Causes of Eating Disorders

No single cause has been identified for eating disorders. However, nearly all
eating disorders begin with dieting to lose weight. Because these disorders
are found almost exclusively in the developed world, where food is plentiful
and where thinness in women is idealized, it appears that social and cultural factors are important contributors. Some theorists believe that cultural values
of independence and personal autonomy, rather than interdependence
and the importance of human relationships, contribute to eating pathology.
Still others point to the changing and contradictory societal expectations
about the roles of women as a contributing factor.
Studies suggest a genetic predisposition to eating disorders, particularly
in those persons who engage in binge eating and purging behaviors. Their
family histories typically include higher than expected numbers of persons
with mood disorders and substance abuse problems. Dysfunctions in the
pathways for the substances that transmit messages in the brain, the neurotransmitters,
are thought to play a role in the development and maintenance
of eating disorders, although these dysfunctions are not sufficient to
explain the entire problem by themselves. The psychological theories about
the causes of eating disorders postulate that individuals with underlying
feelings of powerlessness or personal inadequacy attempt to cope by becoming
preoccupied with their body’s shape and size. Finally, the incidence of
sexual abuse is higher among persons with eating disorders, particularly bulimia
nervosa, than among those in the general population.

Eating disorders seem to develop in three stages. Stage 1 involves the
period from the time a child is conceived until the onset of a particular behavior
that precipitates the eating disorder. During this stage, individual psychological,
personal, and physical factors, plus family, social, and cultural
factors, place the person at increased risk. Individual risk factors include a
personal history of depression, low self-esteem, perfectionism, an eagerness
to please others, obesity, and physical or sexual abuse. Family risk factors include
a family member with an eating disorder or a mood disorder and excessive
familial concern for appearance and weight. Social and cultural issues
include emphasis on the cultural ideal of excessive thinness, leading to
dissatisfaction with the body and dieting for weight loss. Young women who
are dancers, runners, skaters, gymnasts, and the like may be particularly susceptible
to this kind of cultural pressure.

Stage 2 involves the factors which actually precipitate the eating disorder.
Some identified precipitating factors include onset of puberty, leaving
home, new relationships, death of a relative, illness, adverse comments
about weight and body appearance, fear of maturation, the struggle for autonomy
during the midteen years, and identity conflicts.
Stage 3 involves the factors which perpetuate the eating disorder. These
can be cognitive distortions, interpersonal events, or biological changes related
to starvation.