What Causes an Eating Disorder: A Biopsychosocial Perspective by Kendra DeFrank, MA, LCPC
Whether you are struggling with an eating disorder or are the parent of someone struggling with an eating disorder, you have questioned “Why did this develop?”. As a therapist who specializes in the treatment of eating disorders, I have never met a client who can pinpoint the cause to one factor. The truth is eating disorders are complex and have many causes. The underpinnings of an eating disorder can be better understood by looking at the interplay of biological, psychological, and social factors.
The biological piece refers to any predisposing aspects of an individual’s DNA that could cause eating disorder behavior. One example is genetics. People who have an immediate family member with a diagnosis of anorexia are eleven times more likely to be diagnosed with anorexia. Individuals with an immediate family member who struggles with bulimia are four times more likely to be diagnosed with bulimia. Biological factors go beyond genetics. Biology can also refer to temperament traits, like perfectionism and obsessive thinking. Very often those who struggle with eating disorders have type A personalities and strive to be above average in academics, physical appearance, sports/activities, and social status.
The psychological component to the biopsychosocial model refers to distorted thinking patterns and our internal emotional worlds. An individual may have distorted beliefs about their bodies and food that can contribute to the development of an eating disorder, but it can go much deeper than this. Self-esteem issues, feelings of inadequacy, and not fitting in can all contribute. One may feel more confident at a lower weight or feel more admired or liked if they live up to being “thin enough” or “fit enough”. They may cling to an identity all wrapped up in their physical appearance meanwhile feeling internally lost in who they really are. Feelings of shame and coping with trauma are other possible factors. If someone can stay busy thinking about food, weight, or exercise they don’t have to think about other painful things as much. This can be applied to any difficulty in life we have to cope with. If 90% of our time is thinking about our bodies, we can distract ourselves from things like grief, loneliness, and anxiety.
The social component refers to the messages we receive from our environments about food, body shape, and size expectations. This can be on a micro-level, which can include messages individuals receive at home about their appearance or any experience at home that has shaped a distorted relationship with food. Having a parent who criticizes their own body, judges others bodies, frequently diets, or has disordered eating themselves will really impact an adolescent. These messages may also come from doctors, coaches, or friends. On a macro-level, the social component refers to the messages we receive from media, marketing, and advertisements on how we are “supposed” to look. There is a very strong diet culture that exists today. Teens are no longer just seeing this on TV or in magazines, but every time they open Instagram or TikTok they are exposed to messages on how they need to eat or exercise to achieve the ideal body. If you would like a good example of this, watch the “Cost of Beauty: A Dove Film”. Our kids get exposed to messages at such a young age that can fuel eating disorders. This doesn’t mean that our teens should not have phones till they are 20, it just means we need to know what they are seeing and help educate them on the falsehoods.
Now, when we combine some of these factors from each category together, we end up with the perfect storm for this deadly disease. No two eating disorders look alike as the underlying factors with each person always differ. One individual could be a Type A perfectionist who struggles with loneliness and feelings of inadequacy while another individual may carry so much shame and guilt about sexual abuse that they use food as a means to feel less self-disgust. Regardless of the factors, our team is trained to deal with not only the eating disorder itself, but all of the underlying issues that created it in the first place. I hope this helps shed some light on the complexity of how eating disorders develop and if you need further information on treatment, our team is here to answer any questions you may have.
To learn more or connect with someone from our team please reach out to Lotus Therapy Group at 708-552-7330.
