What Causes Anorexia?
When it comes to understanding the cause of anorexia nervosa, there is no one answer. Anorexia is a bio-psycho-social illness, meaning that biological, psychological and sociocultural aspects contribute to the development of the illness. In other words, this is a complex disorder that results from an interplay of these factors. Even when certain predisposing or precipitating factors are identified, like a family history of eating disorders or a traumatic event, there will likely be multiple other contributing factors. Anorexia is not a choice. It is a very serious and potentially life- threatening multi-determined illness.
Genetic Causes of Anorexia Nervosa
Although there is no one cause of anorexia, genetics play a part. Other genetic causes include co-existing illnesses and personality traits. We have known for years now that there is a genetic link to anorexia nervosa. However, this does not mean that there is a particular anorexia gene. Some researchers believe there may be hundreds of genes that impact the disorder.
Twin and family studies have yielded strong evidence that anorexia nervosa, as well as other eating disorders, runs in families. The heritability of anorexia has been reported between 40-60% and relatives of individuals with anorexia nervosa are 11 times more likely to develop the illness than relatives of individuals without anorexia. Although we do not inherit anorexia per se, we can inherit a vulnerability to anorexia.
Co-existing illnesses and Personality Traits
Researchers have identified correlations, and possible genetic overlap, between anorexia nervosa and other psychiatric disorders such as major depression, anxiety and obsessive compulsive disorder as well as certain personality traits. The heritable nature of these traits, including harm avoidance, perfectionism and inflexibility, suggests the relationships may be genetic.
Genetic linkage studies and genome-wide association studies of anorexia are being conducted in order to increase our understanding of the role of genetics in anorexia risk.
Psychological Causes of Anorexia Nervosa
Psychological factors, in conjunction with biological and social influences, can play an important role in the development of anorexia nervosa. We have learned that there are certain characteristics and experiences that are common to individuals with anorexia (including perfectionism, low impulsivity, harm avoidance, low self-esteem, anxiety, low self-directedness and overvaluing body image), that may place a person at greater risk for the illness. These factors are often considered to be maintaining features that contribute to the perpetuation of the illness and can be directly targeted during treatment.
Perfectionism refers to a personality style where an individual strives for flawlessness, is highly concerned with approval, and may be extremely self-critical regarding performance. Mistakes are often viewed as personal failures – and something to be avoided at all cost. For individuals with anorexia nervosa, high levels of perfectionism can be seen within the illness (e.g., strict rules around eating and food) as well as outside of the illness (e.g., extremely high standards and expectations for themselves in academics, work, etc.).
Anxiety disorders and anxious personality traits are very common among people with anorexia and are often present prior to the development of the eating disorder. Mealtime anxiety can be extreme, even phobic-like. The use of avoidance behaviors to manage anxiety (e.g., restrictive eating), may contribute to the persistence of the illness.
Self-directedness refers to the ability to adapt behaviors in a way that is consistent with desired and value- driven goals. It involves the careful evaluation of a situation and development of a thoughtful plan of action. Individuals with anorexia often possess reduced levels of self-directedness. Because of this, there is a tendency to react in a way that may alleviate an immediate concern but is not necessarily in line with long term goals and values. Someone in treatment for anorexia may decide to skip a meal as a way to solve the immediate problem with their body image. Although this may help in the moment, it will also serve to perpetuate the illness – which is not the desired outcome.
Sociocultural Causes of Anorexia Nervosa
The sociocultural context (social networks, media influence and cultural norms relating to eating and appearance) during the development of anorexia nervosa requires important consideration. In fact, there are certain aspects of western society values that have been linked to anorexia including the pursuit of the “ideal body” and the overvaluation of appearance as a measure of success and worth.
Messages promoting unrealistic beauty standards that place high value on achieving a certain look (thinness, muscularity) can create pressure to engage in behaviors, like dieting, that place certain persons at greater risk. Other social influences include involvement in specific activities, groups or occupations that emphasize weight and appearance.
The Thin beauty ideal
Studies have demonstrated that cultural pressures to achieve the thin beauty ideal can lead to increased body dissatisfaction and weight concerns, which may then contribute to the development of anorexia nervosa. Being bombarded with media images of extremely thin models, for example, promotes the internalization of anti-fat attitudes and the need to control weight. With modern developments like social media, western ideals and values have been disseminated globally. Recent studies have demonstrated increases in eating disorders in non-western cultures as well as minority groups.
High-risk social environments
Certain environments have been shown to create an increased risk for the development of anorexia nervosa. Participating in sports that focus heavily on weight (running, dancing, wrestling, gymnastics, etc.), belonging to a sorority, or working in a field highly reliant on appearance and image (e.g., modeling or acting) can create additional pressure to achieve a certain weight and/or appearance in order to achieve “success.”
Get Help for Anorexia
These bio-psycho-social causes of anorexia make it an incredibly complex illness. However, with anorexia, a full recovery is possible. Anorexia treatment requires a specialized, multidisciplinary team who provide medical, nutritional and psychological support to patients.
If you think that you or a loved one needs help, please take our short anorexia self-assessment or call us at 877-825-8584 to schedule a free confidential consultation with an Eating Recovery Center Masters-level clinician.
Anorexia FAQ/More Information
Although research about anorexia nervosa is ongoing, there is a lot you can learn about this eating disorder to understand how to get help or help a loved one. Learn more about anorexia, including the causes, symptoms and available treatment options.
As with other eating disorders, anorexia has no singular cause. However, the evolving scientific literature suggests that this pattern of disordered eating develops from a complex interplay between genetic, psychological and sociocultural factors.
There are many health risks associated with anorexia nervosa. Learn about the short-term and long-term risks to understand the effects of this disorder.
Anorexia treatment is unique to each patient’s needs. Medical stabilization, psychiatric stabilization, nutritional rehabilitation and weight restoration (when appropriate) are considered when determining a patient’s treatment plan.
There are many misconceptions about anorexia, including the fact that it is simply being too thin.
If you or a loved one struggle with some of the symptoms described here, it may be worth speaking with a clinician and considering treatment options.