What are the causes of eating disorders?

There will always be a number of factors in the development of an eating disorder and each individual will be affected by a unique combination.

There is never one simple, single cause, although sometimes there may be one factor in a person’s life which plays a particularly prominent role in his or her eating disorder.

An eating disorder, at its root, is the expression of emotional distress and means of managing difficult and painful feelings. Anorexia is an eating disorder which typically occurs during adolescence, so emotional difficulties are likely to encompass issues at school, trouble with friendships, parental conflict and struggles coping with puberty. Of course, many young people face these sorts of challenges without developing eating disorders; there must be other factors involved which trigger disordered eating.

There are currently a number of studies exploring whether certain personality types may be more predisposed to an eating disorder. The theory is that young people with more rigid thinking styles and perfectionist traits may be more at risk of responding to difficulties through their eating. Young people who develop anorexia frequently express how losing weight provided the sense of control they felt was lacking in every other area of their lives.

Other research about anorexia questions whether we should look more closely within the brain physiologically to understand the cause of anorexia and the factors which lead to its persistence for some people. This theory suggests there is a dysfunction within the part of the brain involved with taste, emotion, appetite and pain which explains why someone with anorexia has such extreme and intransigent behaviour.

There are often questions about the role of the media, both mainstream and social, as a factor in the development of eating disorders. At Newbridge House, we do see some young people who have used pro-anorexia websites which have served to sustain and normalise their eating disorder. Certainly, the idealised images which bombard young people every day do play a role in anxiety around body image, but it would be too simple to suggest that the media causes eating disorders. It may, in some cases, be a factor in creating a disposition to the eating disorder and or perpetuating it after onset.

Family therapy is a cornerstone of the work we do at Newbridge House with young people and their families. It is never about pin-pointing blame on families, although very often parents come into the process with a great fear that the eating disorder reflects their failure in some regard. Although there may some cases where, for example, a mother has food and body image anxieties which are transmitted to their daughter, we see many families where this is not the case in any way. Family therapy and the supporting family work we do seeks to understand dynamics within each family and find ways of harnessing the support within each family in a positive way to overcome the eating disorder.

Some people go through the whole process of having an eating disorder, having treatment and on to recovery without ever fully understanding the original cause. For some, through psychoanalytic psychotherapy, it is very important to illuminate cause and use this understanding to move forward to change. For other, often the younger children we treat, therapy is more focused upon developing different strategies for dealing with difficult and painful emotions, so there is an alternative to disordered eating as a response.

Sometimes families leave Newbridge with an understanding that the cause was a general inability to cope with the pressures that adolescence presented, and that recovery is based on utilising new strategies. One mother, who felt she would never fully understand the root cause of her daughter’s eating disorder, reflected during her daughter’s recovery: “Our daughter now has new and more positive ways of interpreting the world.”

The cause of an eating disorder such as bulimia and binge eating disorder may be a little easier to understand than some examples of anorexia. Treatment is based on a cognitive behavioural therapy approach, encouraging the sufferer to understand what feelings trigger the thoughts and behaviour leading to binge eating. Through understanding of this trigger point, the individual is better able to develop other ways of thinking and behaving at the stage when disordered eating occurs.

In conclusion, the causes of an eating disorder are likely to be complex, not always apparent and will involve an interaction of several factors. It is essential that parents do not blame themselves and that if symptoms of an eating disorder are a concern, that medical help is quickly sought because the longer an eating disorder persists, the more intransient it will be to treat.