What are the causes of Anorexia?

Understanding the causes of anorexia

To understand the causes of anorexia, it is necessary to begin with a clear definition of anorexia itself. Anorexia nervosa is not, as it is often described, a fear of ‘being fat’. Anorexia is an overwhelming phobia of being a normal weight; a compelling fear that drives the individual to severely restrict food intake to a dangerous degree. Anorexia may also lead to other behaviours such as over-exercising, vomiting and the use of laxatives.

The peak age when anorexia is at the highest risk of developing is between the ages of 15 and 19, although onset can be at an earlier age or during adulthood.

The eating disorders charity Beat estimates 125,000 people in the UK have anorexia (representing around ten per cent of the 1.25 million individuals who have an eating disorder of all types). Of course, the causes of anorexia will not be the same; every individual has their own influences and risk factors. The causes of anorexia in a child may be a little different to anorexia causes in adulthood. Below, we describe the main risks, influences and precipitating factors which may be considered causes of anorexia.

Causes of anorexia

The precise interaction of factors will be unique to each individual; however recognised causes of anorexia include:

  • An individual is criticised or bullied for their weight, shape or eating habits
  • Very painful or traumatic life experiences, such as parental separation or trouble settling into school can be one of the causes of anorexia
  • If a close relative has had an eating disorder or mental illness runs in your family, your genetic risk of developing an eating disorder yourself increases
  • Equally, there may also be a social aspect within a family setting, for example, if parents are very concerned with weight, body image and food intake, this can contribute to possible causes of anorexia
  • There is an increased risk of anorexia in certain if you are involved in particular activities such as ballet, athletics and modelling
  • Poor body image/body image disturbance can be both a cause of anorexia and something which maintains the disorder after onset
  • People with autistic spectrum disorder (ASD) have an increased risk of anorexia
  • Low self-esteem, anxiety, obsessive compulsive disorder and perfectionism have all been shown to be linked to the development of anorexia

Anorexia in children

It is very important to identify anorexia in children as soon as possible: insufficient food intake during childhood and adolescence can harm growth and development. Equally, it is widely recognised that treatment for anorexia is more effective if started as early as possible, before patterns become more intractable.

Some of the causes of anorexia in a child or young adolescent can be different to the causes of anorexia in older teenagers and adults. For example, in some children, one characteristic of their anorexia may be mixed feelings or difficulties around the approach of puberty; restricting food intake and weight delaying the onset of puberty. Anorexia in childhood is particularly difficult to diagnose, when many children go through phases of picky eating and challenging eating habits. Children may be less able to talk about or express their feelings and emotions or show typical features of anorexia such as body image disturbance, which can make it harder to identify the disorder.

Treatment and support

It is extremely important that anorexia is identified at the earliest possible stage and treatment commences. For most patients with anorexia, treatment can take place within the home community sitting, so the individual can stay in school, college, work and social support networks. Some people with anorexia will need a higher level of support and treatment and therefore move into day or inpatient care. In any mode of care, it is critical that services are delivered by specialists in eating disorders in a setting where treatments and outcomes are carefully measured for effectiveness.