No single factor can be said to cause an eating disorder. They instead emerge out of a complex combination of socio-cultural, psychological, and biological influences.
Scientists are increasingly identifying biological and genetic components to eating disorders; however, these findings are not comprehensive nor can they accurately predict who will eventually develop an illness.
Certain personality traits may elevate an individual’s risk for developing an eating disorder. For example, perfectionism, obsessive behavior, harm avoidance, reward dependence, and persistence can make someone particularly vulnerable. These are not negative qualities that necessarily can or should be changed, but simply modes of being in the world that can make one susceptible to eating disorders as a means of coping.
In addition to these innate qualities, psychological distress caused by low-self esteem or loneliness as well as mood disorders, like depression and anxiety, can often trigger pathological eating behaviors.
Eating disorders do not evolve in a vacuum within the individual, though, and many social factors contribute heavily to their development. Troubled interpersonal relationships, lack of a support system or place to express one’s emotions, and a history of bullying (especially for weight-related issues) can all play a role as well.
Zooming out even further, cultural contexts often create the perfect storm for these previously mentioned factors to coalesce into eating issues. Unrealistic standards of beauty, the glorification of thinness, and the high value placed on having an “ideal body” foster distorted body images and eating-disordered behavior. The media is often labelled as the culprit for widely propagating these values and ideals. Magazines, advertisements, television, and movies all create a false sense of the “norm” by repeatedly showing the same small range of body types, photoshopping bodies, encouraging weight loss, and constructing a limited notion of beauty.
However, the thin-ideal is not just imposed by the media, but also embedded in the patterns of everyday life. Fat-shaming and other appearance-based discriminations are continually normalized. Moreover, diet-culture is so pervasive that nearly half of college-aged women and nearly a third of college-aged men are dieting to lose weight at any given time. Despite being so widespread, diets are not innocuous and often do lead to pathological behaviors. As Natalia Zunino PhD writes “the most common behavior that will lead to an eating disorder is dieting.”
Another cultural factor that can put individuals at risk is involvement in athletics (a survey of Division 1 NCAA female athletes revealed that over a third expressed disordered eating attitudes that placed them at risk for developing anorexia). While sports should not be blamed for eating disorders and can be an incredibly positive activity, sports culture is a place where certain body ideals and controlling behaviors can sometimes pathologically circulate. Moreover, what is known as “the female athlete triad” (the combination of disordered eating and high intensity exercise that leads to osteoporosis and amenorrhea) can have especially destructive, lasting physical consequences.
Lastly it has to be emphasized that many different demographics are susceptible to these disorders. While representation in the media often gives unbalanced visibility to young, wealthy, white female celebrities, eating disorders impact a huge range of people regardless of gender, sex, age, or ethnicity. Additionally, physical appearance is not always an accurate indicator of these disorders or their severity; individuals can be grappling with dangerous eating and body issues at any weight.
Strategies for Family and Friends
What can I do?
The family and friends of someone who is suffering from an eating disorder can often feel alienated or powerless to help. While the most effective form of support and intervention will vary from person to person, here are a few guidelines.
- Educate yourself: You may not be able to understand what your friend or loved one is going through, but you can set the stage for open and productive communication by learning more.
- DON’T stay silent: Eating disorders are serious and potentially life threatening; the longer they go on, the harder they can be to recover from. Therefore, if you suspect your friend or family member is struggling, it is important to address it.
- But DO plan when to speak: Having a conversation with your friend or family member about their disordered eating can be incredibly difficult, especially the first time you bring it up. Find an appropriate time and a safe space to express your concerns. Don’t impulsively accuse your loved one in the moment if you see them behaving in a unhealthy way, but instead make time for a supportive discussion on neutral territory.
- Continue communicating: Bringing up your concerns won't automatically lead to a solution and you may even encounter some resistance from your friend or loved one. Don’t be frustrated or place blame if he/she is not ready for recovery and certainly don’t try to enforce a “cure” yourself. The important thing in this stage is to continue checking in and to be a resource for care.
- Remember that you cannot force someone to seek help. But if you are concerned for your friend or family member’s safety it may be appropriate to seek guidance from a medical professional.