There are so many avenues to developing an eating disorder. There is no one single cause but rather a complex interaction between the biological issues, such as genetics and metabolism, etc., psychological issues, such as control, coping skills, personality factors, family issues, and social issues, such as a culture that promotes thinness and media that transmits this message.
Dieting
Why do some dieters develop eating disorders and others do not?
In adolescents who develop eating disorders, those who were labeled as "severe dieters" had an 18 times greater chance of developing an eating disorder; with moderate dieting, 5 times greater; non-dieters a 1:500 chance of developing an eating disorder.
Genetics
Genes load the gun and the environment pulls the trigger.
We are far from knowing specific genes that cause eating disorders. There are a number of genes that work with environmental triggers. Dieting and loss of weight may influence the development of anorexia by turning on a gene that may influence an eating disorder.
There are many cases of transgenerational eating disorder and twin studies which make this connection. There is probably a 5-6 greater chance of developing an eating disorder if an immediate relative has an eating disorder.
Depression and Anxiety
Looking at depression and anxiety disorders as psychiatric illnesses which are biological in nature, we see that they commonly co-exist in the eating disorder patient and their families.
Excessive Exercise
Referred to as an exercise-induced anorexia, this concept is being explored.
Thought: Did you know that rats who were put on a restrictive diet spent increasing amounts of time running on their activity wheel? They lost a great deal of weight. If the researchers had let them continue to do this, the animal would have died.
Psychological Factors
No one factor causes an eating disorder. The list below is long and incomplete. Everyone is unique but sometimes there are patterns.
For anorexia: - fear of growing up - inability to separate from the family - need to please or be liked - perfectionism - need to control - need for attention - lack of self esteem - high family expectations - parental dieting - family discord - temperament - often described as the "perfect child" - teasing about weight and body shape
For bulimia: - difficulty regulating mood - more impulsive - sometimes with shoplifting, substance abuse, etc. - sexual abuse - family dysfunction
Social-cultural Causes
-emphasis on thinness as the ideal for beauty -availability and indulgence of food -role of the media -obesity and reaction to the larger body size
Thought: If we took an average 5' 2'' woman, age 22 and normal weight of 125 lbs. and expected her to fit the Barbie image, she would have to be 7' 2'' tall.
Mortality Rates: Anorexia nervosa has a higher mortality rate than any other cause of death among females between the ages of 15 and 24, according to the National Institute of Mental Health. The mortality rate is about 5% for each decade and increases up to 20% for patients who have the illness for more than 20 years.
As you look at the medical complications below, understand that this is just a partial list. Also remember, it is entirely possible to FULLY recover from an eating disorder.
-Slow irregular, pulse -Low blood pressure -Dizziness or faintness -Shortness of breath -Chest pain -Decreased potassium levels may result in life-threatening cardiac arrhythmias or arrest -Electrolyte imbalances may lead to life-threatening cardiac arrhythmias or arrest
Muscular Skeletal (Bones):
-Stunted growth in children -Stress fractures and broken bones more likely -Osteoporosis
Mouth:
-Enamel erosion -Loss of teeth -Gum disease -“Chipmunk cheeks”- swollen salivary glands from vomiting -Sore throat because of induced vomiting
Esophagus:
-Painful burning in throat or chest -May vomit blood from small tear(s) in esophagus -Rupture of the esophagus, may lead to circulatory collapse and death
Endocrine System:
-Thyroid abnormalities -Low energy or fatigue -Cold intolerance -Low body temperature -Hair becomes thin and may fall out -Development of fine body hair as the body’s attempt to keep warm
Stomach:
-Stomach may swell following eating or binging (causes discomfort and bloating) -Gastric rupture due to severe binge eating (gastric rupture has an 80% fatality rate) -Vomiting causes severe electrolyte imbalance which can lead to sudden cardiac arrest.
Intestines:
-Normal movement in intestinal tract often slows down with very restricted eating and severe weight loss -Frequent Constipation -Chronic irregular bowel movements
Complications Associated with Laxative Abuse:
-Kidney complications -“Cathartic colon,” refers to the colon’s inability to function normally without the use of large doses of laxatives due to the destruction of the nerves in the colon that control elimination -Electrolyte imbalance -Dehydration -Potassium depletion -Dependence on laxatives
Complications Associated with Ipecac Abuse:
-Toxic to heart (irregular heart beat, rapid heart rate, cardiac arrest) -Sudden death
