By Jennifer Amlen, MSW, LCSW

There is no one known cause for eating disorders. However, there are several possible causes such as biological factors, socio-cultural factors, and psychological factors. Scientists have studied the genetics, biochemistry, and environments of people with eating disorders and they have found it to be more complex than expected.

There are several types of eating disorders including anorexia nervosa, bulimia nervosa, and binge eating disorders. Anorexia nervosa is an eating disorder in which a person refuses to stay at even the minimum body weight considered normal for their age and height. Bulimia is an illness defined by food binges, or recurrent episodes of significant overeating, that are accompanied by a sense of loss of control. Binge eating is an eating disorder characterized by eating more than a person needs d to satisfy hunger. It is a feature of bulimia, a disorder that also includes abnormal perception of body image, constant craving for food and binge eating, followed by self-induced vomiting or laxative use.

Some people may have a combination of all three conditions. Some people with bulimia nervosa may never even purge. Those with “exercise bulimia” will exercise compulsively as an alternative to purging.

It is unknown whether or not a person’s biochemistry changes as a result an existing eating disorder. However, experts have studied how the brain works in people with anorexia and have found higher levels of the neurotransmitter serotonin. This is the chemical in the brain that reduces cravings for food and can cause an individual to withdraw socially. Once a person begins to starve, stuff, or purge, these behaviors can alter the brain chemistry.

Possible Causes of Eating Disorders

Different people develop eating disorders for different reasons even though the behaviors may be very similar. Although many people view eating disorders as self-destructive, most individuals with eating disorders begin trying to control their food intake because they are actually trying to fix other problems.

Life Transitions

Many people who develop eating disorders have difficulty with change. Anorexia may develop during puberty when the body is changing and one is entering high school, and facing independence and early adulthood.

Family Pressures

Many people with eating disorders come from difficult family environments. They may feel that they are being dominated and try to control their weight and eating to gain a sense of control over their lives. Many women with anorexia may have come from families where they have felt overprotected and smothered. Others may have felt abandoned, misunderstood, and alone. Others may be attempting to distinguish themselves from their family and developing their own identity.

Social Pressures

Many people develop an eating disorder because they perceive it as being the answer to other problems. “If I were thin I would fit in.”

Some people with eating disorders who were socially isolated, teased or bullied set unrealistic standards for themselves in order to be accepted.

Perfectionism

People with eating disorders tend to be perfectionists with very high expectations. In spite of their many achievements, there is a strong feeling of inadequacy. Many have their self-esteem tied to success and any failure can produce devastating feelings of guilt, shame, and worthlessness.

Trauma

There is strong correlation between sexual abuse and eating disorders. Many survivors of sexual and physical abuse have avoided facing the pain and have even blocked out the experience by focusing their attention on their bodies. In some ways, they are recreating abuse and harm to their bodies as had been done to them in the past.

Depression and Anxiety

It is estimated about one half to one third of those struggling with eating disorders have experienced anxiety or depression before their disorder began. The feelings were severe enough that these people felt overwhelmed by the emotions and extremely out of control.

Cultural Ideals

Cultural pressures clearly contribute to promoting unattainable and unrealistic images of beauty. Young girls and boys are bombarded with TV shows, movies, and magazines with images of the “ideal “body type.

Treating Eating Disorders

With all eating disorders, the main focus of life is about weight However, the person’s weight is not the underlying cause.  Often the real causes are painful and uncomfortable feelings that are not being dealt with. When someone is focused primarily on food, weight, and calories, they are blocking out painful feelings and emotions. Food and weight become their obsession, just like any other obsessive compulsive disorder or addiction.

Individual Psychotherapy Therapy

Individual therapy addresses the underlying cause of the eating disorder. Therapy can help one learn new skills, cope with feelings, and overcome fears. Psychotherapy may help one to address causes of low self-esteem.

Cognitive Behavioral Therapy

Cognitive behavioral therapy focuses on the thoughts surrounding food and eating. One develops a new relationship with food and becomes more self-aware. One may keep a food journal. Behavior therapy focuses on changing one’s destructive behavior by using rewards and repercussions. One learns new coping mechanisms to solve problems in the place of food.

Stress Reduction Therapy

Stress reduction therapy can be very useful for those with addictions and compulsions. Simple relaxation techniques, visualization, and deep breathing can help one to stay calm and focused on one’s feelings. It helps one get better in touch with the body and inner experience.

Family Therapy

Family therapy looks at the dynamic in the family that may contribute to one’s role with food and eating. The person with the eating disorder may be distracting the family from other issues that are not being addressed. Family sessions may be very beneficial to identify unresolved issues with in the family.

Group Therapy

Group therapy is helpful in breaking the pattern of isolation and from the belief that one is alone. Group members can help support each other by sharing similar experiences with their eating disorders.

Self Help Groups

Twelve-step programs are very useful. One can find plenty of support and there are meetings every day throughout the country.

Meetings to look for are Overeaters Anonymous and Anorexics and Bulimics Anonymous.