There is More to Learn About Eating Disorders by Lisa Geraud

Lisa Geraud, MA, MS, RD, LMFT, Executive Clinical Director, Eating Recovery Center, Washington, shares her perspective on genetic predispositions to developing eating disorders.

Anyone who has an eating disorder or loves someone with an eating disorder is apt to wonder about cause. It is our nature to seek answers. There is more to learn about eating disorders than we know, and it is clear that there is no single cause of eating disorders. However, what is widely accepted by leaders in the field is that eating disorders are highly heritable. Experts agree that roughly 40-60% of the cause of eating disorders is genetic. Expanding on what is inherited genetically, Emmett Bishop, MD, psychiatrist and co-founder of Eating Recovery Center explains, “The answer may lie in the ability to identify phenotypic traits of the personality, such as cognitive style, temperament and character. Substantial evidence exists to support the theory that phenotypic traits are the result of expression of genes under environmental influence." Words and phrases used to describe individuals with eating disorders often include perfectionism, negative emotions, obsessive thinking, anxiety proneness and compulsive behaviors. Impulsivity is an added descriptor for bulimic persons. Interestingly, there is always evidence that these traits were present in the individual prior to the onset of an eating disorder, and the traits persist still after recovery." Our thinness-obsessed culture with a narrow definition of attractiveness is not enough in itself to cause eating disorders. However, culture has its influence as an environmental factor. It may inspire people to seek to improve themselves or attenuate emotion through weight loss dieting. Weight loss dieting so frequently precedes eating disorders that clinician and researcher Craig Johnson, PhD has named it the "gateway behavior." A common saying in the eating disorder field is that "genetics load the gun and environment pulls the trigger." Although ceasing dieting behavior and restoring normal eating for both sound nutrition and pleasure is one aspect of eating disorder recovery, the psychotherapeutic work involves accepting and understanding one's temperament and thinking style in such a way as empowers management of these traits. The core of recovery is willingness to have the thoughts, emotions and sensations that a person may have concluded were intolerable and that the eating disorder mindset seeks to distract from or numb through restricting, binge eating or purging. Successive willingness and practice at experiencing these private mental events fosters psychological flexibility and resilience serving recovering people well in life and relationships the remainder of their lives.

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