The Causes of Eating Disorders

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An eating disorder is a serious health condition that can affect all areas of life but centres around food consumption. Many myths and mistruths about eating disorders circulate mainstream discourse, commonly relating to the causes of these debilitating disorders. While researchers are still studying the cause of eating disorders, it is thought to be due to an interplay of factors, including genetics, society, brain chemistry and psychological or mental health.

Types of Eating Disorders

The term eating disorder encompasses various forms, each with its own symptoms and behaviours. While not all symptoms relate directly to eating, these disorders are listed in the DSM-5 (Diagnostic & Statistical Manual of Mental Disorders, Fifth Edition) under “Feeding & Eating Disorders”. In this diagnostic manual, an eating disorder is characterised as a persistent disturbance of eating or eating-related behaviour resulting in the altered consumption or absorption of food that significantly impairs physical health or psychosocial functioning.

Eating disorders are most often diagnosed in adolescence or young adulthood, affecting approximately 1.25 million people in the UK. Eating disorders have the highest mortality rate of any mental illness, so prompt diagnosis and treatment are highly recommended. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge eating disorders.

Anorexia Nervosa

Anorexia nervosa, more commonly known as anorexia, is perhaps the most established eating disorder. Individuals with anorexia nervosa generally have a very, often dangerously, low weight coupled with an intense desire not to eat or put on weight. People with anorexia engage in risky behaviour to avoid gaining weight. This may include skipping meals, starving themselves to the point of malnourishment, or avoiding certain foods. People with anorexia also often exercise excessively to lose weight as a result of body dissatisfaction.

It is also common for people with anorexia nervosa to see themselves as overweight, even if their body weight is incredibly low. This behaviour is a distorted perception of weight or body image and is one of the critical warning signs of anorexia. Even when individuals with anorexia nervosa are aware that their food intake and exercise behaviours are dangerous or even life-threatening, they can still experience an intense desire not to gain weight – this is one reason why eating disorders have such a high mortality rate.

Campaigners say more research needs to be done, as the exact causes of anorexia are not all known. Some research suggests a link to trauma, neglect or an unstable living environment, while culture, social pressure and sexual identity also play a role. Fat teasing at school, diet culture and societal expectations of bodies are all thought to be linked to the onset of anorexia. Women are diagnosed with anorexia at a much higher rate than men, and it is the second leading cause of death in the US for women under 50 after opioid abuse.

Many people, especially women, will attempt to lose or control weight through dieting at some point in their life, and for most, this isn’t harmful or obsessive. Anorexia nervosa differs in that while aesthetics and body image play a role, it is often an attempt to gain control over an aspect of their life or emotions, especially for those with a history of trauma or in a chaotic environment.

Bulimia Nervosa

Bulimia nervosa affects around 97,557 people in the UK and is one of the most prevalent eating disorders, characterised by regular episodes of binge eating and purging. Binge eating involves the consumption of a large quantity of food very quickly, often to the point of discomfort.

Purging is an attempt to remove this food from the body, often through vomiting or the use of laxatives. Bulimia nervosa is often accompanied by intense feelings of guilt, disgust or discomfort after binge eating, and the food people eat during this period may include things they would typically avoid. During a binge, individuals with bulimia often report not feeling in control of the quantity or speed they are eating; this is often coupled with feeling disconnected from what they are doing.

Purging can cause serious physical complications. Frequent vomiting harms the teeth, and people with bulimia nervosa often go to great lengths to purge, even if it means causing themselves harm. Misusing laxatives can cause dehydration and seriously affect the heart and digestive system.

Individuals with bulimia nervosa may be a normal weight, so it can be difficult to notice that they are struggling with the disorder.

Binge Eating Disorder

With binge eating disorder (BED), individuals continue to eat even when they feel full, sometimes to the point of nausea. Binge eating disorder can affect anyone of any gender, shape or size and can be accompanied by feelings of shame about food intake. However, this is not included in the diagnostic and statistical manual criteria.

Binge eating is similar to binge episodes experienced by people with bulimia; however, it differs in that binge eating disorder does not feature recurrent use of purge behaviours to compensate for food intake during binge episodes. Usually, someone with a binge eating disorder will engage in this form of disordered eating at least once a week. Individuals with BED can have varying body mass index scores but are often overweight or obese. It can be accompanied by low self-esteem, and individuals can feel embarrassed about eating patterns in private.

Risk Factors for Eating Disorders

Certain risk factors for developing eating disorders include mental health, genetic, and environmental factors.

Family History

Your family history is a significant risk factor for developing an eating disorder. If you have a parent who has struggled with disordered eating, you are at increased risk of developing an eating disorder.

Biological Factors

Age, gender, ethnicity and changes in brain chemicals all affect your risk of developing an eating disorder. Young women are typically the most likely to fall victim to eating disorders.

Environmental Risk Factors

Significant influences in a person’s life, including diet culture, the media, trauma, and weight teasing, are all risk factors for developing an eating disorder and other mental health issues. Growing up in an environment where shame and criticism of certain eating behaviours are normalised can influence eating habits as a person grows.

Having a parent or other family member that regularly talks about weight loss, body shape and worries about gaining weight are all environmental factors that can increase a person’s risk of developing an eating disorder.

Psychological Factors and Other Mental Illnesses

People with eating disorders often have other psychological problems such as low self-esteem and even mental illnesses like anxiety, obsessive-compulsive disorder (OCD) and depression. People with eating disorders are also often at a higher risk of developing mental disorders due to changes in brain chemistry and the emotional problems this can contribute to.

Trauma

Recent studies have demonstrated that trauma is a risk factor for developing an eating disorder. While more research is needed, the link between trauma and eating disorders is thought to be related to the emotional and behavioural dysregulation that trauma can cause, and cognitive factors such as self-criticism and internalised self-dissatisfaction.

Moreover, there is thought to be a correlation between the feelings of powerlessness and lack of control caused by traumatic experiences such as sexual abuse and the sense of control in specific eating disorders. It is theorised that for young people with little stability and control in their life, or who face abuse from family members in particular, tightly restricting their eating habits is one way of feeling in control of one aspect of their life.

Signs a Person Has an Eating Disorder

Most eating disorders have signs that you can look out for.

Physical Signs

  • Fluctuating body weight – displaying weight gain then weight loss periodically
  • Seemingly obsessive or strict eating habits
  • Using the bathroom frequently after a meal

Behavioural and Psychological Signs

  • Expressing intense fear of weight gain
  • Regularly talking about the need to lose weight
  • Obsession with physical appearance, weight loss and other’s perception of their body
  • feelings of guilt and shame around eating habits or gaining weight

Contact Us

At The Wave, we understand how difficult living with an eating disorder can be. What may have begun as a focus on healthy eating or typical teenage body image can spiral out of control. Additionally, early childhood trauma or abuse, environmental factors such as culture and stigma or peer pressure could have contributed to the development of a specific disorder.

Whatever your situation, we know that your overall health is the priority. If you are ready to seek treatment, The Wave uses a range of treatment modalities, including trauma theory, to help you address the root of your disorder, build coping strategies and healthy eating behaviors and overcome what can be a life-threatening disorder. 

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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