What Causes An Eating Disorder

The reasons behind why someone develops an eating disorder are complex and are often a combination of various interwoven issues caused by social, psychological, and biological factors.

It is a myth that eating disorders are a result of vanity, attention seeking, or a desire to be skinny. No one purposely chooses to have an eating disorder. Although its common for a lot of eating disorders to stem from diets, low self esteem, or feelings of insecurity around ones weight and body image, to say that eating disorders are simply a 'diet gone wrong' is far from the truth.

Anyone can develop an eating disorder. It doesn't have to always stem from traumatic events such as bereavement, sexual or physical abuse, bullying etc - although there is no doubt that these things can develop into eating disorders, there is a large percentage of eating disorder sufferers who have no obvious traumas that have triggered their illness.

Social Influence

We can't deny that the emphasis on diets and being thin in the media has led to a possible increase in eating disorders, especially to the rise in childhood eating disorders. It is too easy to blame the 'size zero' mentality as the sole reason behind eating disorders. However I cannot believe that anyone could develop an eating disorder simply because they wanted to lose weight. It is far more likely that the media's emphasis on being slim, beautiful and perfect contributes to pre-existing psychological problems, encouraging low self esteem and a sense of 'not being good enough'.

Often there is an emphasis on weight and appearance being the primary concerns in eating disorders. Although you can't deny that it plays a part, it is wrong to assume that it goes no deeper. Often the preoccupation with food, size and weight is a coping mechanism for difficult emotions such as anxiety, depression, low self esteem, anger, stress, and various others. Therefore, it would be incorrect to state that eating disorders are caused by supermodels and crash diets.

Often difficulties within families and friendship circles can contribute to the cause of eating disorders. That is not to say that anyone is to blame for their loved one getting an eating disorder - it is often common to point fingers at the parents, claiming they are overbearing, or put too much pressure on their children - however from my experience, the majority of people I know who suffer from eating disorders come from loving and caring parents. That is not to say they are perfect, every family has its ups and downs, but it may be that the person with the eating disorder is particularly sensitive towards family frictions, or perhaps they feel a sense of responsibility or blame.

For an interesting article exploring the connections between the media and eating disorders visit something-fishy.org

Psychological Influence
Low self esteem is a common attricute to most eating disorders. Often people with eating disorders are self critical, perfectionists, feel under pressure to appear 'ok' or are unable to discuss any problems that they may be having. They may feel scrutinized for their appearance or feel that they are not good enough or don't fit in well enough. They often feel like they would be a burden if they discuss their insecurities, or even feel like they shouldn't even have insecurities, that what they are feeling is not normal or not allowed.  They often feel like they don't really deserve help, that their problems are not serious and that other people deserve more help then they do.

When faced with all these complicated emotions, they often turn to food as a way of coping, whether thats restricting their diet or binge eating. By having some control over their diet, it can make everthing feel less stressful and reduce anxieties - or by overeating food can be used as a comfort or as a distraction from what they are really feeling. Overtime, these behaviours are reinforced and it becomes learnt that the only way they can cope is by drawing their attention to food and weight. It can be distressing to give up these behaviours as often the emotions behind the eating disorder can feel extremely intense and overwhelming.

The psychological influences on why people develop eating disorders is so vast that I could probably fill up several blogs discussing it. Althought there are common traits within eating disorders it is important to recognise that every individual is different and will have developed an eating disorder for different reasons.

Physiological Influence

There has been some evidence that some people might be genetically predisposed to develop eating disorders, or that they stem from a chemical imbalance in the brain. It is very likely that there are physiological reasons behind the causes of eating disorders. In addition, once an eating disorder has started to develop, there are many physiological factors that can encourage the behaviours of eating disorders, leading a person further and further into it to a point where it becomes almost impossible to escape without professional help.

When you restrict your diet to a low caloric intake for a long period of time often your body will respond by becoming preoccupied with food, becoming obsessed and constantly thinking about food, and even leading to unwanted binges as a way to break the fast. There is a risk that prolonged low calorie diets could lead to episodes of binge eating and the loss of control and guilt felt after a binge could develop into Bulimia or Binge Eating Disorder. It is very difficult to manage a regular eating pattern once caught in the restrict - binge cycle.

In addition once your body weight drops below its set-point (that's the weight that your body is most comfortable with, usually predisposed by genetics) the body will increase thoughts of food, start to brea down fat and muscle, often resulting in decreased brain function. This is often referred to as starvation mode. Once in this state, it is very difficult to challenge any psychological issues related to the eating disorder as the brain is less likely to think clearly or rationally. Although this is not the cause of eating disorders, I feel its important to acknowledge that once in the grips of an eating disorder, it is incredibly difficult to break free.

Conclusion

It is the complexity of eating disorders that often makes it difficult for outsiders to understand. Eating disorders are multi-layered and often it is impossible to seperate one cause from another. It takes years to be able to recover from an eating disorder - it is not just a fad or phase that someone goes through - it is a serious mental illness that need intensive support and treatment.

Taking time to understand the real reasons behind eating disorders can help prevent prejudice towards those suffering from an eating disorder. Often suffers can feel judged or ashamed of their eating disorder due to the stereotypes surrounding the illness. It can prevent someone from asking for help as they worry that they will be seen as shallow or vain for having an eating disorder. This is not true. Without help, eating disorders can destroy lives and can even lead to death.

To find out more about the causes of eating disorders visit these websites:
Somethingfishy.org
Eating Disorders Help Guide - Low Self Esteem
NHS - eating disorders explained

Types of Eating Disorders

The Eating disorders I wish to focus on are: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder (BED), Orthorexia, & Eating Disorder Not Otherwise Specified (EDNOS):

For more information on the signs and symptoms of eating disorders visit somthing-fishy.org

Anorexia Nervosa

This is a potentially life threatening eating disorder typically characterised by self-starvation, excessive weight loss, and a distorted body image that traps the sufferer from seeing themselves as how they truly are. It is this distortion that can lead a sufferer to see themselves as 'fat' or 'not thin enough' even when they are underweight. The fear of weight gain can lead the sufferer to restricting food intake to very dangerous levels.

When someone with Anorexia becomes dangerously underweight, it can become imensely difficult to make steps to overcome the eating disorder. This is due to a variety of factors such as reduced brain function caused by starvation, extreme anxiety towards foods and weight gain which keep someone trapped in their eating disorder, and the dependence of their disorder as a coping mechanism from difficult emotions and situations. Therefore it is important that someone diagnosed with Anorexia Nervosa gets treatment as early as possible to ensure a higher chance of recovery.

Common signs and symptoms of someone with Anorexia Nervosa are:

• Dramatic weight loss - often this is rapid over a short period of time (BMI below 17.5)
• Obsession with calories/grams of fat/nutrition - reading labels, only allowing themselves to eat below a specific calorie limit  / grams of fat (often very low)
• Amenorrhea - loss of menstruatuin (for longer than 3 months)
• Preoccupation with food - obsessions with cooking programmes, cookery books, collecting images of food, cooking for others whilst not eating themselves, talking about food, planning meals whilst eating little
• Strange or secretive food rituals - such as cutting food so many times, chewing for a specific number of times, using specific plates and cutlery, eating alone
• Feeling fat/dieting despite being underweight - often weighing self several times a day, hiding specific parts of body that they feel is fat/they don't like
• Obsessed with body image - avoiding mirrors or frequently checking in mirrors, feeling areas of body for fat/bones, obsessed with clothes sizes, contantly comparing self with others
• Denial that they are too thin - unable to see that they are underweight, passing off comments about their weight, denying that they're low weight is a problem.
• Compulsive exercise / laxitive use / vomiting - in order to compensate for eating, or feeling of fullness and overeating.

Over Physical Symptoms include: hair loss, feeling cold, brittle nails, dry skin, loss of concentration, depression, loss of bone density potentially leading to oesteoporosis, loss of muscles tissue, reduced pulse, irregular heartpeat and plapatations - and in severe cases Anorexia can lead to organ failure, heart failure and death.


Anorexia can have serious health problems - see the diagram below taken from this website.

Something-fishy.org

MedicineNet.com

Bulimia Nervosa
This eating disorder is characterised by periods of binge eating where large amounts of food are eaten that would not be considered normal by a healthy person in the same circumstances. The binges are followed by a need to compensate for the binge, e.g. induced vomiting, excessive exercise, use of laxatives / diuretics, restricted diet.

Often the sufferer can become trapped in a binge / purge cycle. Often someone with bulimia will restrict for long periods after a binge, however starvation makes them more likely to binge. In addition they often feel extreme guilt, disgust and shame after purging making it more likely that they will binge again.

It’s very likely that the person suffering from bulimia is at a normal weight, and due to the secretive nature of binging and purging, it can make it difficult to recognise that someone is suffering from an eating disorder.

Some on the signs and symptoms of Bulimia include:

• Going to the bathroom after eating – to vomit
• Excessive exercising and obsession with weight
• Disappearance of food / hiding food – empty wrappers hidden, food stored for binges
• Secrecy around food – sneaking into the kitchen after people have left
• Swollen cheeks – from excessive vomiting
• Calluses on knuckles – from using hands to induce vomiting
• Broken veins in and around the eyes – from repeated vomiting

Health risks caused by Bulimia include:

• Erosion of enamel on teeth – from the acid in vomit
• Ulcers, bleeding, or tearing of the oesophagus – from excessive vomiting
• Edema – swelling and excess water from frequent use of diuretics
• Loss of normal bowel function – from persistent laxative use
• Electrolyte imbalance – due to frequent vomiting or laxative / diaretic abuse – this can lead to severe heart complications such as irregular heart beats and in severe cases can cause death by heart failure.

It is important to note that someone suffering from Bulimia can also experience bouts of Anorexia as both eating disorders are similar on many levels. In addition, someone with Anorexia could also purge after eating or binge at less frequent periods / on smaller amounts of food that they might see as a binge or ‘mini binge’. It is very common for someone to suffer from both Anorexia and Bulimia at different points in their life.

something-fishy.org

helpguide.org

Binge Eating Disorder (BED)

This eating disorder is characterised by compulsive overeating where the person eats large amounts of food, either in a short period of time or throughout the entire day, that leaves them feeling unable to stop and out of control. Often they will continue to eat even when not hungry, eating beyond the point of fullness. Unlike Bulimia, the sufferer does not take part in any compensatory behaviour.

It’s easy for the sufferer to get stuck in a binge cycle, whereby the feelings of guilt, disgust, and depression after a binge can lead that person to return to food as temporary relief and comfort, using food as a way to cope from their difficult emotions. In addition, continuous overeating usually leads to weight gain where the person begins to feel increasing unhappy with their appearance and situation, turning even more to food as a way to cope.

Signs and Symptoms of BED include:

• Feeling out of control when eating – not feeling able to stop
• Rapidly eating large amounts of food
• Eating even when you’re full
• Hiding food – in order to eat in secret later
• Eating normally around others – but later binging when alone
• Eating continuously throughout the day – often with no set meal times
• Feeling that food relieves stress and tension
• Embarrassment over how much you’re eating
• Feeling numb while bingeing—like being on auto pilot
• Never feeling satisfied - no matter how much you eat
• Feeling guilty, disgusted, or depressed after overeating
• Desperation to control weight and eating habits

Health Impacts include:

• Type II Diabetes
• High cholesterol / blood pressure
• Heart Disease
• Joint and muscle pain
• Osteoarthritis
• Gallbladder disease

helpguide.org

Orthorexia

This is an eating disorder that was only diagnosed in the late 90’s and is characterised by an unhealthy obsession with eating healthily. Usually it starts as a genuine desire to live a healthy lifestyle, but can develop into a limited, restricted diet. For example, someone might choose to emit red meat from their diet, but over time completely eliminate all meats from their diet. Orthorexia is similar to Anorexia, although it focuses more on eating foods that are seen as ‘good’ or ‘healthy’, often becoming obsessed with the health benefits of food and how it is prepared or processed.

Orthorexia is not as severe as other eating disorders such as Anorexia and Bulimia, the sufferer is at risk of developing these eating disorders over a longer period of time. For example, as a diet becomes more limited and restricted it could easily develop into Anorexia. Alternatively, as the sufferer becomes more undernourished, it could lead to binges, and there is a possibility that the guilt could lead to purging behaviours, developing into Bulimia.

Orthorexia.com
Disordered-Eating.co.uk

Eating Disorder Not Otherwise Specified (EDNOS)

When someone does not fit neatly into a specific eating disorder, they will most likely be classed as eating disorder not otherwise specified (EDNOS). For example they may fit into most of the criteria of Anorexia but they still have a regular period or have a BMI above 17.5. Or perhaps they fit into the Bulimic category only periods of binging are less frequent, or they are more frequent but involve smaller amounts of food.

Often people think that someone with EDNOS is not as serious as other eating disorders. In fact, more people with EDNOS are diagnosed than that of Anorexia and Bulimia put together. Often people with EDNOS still engage in the same risky behaviours as Anorexia and Bulimia, so they are at just as much risk of the negative health consequences of their eating disorder.

Somethingfishy.org

The facts about eating disorders are not limited to what is written on this page. There are many more types of disordered eating. Please feel free to explore more by visiting the links I've provided.