Causes of Bulimia Nervosa

The sociocultural context (social networks, media influence and cultural norms relating to eating and appearance) during the development of bulimia nervosa requires important consideration. In fact, there are certain aspects of western society values that have been linked to bulimia 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.

Traumatic Events

Research shows that many patients who are struggling with an eating disorder have experienced a traumatic event in their lifetime _[1]. This is particularly true for patients who have bulimia-spectrum eating disorders _[2]. Traumatic experiences, with or without a PTSD diagnosis, can lead to disordered eating behaviors as the person attempts to cope with the distressing effects of the traumatic event.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966425/
[2] Brewerton, T. D. (2007). Eating Disorders, Trauma, and Comorbidity: Focus on PTSD. Eating Disorders,15(4), 285-304. https://doi.org/10.1080/10640260701454311

The Thin Beauty Ideal

Western societies equate thinness with female beauty and success, a condition known as the “thin beauty ideal.” ^{[3] 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 bulimia nervosa. Western norms for male bodies emphasize extreme muscularity in an equally unrealistic standard. 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.}

[3] Morrissey, R. A., Gondoli, D. M., & Corning, A. F. (2019). Reexamining the restraint pathway as a conditional process among adolescent girls: When does dieting link body dissatisfaction to bulimia? Development and Psychopathology, 32(3), 1031–1043. https://doi.org/10.1017/s0954579419001287

Pressure from Social Media

With social media being a major influence on culture today, there are many negative effects that can lead to disordered eating and bulimia nervosa _[4]. Being bombarded with media images of extremely thin models, for example, promotes the internalization of anti-fat attitudes and the need to control weight. On social media, there are many images of "perfection", diet talk and before-and-after images that can influence eating disorder development and maintenance.

[4] Rounsefell, K., Gibson, S., McLean, S., Blair, M., Molenaar, A., Brennan, L., Truby, H., & McCaffrey, T. A. (2019). Social media, body image and food choices in healthy young adults: A mixed methods systematic review. Nutrition & Dietetics, 77(1), 19–40. https://doi.org/10.1111/1747-0080.12581