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- What is Anorexia?
- Intimacy and Anorexia Nervosa
- Regaining Weight in a Healthy Way
- Medical Symptoms and Complications Associated with Anorexia
- Bone Loss in Anorexia Nervosa: Mechanisms and Treatment Options
- Evolving Treatments for Adolescents with Anorexia Nervosa: The Role of Families in Recovery
- Osteoporosis and Eating Disorders
- Pictures of Anorexia or Bulimia and Pro Anorexia Websites
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Why do People Become Anorexic?
One common misconception is that people become anorexic because they are self-absorbed, vain individuals who place too much importance on their looks. While the culture of thinness in which we live is certainly an influential factor in the development of anorexia, it is by no means the sole cause. In fact, there is no sole cause. Anorexia is a response to a complex mix of cultural, social, familial, psychological, and biological influences unique to each person. The answer to the question "Why?" is an individual one requiring deep introspection on a personal level. Some possibilities are discussed below.
One widely-accepted theory is that people develop anorexia because they seek control over themselves and their lives. Food and weight can be controlled when other aspects of life cannot, and indeed significant events, such as leaving home for the first time, a divorce, or a serious illness are examples of out-of-control situations which can trigger anorexia. Restricting food intake while in the presence of enticing foods, meticulously adhering to arduous rules and regimens, and successfully losing weight while so many others can't, evokes feelings of accomplishment while providing a sense of security. Eventually, though, anorexics feel even less in control as they become imprisoned by behaviors and thought patterns that, despite concerted efforts, they cannot relinquish.
A high percentage of people struggling with anorexia have a history of abuse, neglect, or other traumatic experiences, and develop anorexia as a coping mechanism. In her book, A Hunger So Wide And So Deep (1996), Becky Thompson not only discusses sexual and physical trauma and their relationship to eating disorders, but she also illustrates that living in poverty, enduring acculturation, and suffering racial, sexual, religious, or other forms of discrimination are also traumatic events which can be contributing factors.
Anorexia is an effective way to cope with difficult circumstances because it serves to distract the sufferer from the pain. Losing weight provides a concrete goal that requires energy, planning, and effort. The amount of time spent tallying calories, exercising, and thinking about food is time spent not thinking about pain. Also, many anorexics experience a "high" when they are at a low weight because only there do they feel a sense of power and success. In addition to food restriction, bingeing can both numb and bring comfort. Medical theory suggests that the consumption of carbohydrates boosts serotonin levels in the brain, which in turn alleviates feelings of depression. Similarly, the ingestion of sweet or fatty foods tends to increase the level of endorphins, which are the body's natural pain killers (Marx pp. 88-89). Thus, the phrase "food is a drug" may have validity for some people.
For young men and women, anorexia can be a way to handle the confusion of changing societal roles. These days, it is difficult to know whether being a woman means nurturing or assertive, at home or at work, independent or dependent, etc. Also, in spite of economic and political advances, unnaturally thin bodies continue to be used to sell products and life-styles, implying that the "right body" will bring happiness, success, and a better life. Women on the brink of womanhood receive the conflicting message, "You can be whatever you want to be, but you better be thin." Young men, whose roles are also in flux, face similar conflicts about whether they should be at work or at home, sensitive or tough, the breadwinner or bread maker. They, too, are exposed to images of the perfect body type, muscular, fit, and lean-again, not fat. Anorexia can be a way to postpone or avoid the confusion of what it means to be a modern-day man or woman.
Losing weight is also a way for some women to avoid developing into mature sexual beings, in effect to remain in a child's body without the demands of intimacy and responsibility that accompany adulthood. For example, a survivor of sexual abuse might feel unsafe and would logically reason-consciously or unconsciously-that a body which resembles a preadolescent is no longer sexually desirable or appealing. For her, losing weight could well be a means of protecting herself so that she would be less vulnerable to assaults.
Families are often a factor in the development or maintenance of an eating disorder, although it is sometimes difficult to determine whether family dysfunction is a cause or effect. There may be a predisposition to an eating disorder in families with a history of depression or alcoholism, or who impose actual or perceived rules and expectations on the children. An obsession with food and weight can be an effective way to "disappear" from these unhappy family situations, or in contrast, to take the focus away from other problems at home. Some anorexics alleviate their own discomfort by controlling or manipulating those around them. For example, it is not unusual for an anorexic to do all of the shopping and cooking for a household, while starving herself.
Father/child and mother/child relationships are often central to the development of an eating disorder. "Father Hunger" is a term that refers to the emptiness experienced by children whose fathers are physically or emotionally absent, which creates a void in the family structure. For adolescents at the threshold of adult roles, the absence of a father to guide and reassure them can result in an unrealistic body image, food fears, and insecurity about their roles and budding sexuality. (Maine 1991)
Anorexia can also develop in response to mother/child relationships which have been too close. Relationships such as these make it difficult for a son or daughter to grow into their own, separate identity at the appropriate developmental stage. The child may feel somehow responsible for their mother's happiness or may be afraid of leaving her protection to live in what they both perceive of as a hostile outside world. Mothers sometimes have trouble letting go, as well, when their identity is based on being needed. In many of these cases, anorexia symbolizes an attempt by the child to become an autonomous individual, with boundaries strong enough to keep out intrusion.
Also, family members who diet or make derogatory remarks about fat people clearly deliver the message that thinness is important. In some such cases, anorexia can be the result of dieting competitions between family members, or a way for one member, who is otherwise ignored, to be seen and heard. Losing weight makes them feel powerful and special, providing them with a sense of worth that may otherwise be absent. It is often said that an eating disorder is a way of saying something with the body that cannot be said in words, and this is especially true in families where lines of communication are not always open.
Dieting has become an unfortunate cultural phenomenon, especially for women and girls, whose self image is often closely linked with their body image. Depending on the particular diet, foods are categorized as either "good" or "bad" and they become good or bad for eating them. Sometimes, all it takes is one critical comment from a significant person such as a coach, parent, or friend to begin restricting behaviors. Under the right circumstances, such as those previously mentioned, dieting can easily become an illness.
Unfortunately, the message that thinner is better is affecting younger and younger children. One study of fourth grade girls reports that 80% had already dieted. Many young girls are unaware that they will naturally gain weight during puberty, and begin to restrict their food intake at a time when nature is preparing them for childbirth and they especially need to grow. For many, dieting is disguised as healthy eating, as when a vegetarian diet is manipulated to include only apples and oranges, or when an eating plan includes little or no fat at all. All too often, even when their weight drops below a certain point, many girls have trouble seeing their bodies realistically and insist that they are still fat.
Individuals with anorexia are often described as having been model children who have always done what was expected of them. This has a flip side, for in putting the needs of others first, these children do not develop an adequate sense of self. This low self-esteem can underlie other characteristics such as perfectionism, denial of one's own needs, and approval seeking, all of which are integral symptoms of anorexia. This desire to please, combined with onset of sexual development and the persuasiveness of cultural values, puts teenagers at particular risk.
It is important to remember that different people develop anorexia for different reasons, and what may be true for one person may not be for another. Whatever the reasons, they deserve to be heard, respected, explored, and addressed.
Here are some of the causes that our contributors gave for their eating disorders:
My childhood was very scary and pain-filled. Anorexia helped me to be unaware of my feelings, wants, and needs in order to survive.
Food problems isolated me from myself and others. Focusing on food and weight kept me from seeing how horrible my home life really was.
Focusing on my body has helped me to avoid more pressing problems, such as the sadness of the declining health of loved ones, marital/parental conflicts, and feelings of failure.
My father's emotional abuse clearly contributed to my illness. I have now distanced myself emotionally from my family of origin. This has been painful, but necessary. My recovery depended upon my refusing to continue to tolerate unacceptable behavior.
I used anorexia to hide from the real issues like relationship problems, low self-esteem, loneliness, and shyness.
Thinness brings confidence, attention, activity. To my anorexic self, thin was the answer to all my problems. Thin gave me that which I craved mostattention. My anorexic self was unable to see that thin brought a false confidence and it was the confidence (not the thinness) that led to friendships, dates, etc.