Why some develop eating disorders?

A man with eating disorder problems.

No one really knows why some people develop an eating disorder while others in a similar situation do not.

Culture, genetics, health or biochemical abnormalities, and family environment evidently all play a part.

Yet, there are certain personality traits that seem to be characteristic of most sufferers. Here are some of them:

Striving to Be Perfect


As a group, most of those with eating disorders tend to be high achievers and perfectionists who excel in school or at work.

After treating over 130 patients with anorexia, Dr. Hilde Bruch, in her book The Golden Cage, describes the feelings that are typical of such ones:

You have one great fear, namely that of being ordinary, or average, or common—just not good enough. . . . You think you are worthwhile only if you do something very special, something so great and dazzling that your parents and other people you care about will be impressed and admire you for being super-special.”

 Lee, who developed anorexia, admitted:

I was trying to do the superb thing, trying to be the best at everything I did.” 

Often this striving to be perfect is demonstrated by a fervent desire to please others, to be the ‘best little girl in the whole world.’

Perception of society


How a woman perceives her role in society may also make her especially vulnerable. Though men do develop eating disorders, those affected are predominantly women.

The book Surviving an Eating Disorder explains:

Girls who become eating disordered have often grown up believing that they should be undemanding of others. The good girl is the quiet, unseen girl who learns not to show what is bothering her.” 

However, such an upbringing causes some to feel that they have no control of their lives.

For some women, trying always to please others while at the same time suppressing their own desire to take charge of their lives creates an inner conflict that can lead to an eating disorder.

Dawn, now recovered from compulsive overeating and bulimia, explains:

My family expected me to do it all their way, to be what they wanted me to be. While on the outside I appeared very secure and very intelligent, inside I wasn't that way at all. I never felt I could live up to their expectations. I couldn't please anybody—my friends or my parents. Then I realized that I could control the weight! I could gain it, I could lose it, I could do what I wanted with it. That gave me a sense of control of my life. If I could control this, I could control everything.”

Feelings of Inadequacy


Dawn’s insecurity is typical of the self-doubts many with eating disorders have. Despite having talents, most have a basic lack of self-worth.

Overeating may at times be an indication of low self-esteem. The person is saying, in effect: ‘I’m not worth anything. Why should I care about myself or my weight?’

Such feelings spawn depression, which afflicts nearly all who have eating disorders.

What causes this spirit of worthlessness?

A variety of things can cause inner pain—bitter disappointments, rejection, an environment where one’s emotional needs are ignored, or traumatic childhood experiences, to name a few.

Research reveals that a surprising number of patients with eating disorders have been sexually abused, even raped.

But low self-esteem may also develop because of the attitudes of others.

One young woman explains:

As far back as I can remember I was too fat and my mother always harped on it. Everything was done to make me thinner; that was the only thing that mattered. That’s why I hate myself and my body.” 

Today’s social climate, which greatly praises slenderness, contributes to the self-hatred of some who are overweight.

In other cases the eating disorder itself strips away one’s self-respect. Lynn, who vomited as many as ten times a day, admitted:

I would look at my face in the mirror after I purged and say, ‘I hate you,’ and then I would cry. I felt worthless.”

Deep down, most people with eating disorders are convinced that their basic personality is defective.

Thus, all their efforts are directed toward hiding the fatal flaw of their basic inadequacy and to finding ways to build their self-esteem.

Those who become anorexic try to do this in a unique way. Their effort to find self-worth is what makes anorexia so insidious—and deadly.

When Lee was rejected by a man she loved, her self-esteem plummeted:

 I wanted to prove that he passed up a good thing,” she said. “So I was determined to be super thin and super smart” To trim down, she stopped eating and became intensely busy. “I began to feel good about myself. I felt that I was really special because I could do something others could not do. I thought, ‘I am a strong person.’”

Lee’s weight dropped from 160 pounds [73 kg] to a disturbing 103 [47 kg]. Reflecting on those who tried to get her to eat, she said:

I thought that all those people were trying to ruin my life and my happiness by taking away all my self-esteem. I thought that I would end up being just like everybody else.” 

That stance by Lee is typical of anorexics, who try to gain self-worth by subduing their desires and doing what others cannot do.

If a girl’s emotions have been exploited, her efforts to protect her fragile self-esteem from further abuse may also lead to anorexia.

Shirley, for instance, was disturbed by the way boys treated her because of her newly developed shapeliness.

Then her own father made improper advances.

I was so embarrassed and disgusted that I went to my mother and just cried,” Shirley said. “After I lost weight and got rid of my curves, no one was bothering me. I was free of the attention of the opposite sex.”

In some cases anorexia is a flight from the duties of adulthood. “I didn't want to grow up and face family responsibilities,”

Shirley commented,

How could I ever let myself gain weight? No, never! Not for anyone!” 

Sadly, her obsession with making time stand still led to a painful death due to self-induced starvation.

Not all anorexics fit these descriptions. However, it seems that all of them gain a feeling of strength by making out of themselves someone whom they can admire.

They thereby gain a little self-esteem. Thinness becomes their pride and joy.

Handling Painful Emotions


Since food soothes and calms, it may be misused to cope with feelings of loneliness, anxiety, boredom, anger, depression, rejection, or betrayal.

Dawn explains,

While in school, I was a victim of a harsh experience that was too painful to talk about, Whenever I thought of that incident, or there was a situation that I couldn't face, I would go on a binge. I just tried stuffing these feelings with food.” 

The food numbed her emotional pain. But her compulsive overeating led to a 100-pound [45 kg] weight gain.

At times the eating disorder becomes an escape from the pressures of life.

For instance, Anne was reared in a home with an alcoholic father and was constantly teased about her weight. She explained why she became bulimic:

It was my way to deal with everyday stress, and it worked because when you are obsessed with something, you don't have to think about your real problems. You blame everything on your being overweight and tell yourself that when you lose the weight, life will be great.”

While all of us may eat a little more if we are upset or lonely, a person at risk of developing an eating disorder does not use the normal means of dealing with inner turmoil.

For instance, the individual may feel an underlying hostility toward some person or situation but would rather eat to soothe his hostility than voice such resentment.

The Role of Dieting


When people try to follow a strict diet, they usually cut out sweets and other good-tasting foods. These “forbidden” foods become a constant temptation.

Then, when upset, anxious, or lonely, they feel sorry for themselves.

To improve their mood, they gorge on the very foods that they have deprived themselves of. Then follows an even more stringent diet, leading to the same result—a binge.

This vicious cycle leads to weight gain and eating disorders. Lee explained how dieting created the environment for her anorexia:

I had tried all kinds of diets. I would lose weight, and then I would gain it back. This time I wanted to keep it off.”

While knowing the causes of an eating disorder is not the full answer to overcoming it, such knowledge can help one to break free. It can also help prevent problems from starting.

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