Eating disorders are so prevalent that statistically, you’ve had one yourself, or you know someone who has. The National Eating Disorders Association (NEDA) has taken surveys of men and women across the United States. The results indicate that 20 million women today will develop an eating disorder at some point during their lives, and 10 million men will.
If you’ve already experienced one of these disorders, or your loved one has, you know just how devastating they are. The earlier they’re treated, the more hopeful the prognosis, so it’s vital to understand the causes and symptoms.
Although there are multiple sub-categories of eating disorders, for simplicity’s sake we will be focusing on the three most well-known types: anorexia nervosa, bulimia nervosa, and binge eating disorder.
Before we start discussing the risk factors, let’s remember that eating disorders are incredibly complex. They are generally triggered by multiple factors working together. Also, the mere presence of one or more risk factors doesn’t guarantee the development of a disorder.
Common Risk Factors Associated with Eating Disorders
1. Cultural and Societal Factors
When you think of what leads to an eating disorder, this factor is probably one of the first that pops into your mind. After all, it’s one we’re all familiar with, and one that affects all of us at some level: the perfect body, as defined by media.
This pressure can come from social media, Hollywood, magazines, TV shows, or movies, but the immediacy of social media is probably the most extreme version right now. Portraying ideal features as superior can lead to issues with self-esteem and body image struggles.
NEDA has shared research demonstrating that the more a person is exposed to an idealized thin body type, the less satisfied they become with their own body. And body dissatisfaction is one of the risk factors for developing an eating disorder.
Someone who is already predisposed to an eating disorder may be pushed over the edge when confronted with idealized images of the “perfect” body. Criticism or bullying can also lead to an eating disorder, not just for teenagers, but for adults as well.
2. Psychological Characteristics and Temperament Factors
Everyone with an eating disorder does not fall into one personality type, but if you look at people who do have disorders, they do tend to have certain traits in common. These traits don’t necessarily cause the disorder; they merely make a person more likely to develop one.
These are some of the characteristics that have most commonly been linked to eating disorders:
- Difficulty expressing emotions: Sometimes this is a personality trait, or it may be due to being raised in a family where emotional expression was discouraged. Often, people with eating disorders feel like they have to wear a mask of happiness and being “okay,” even when they’re not, just for people to love and accept them.
- Difficulty coping with emotions: Eating disorder behaviors can become coping mechanisms when an individual does not know how else to handle their negative feelings. Learning emotional regulation skills through Dialectical Behavioral Therapy can be part of an eating disorder treatment plan.
- Emotional disorders: Depression, anxiety, substance abuse issues, and other mental health issues may contribute to the onset of an eating disorder.
- Obsessiveness and/or compulsiveness: This may or may not take the form of full-fledged Obsessive-Compulsive Disorder.
- Body image dissatisfaction.
- Low self-esteem.
- Feeling a lack of control over one’s own life: Sometimes the eating disorder is the only area in which an individual feels entirely in control in a chaotic life.
- Perfectionism: NEDA identifies perfectionism as one of the top risk factors for eating disorders. Unrealistic personal standards and perfectionism go hand in hand.
- Being highly self-critical: This trait is similar to perfectionism but distinct in that it describes an overall negative attitude towards oneself.
3. Traumatic Events
The exposure to an overwhelming or life-threatening event (or series of events) can contribute to an eating disorder. Research has shown a link between physical and sexual abuse and eating disorders. Abuse survivors may struggle with shame and body image issues, and they also may use disordered eating to cope with their overwhelming emotions and a sense of being out of control of their own life.
4. Biological and Genetic Factors
Research has shown an increased risk for developing an eating disorder if someone in your immediate family has an eating disorder or other mental illness themselves.
Experts aren’t sure what exactly causes this relational link. Maybe specific genes create a predisposal to an eating disorder, and when the right trigger happens from other risk factors, the disorder develops.
Also, eating disorders are much more prevalent in females than in males. There are many explanations or hypotheses for why this is so, but we do know that statistically if you’re a girl or a woman, you have a much higher chance of developing an eating disorder at some point in your lifetime.
We tend to think of dieting as a sign of discipline, but it can contribute to the development of destructive patterns. Along with a genetic predisposition, it can trigger a disorder. It can increase an individual’s preoccupation with weight, body image, and food, which is one of the salient characteristics of every eating disorder.
6. Sports and Career Factors
Athletic programs can be positive environments for competition, cultivating one’s physical abilities, and team-building, but they’ve also been linked to eating disorders in athletes. Some sports have a higher link than others, including dance, gymnastics, track, swimming, and wrestling.
These activities tend to require athletes to be a certain size and/or weight. Professions such as modeling, which also require a specific size, are associated with eating disorders too.
7. Family Factors
The Academy for Eating Disorders has shared that according to research, family factors are not generally one of the primary causes of an eating disorder (Grange, D.L., Lock, J., Loeb, K, & Nicholls, D., 2010). Parents, in particular, may blame themselves if their adolescent child develops one of these disorders, but this is usually false guilt.
It’s also hard to separate existing family dynamics from what things were like before the disordered eating. However, this isn’t to say that family dynamics play no role. They’re just not usually the primary trigger for the disorder. They can affect how well an eating disorder can be sustained.
So, here are some of the family dynamics that are associated with (but generally not the primary cause of) eating disorders:
- A perfectionist environment where criticism is normal.
- Improper boundaries, whether too rigid or too unclear, physically or emotionally. Limits provide a clear sense of identity and protection in families. Without proper boundaries, emotional and social development can be hindered.
- Lack of family connection.
- Emotional disorders among family members.
- Substance abuse among family members.
- Chaos in the home environment.
- Too much emphasis on physical appearance.
- Lack of healthy emotional expression.
The family is one of the most powerful components in eating disorder recovery, especially for children and teenagers. Family therapy can help each individual cope with the disorder and learn how to support the recovery process, as well as learning how to interact in healthier ways. Family members can also promote a healthy body image and positive coping skills.
Signs and Symptoms of Eating Disorders
So you might be wondering, “What are the red flags I should know about in someone who’s at risk for or already in the clutches of an eating disorder?” Since these disorders are inherently secretive, it can be hard to figure out what’s going on in the beginning, but there are red flags that you might begin to notice. Of course, do not use these symptoms to attempt to diagnose a disorder; they’re just something to be aware of as you start to ask questions.
Here are some symptoms that may point to a possible eating disorder:
- Being obsessed with weight, body size, and the scale
- Tooth decay, which may indicate purging
- Knuckle scar, which may mean purging
- Secretive behavior around food, including hoarding
- Cooking or baking for other people without eating it
- Only eating alone
- Being generally isolated from other people
- Wearing baggy clothes to conceal weight loss
- Going to the bathroom during or immediately after each meal
- Excessive focus on “clean” or “healthy” eating
- Skipping meals frequently (often while saying, “I already ate” or promising to eat at another time)
Overview of Eating Disorder Treatment
If you do suspect that someone you love has an eating disorder, please know that they need help as soon as possible. Eating disorders, especially anorexia nervosa, sometimes have an aura of glamor around them from pop culture, but this is a complete facade. Eating disorders have the highest mortality rate of any mental illness.
- Anorexia is associated with medical complications such as osteoporosis, low blood pressure, heart problems, and organ problems.
- Bulimia is associated with tooth decay, esophageal ruptures, stomach ruptures, severe dehydration, and heart problems.
- Binge eating disorder is associated with heart disease and high blood pressure.
Eating disorders have social and emotional ramifications as well. They negatively affect one’s family, school or work, friendships, and every other area of life.
Treatment for eating disorders usually requires a team of professionals, such as therapists, dietitians, and physicians. Eating disorders often go hand in hand with issues such as anxiety, depression, and addictions. To treat one, therefore, requires a comprehensive physical and psychological evaluation.
Some individuals are able to recover by attending outpatient treatment once or twice a week. Intensive outpatient treatment requires visits of several times a week. Partial hospitalization is another option, and residential (or inpatient) is the most intense form of treatment. The patient’s medical condition and severity of symptoms will be taken into consideration when deciding on a form of treatment.
It’s important to find a therapist or counselor who is experienced in eating disorder treatment, and the same goes for a physician and dietician. All three professionals will work together to decide on a treatment a plan.
Eating disorders are a medical and psychological condition. They are not just an obsession with weight; they affect every aspect of an individual’s mind, body, and soul. They are both serious and debilitating. There are many risk factors and possible triggers that can lead to an eating disorder, and there is also hope for healing with a proper treatment plan.
Whether it’s you or a loved one who’s struggling with an eating disorder, we are available to help. Counseling is paramount to recovery, along with medical and nutritional help. You are not alone, although it may feel like it now. Call us today to begin your journey towards health and healing.
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