to their condition. Approximately one third are chronically afflicted. Thus, in retrospect, while we know this response is often not helpful, it is quite understandable that parents, siblings, or other relatives would try desperately to do anything they could think of, including intrusive and coercive methods, to get their anorexic family member to eat rather than die.