Causes of Eating Disorders

Ohio State University Researchers

There is no known cause, or specific etiology, for the development of eating disorders. The causes of eating disorders are complex, varied and of the long term nature. However, there are a few well research areas that carry particular importance in the development of eating disorders. These include biological factors, socio-cultural factors, and psychological factors.

Biological factors are genetic tendencies that put some people at risk for developing certain features related to eating disorders. Evidence for this is found in the twin and family literature. Sisters of anorexics have a higher incidence of anorexia than the general population. This may be influenced by other family factors, but identical twin studies have shown a higher concordance rate in identical twins. Past research has linked anorexia with hormonal disturbances, particularly in the hypothalamus and the anterior pituitary gland. Anorexia in particular has been shown to be associated with right temporal disturbance. These disturbances are often not considered primary, but secondary factors in the etiology of either anorexia or bulimia. In fact, hormonal changes have been shown to occur as a result of starvation. Extreme loss of adipose (fat) tissue and the subsequent complications concerning pregnancy are the result of such abnormal weight loss. The effects of starvation is a major factor. Starvation can induce mental states such as anxiety, depression, and even psychosis. In addition, excessive exercise produces endorphins that alter ones behavior and the continuation of the over-exercise pattern. To compound the problem the body turns to using muscle as an energy source under the conditions of starvation. As a results an intense "high" is often experienced and an added addictive component make the pattern of extreme physical exercise more difficult to break.

Socio-cultural factors get significant attention, especially in the media. Eating disorders tend to be more common in industrialized countries, however, this is changing as less developed parts of the world have access to new technology and become Westernized. Generally, cultural factors are thought to stress standards and ideals of beauty and thinness that are difficult, if not impossible to attain. These images of beauty have been said to be aimed mainly at women and act to oppress them by demanding conformity to transitory standards that come and go with time. Anorexics are sensitive to society's influence and subsequent approval and disapproval. As a result they attempt to attain the ideal societal perception that thin is superior and become obsessed with weight and body image. It is thought that self-worth is therefore equated with a slim appearance and vulnerability to eating disorders increases. Western culture is blamed for being obsessed with the human body and a lean and lithe appearance. Beauty is sold as the key to happiness and the ultimate goal. Such images of beauty are delivered in a daily barrage in numerous woman's magazines (see the graphic to the left), on television, film, and other forms of mass media. However powerful these influences may be socio-cultural factors should not be considered to be the only cause of eating disorders, but one ingredient in a complicated formula.

Psychological factors help explain some of the features of eating disorders that socio-cultural factors fail to address. A number of psychological factors have been suggested as being relevant in the development of eating disorders. In discussing the issue it is important to remember the integral relationship between psychological and familial factors. The individual is part of the family system and develops within it. Thus, both individual and family psychology has been implicated and theories of causation tend to be related to this interaction. Eating disorders are typically considered to be related to problems during upbringing, family dysfunction, low self-esteem, over-controlling parents (particularly mothers and distant fathers), and sexual abuse. The family is strained and experiences difficulties long before the patient moves to receive treatment. There has usually been a struggle with the eating disordered child over eating and conflicts around food over some period of time before treatment.

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Individuals suffering from eating disorders are typically described as having low self-esteem and experiences of feeling inadequate. They often report fearing sexual maturation, have trouble coping with stress, and tend to behave with a non-assertive manner. They are conflict avoidant and rarely resolve conflicts with others in a mature way. There are usually problems for the adolescent with separating from the family and normal individuation. These are thought to be problematic because of disturbances in communication, role structure, affect modulation, and boundary diffusion. These families have been described as enmeshed, over-protective, and as co-opting the anorexic daughter in destructive alliances with one parent or another (triangulation). It is postulated that the family has difficulty coping with stress, that the parents have an unacknowledged problem in their relationship, and that the daughter is enlisted to balance an otherwise unhealthy situation. Parents have even been described as affectionate, intrusive, but also neglectful and controlling. The anorexic daughter is more submissive than are teens without eating disorders.

In conclusion, it is important to consider all factors in the etiology of eating disorders. It has roots in the biological, psychological, and socio-cultural. All these complex factors interact and are interrelated. It is important to consider individual differences in assess an individual with a possible eating disorder.

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