Eating disorders, including anorexia and bulimia, are complicated, serious and potentially devastating. They’re caused by a complex combination of factors, including genetic, biochemical, psychological, cultural and environmental. While researchers haven’t been able to pinpoint the specifics behind these causes, they can identify various factors that make individuals susceptible to eating disorders.
Eating disorders are illnesses, not character flaws or choices. Individuals don’t choose to have an eating disorder. You also can’t tell whether a person has an eating disorder just by looking at their appearance. People with eating disorders can be underweight, normal weight or overweight. It’s impossible to diagnose anyone just by looking at them.
Eating disorders frequently occur together with other psychiatric illness such as depression, substance abuse, or anxiety disorders. In addition, people who suffer from eating disorders can experience a wide range of physical health complications, including serious heart conditions and kidney failure, which may lead to death. Recognition of eating disorders as real and treatable diseases, therefore, is critically important.
While no one thing causes eating disorders, here are some of the factors that may contribute to the problem:
Genetics
Genetics has a significant contribution and may predispose individuals to eating disorders. Researchers have found that eating disorders tend to run in families. Also, there seem to be higher rates of eating disorders in identical twins than in fraternal twins or other siblings. In addition, specific chromosomes have been linked to both bulimia and anorexia.
Biochemistry
Individuals with eating disorders may have abnormal levels of certain chemicals that regulate such processes as appetite, mood, sleep and stress. For instance, both people with bulimia and anorexia have higher levels of the stress hormone cortisol. Some research also suggests that individuals with anorexia have too much serotonin, which keeps them in a constant state of stress.
Psychology
Various psychological factors can contribute to eating disorders. In fact, eating disorders are common in individuals who struggle with clinical depression, anxiety disorders and obsessive-compulsive disorder. Other factors include:
• Low self-esteem
• Feelings of hopelessness and inadequacy
• Trouble coping with emotions or expressing your emotions
• Perfectionism
• Impulsivity
Culture
Dieting, body dissatisfaction and wanting to be thin are all factors that increase the risk for an eating disorder. Unfortunately, our society encourages all three. You can’t walk by a cash register without seeing a magazine that encourages rapid weight loss, calorie counting or feeling guilty after a meal. Here are some aspects of our culture that contribute to eating disorders:
• An over-emphasis on appearance, at the expense of more meaningful attributes
• Societal beauty standards that promote an unrealistically thin body shape
• Associating thinness with positive qualities like attractiveness, health, success and love
• Media’s focus on dieting and striving for a slim and toned silhouette
• Messages that perpetuate a fear of fat and food; viewing fat as undesirable or foods as “good,” “bad” or “sinful”
Environment
Your environment can also play a major role in developing an eating disorder. These factors include:
• Family or other relationship problems
• Difficult or turbulent childhood
• History of physical or sexual abuse
• Activities that encourage thinness or focus on weight, such as gymnastics, dancing, running, wrestling and modeling
• Peer pressure
• Being bullied because of weight or appearance in general.
Coeliac disease
Coeliac disease is a condition that causes inflammation in the lining of the small intestine (part of the gut).
Coeliac disease is not a food allergy or a food intolerance. It is an autoimmune disease. The immune system makes white blood cells (lymphocytes) and antibodies to protect against foreign objects such as bacteria, viruses, and other germs. In an autoimmune disease, the immune system mistakes part or parts of the body as foreign. Other autoimmune diseases include type 1 diabetes, rheumatoid arthritis and some thyroid disorders.
The inflammation in the lining of the small intestine stops food from being properly absorbed. You then do not absorb nutrients very well into your body. A variety of symptoms may then develop.
Anorexia Nervosa
Anorexia is an obsessive fear of gaining weight characterized by excessive dieting and an intense preoccupation with food. People with anorexia have a distorted body image and will often see themselves as fat when they are actually very thin. Anorexics will commonly control their weight through starvation, but other forms of weight control include purging, excessive exercise, laxatives and diet pills. Anorexia can lead to irregular or absent menstrual periods, dry skin, hair loss, and growth of fine body hair in addition to more serious health consequences such as heart problems, organ damage and bone loss.
Anorexia Athletica (also known as Compulsive Exercise)
Compulsive exercising is taking exercise to the extreme, beyond healthy requirements, in order to maintain or lose weight. People who suffer from anorexia athletica are fanatic about their weight and diet and will experience extreme guilt and anxiety if they miss a workout. Sufferers will isolate themselves by choosing to exercise over spending time with friends and family, define their self-worth by their athletic performance, and can cause damage to their body through overexertion.
Bulimia Nervosa
Binge Eating (also known as Compulsive OverEating)
Binge eating occurs when someone uncontrollably eats past the point of feeling full, followed by intense feelings of shame and self-loathing. It can occur impulsively during a single episode or occur as continuous eating throughout the day, and the sufferer can consume anywhere from 5,000 to 60,000 calories a day. Compulsive eaters will not purge but may repeatedly attempt to diet in order to maintain their weight. These diets inevitably fail because their core addiction to food is never treated. Consequences of binge eating include obesity and depression over their feelings of guilt and anger about their disorder.
Night Eating Syndrome
Orthorexia Nervosa
Orthorexia is an unhealthy obsession with healthy foods. People who suffer from this disorder will restrict their diets and only allow themselves to eat what they perceive to be healthy foods. Unlike anorexics who restrict their diets because they fear becoming fat, orthorexics know they are thin and restrict their diets because they only want to consume foods they consider to be “pure.” This restriction of food often results in a limited diet that lacks proper nutrition and calories. It is a form of obsessive compulsive disorder and can lead to malnutrition and even starvation.Osteoporosis
Osteoporosis is a medical condition in which the bones become brittle and fragile from loss of tissue, typically as a result of hormonal changes, or deficiency of calcium or vitamin D.
If you want to build stronger bones, you need three key elements: calcium, protein, and vitamin D. Bones are largely made up of a protein -- collagen -- bound together by calcium and other trace minerals). Vitamin D helps your body absorb calcium so it can do its job building strong bones.
Next to genetic predisposition, poor nutrition is the most common cause of osteoporosis. Making healthy food choices can help prevent dangerous bone loss, and food is one of the most important treatments recommended by physicians and nutritionists alike once osteoporosis is diagnosed.
High blood pressure
High blood pressure or hypertension increases the risk of heart disease and stroke. Hypertension risk factors include obesity, drinking too much alcohol, smoking, and family history. Beta-blockers are a common treatment for hypertension.
One step to lower high blood pressure: Incorporate the DASH diet into your lifestyle. Doctors recommend:
Eat more fruits, vegetables, and low-fat dairy foods
Cut back on foods that are high in saturated fat, cholesterol, and trans fats
Eat more whole grain products, fish, poultry, and nuts
Eat less red meat (especially processed meats) and sweets
Eat foods that are rich in magnesium, potassium, and calcium
The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is an example of such an eating plan. In research studies, patients who were on the DASH diet lowered their blood pressure within two weeks. Another diet -- DASH-Sodium -- calls for cutting back sodium (salt) to 1,500 mg a day (about 2/3 teaspoon). Studies of people on the DASH-Sodium plan significantly lowered their blood pressure as well.
Cancer
A review of how lifestyle affects your risk of developing cancer was published in 2011. This review included diet. It found that around 1 out of 10 cancers (10%) may be linked to diet. Over half of these were caused by eating less than 5 portions of fruit and vegetables a day. Other factors include eating too much red meat, not eating enough fibre and eating too much salt.
We also now know that alcohol can increase your risk of a number of cancers. A review in 2011 by Cancer Research UK suggests that around 4 out of 100 cancers (4%) are linked to alcohol. It increases the risk of mouth cancer, liver cancer, breast cancer, bowel cancer, and throat cancer, which includes pharyngeal cancer, laryngeal cancer and cancer of the food pipe (oesophagus).
Even moderate alcohol intake increases your risk of cancer. A recent UK study showed that women who drink 1 or 2 drinks a day have a slightly increased risk of cancer.