There are no simple answers to this question. The causes are diverse, complex, and numerous. We may never know all of the contributing factors. We do know some of the ingredients that seem to be part of the recipe that makes one vulnerable to becoming in bondage to an eating disorder. When only a few of the “ingredients” are present, the person may only exist in some level of disordered eating and never move into a clinically diagnosable eating disorder.
One fundamental circumstance that is prevalent among those suffering from eating disorders is that they come from societies where thinness is prized and promoted as the ideal. In the United States it is estimated that 70% of all girls and young women have “felt fat” to the point of going on a diet before the age of 21. Thinness is equated with achieving happiness, success and all good things in much of our media and advertisements. It has been my experience that very few people swing into eating disorders without having participated in some form of dieting or restriction. This often opens the door to undertaking other artificial, disordered measures to achieve a weight that is unnatural and a body that is unobtainable through rational means.
Participation in a sport that emphasizes a leanness- performance connection or that involves wearing scant clothing seems to create an environment that can predispose one to the development of an eating disorder. Research indicates that anywhere between 30 – 70% of girls and young women that participate in sports such as dance, gymnastics, or track engage in some form of disordered eating practice. There has been an increasing awareness of the occurrence of eating disorders among males involved in certain sports such as wrestling and long distance running. Research into eating disorders among males is lacking.
Eating disorders often develop as a means of getting needs met. There are two age categories when a young woman appears to be vulnerable from this standpoint. These age groups are 13-14yr. olds and 17-18 yr. olds. These are ages when one deals extensively with self-esteem and body- esteem issues, identity and self-determination issues, and major changes (such as going into junior high or leaving home for college or work). Disordered eating behaviors may evolve as a mechanism to deal with stress, achieve “control” at a time in life when other circumstances seem uncertain and unmanageable, or it can be a form of rebellion (anorexia is often referred to as a “hunger strike”). These behaviors can serve the “purpose” of providing a way of gaining attention and a unique identity for oneself. As one recovers, healthier coping methods are learned to get needs met and to deal with difficult feelings, thoughts, and circumstances.
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There is research ongoing to discover if there might be a genetic component to the development of eating disorders. While the jury is still out on the final verdict, there does seem to be evidence that many of those with eating disorders come from families where there has been substance abuse. This also could be evidence of the impact that family dysfunction could have in this area.
The Medical and Psychological Consequences of Eating Disorders
The medical consequences of these eating disorders can vary from the most common (menstrual irregularities or amenorrhea) to death. It has been estimated that the long- term death rate for those afflicted with anorexia or bulimia can be as high as 20 – 30%. Electrolyte deficiencies can arise that may cause nausea, fainting, muscle cramps, and damage to the heart muscle. In the worst case scenario, the cardiac muscle will cease functioning and death will occur. Other organs, such as the liver or kidney, may be damaged. With bulimics or purging anorexics, the esophagus may become irritated or ruptured. Laxative abuse can lead to irritable bowel disease or create an addiction to laxatives. Vitamin and mineral deficiencies can emerge from starvation or purging that can bring about problems with eyesight, skin, hair loss, osteoporosis, or easily fractured bones. The longer this disorder prevails, the more likely that some undesirable medical consequence will occur.
From a psychological perspective it can sometimes be difficult to decipher what problems have arisen as a result of the eating disorder verses what psychological conditions might have been a precursor to the development of anorexia or bulimia. This is particularly true with the most prevalent psychological state, depression. With severe nutritional imbalances and starvation, depression is a general consequence. Therefore, these issues may need to be addressed prior to determining if there was an undiagnosed depression that contributed to the eating disorder. Brain functioning may be affected, which is exhibited by the lack of ability to concentrate. Obsessive and compulsive behavior traits may be exhibited for the first time, or there may be a worsening of obsessive/compulsive disorders. In general, most of the psychological consequences will not be permanent in nature. Therapy and appropriate medications are veiy affective in addressing these issues.