What Causes Eating Disorders?

Eating disorders are caused by a complex combination of biological and environmental factors. Having these factors doesn’t necessary mean someone will experience an eating disorder.

Causes include:

• Genetics: eating disorders may run in families, but this doesn’t mean everyone with a family history will develop an eating disorder
• Environment: bullying, peer pressure, sociocultural thin-idealization
• Epigenetics: how your environment influences or impacts your gene expression or the interplay between genetics and environment

A 2022 study revealed that the eating disorder anorexia can lead to structural changes in certain areas of the brain.

Specifically, grey matter, the area involved in sensory perception, emotions, memory, speech, self-control, and decision-making, was 2-4 times smaller in people with anorexia than in people with ADHD, OCD, and depression.

This study speaks to the importance of early intervention to prevent brain changes that may make recovery more challenging.

Risk factors for eating disorders

Under the larger causes of eating disorders are the many risk factors that may contribute to a person’s susceptibility of developing an eating disorder.

• early puberty
• neurochemical regulation differences
• gene mutations
• body dissatisfaction
• perfectionist tendencies (especially when combined with low self-esteem)
• mood disorders and substance use disorders
• traumatic chronic abuse (ie., sexual physical, or emotional abuse)
• parental figures expressing body dissatisfaction or thin-ideal
• parental figures who are overly critical or overly involved (negating self-expression and autonomy)

Symptoms of eating disorders include physical symptoms, emotional or psychological symptoms, and social symptoms.

Generally speaking, early warning signs of eating disorders include:

• drastic weight changes
• strict adherence to diets
• obsession with food, calories, or exercise
• secretive behaviors (ie., eating in private, hiding food, withdrawing from friends and family)
• preoccupation with body image and body size

Each type of eating disorder may also have its own specific warning signs.

Anorexia symptoms:

• severe calorie restriction
• intense fear of gaining weight
• perfectionist tendencies

Bulimia nervosa symptoms:

• recurring episodes of uncontrolled binge eating
• purging behaviors to counteract calorie consumption
• oral health issues including tooth decay and mouth ulcer from self-induced vomiting

Binge eating disorder symptoms:

• recurrent episodes of binge eating which include feeling distressed while and after eating
• no counteractive or compensatory behaviors after binging (ie., no purging)

Establishing a healthy body image, sense of self-worth, and relationship to food are all protective factors in preventing eating disorders.

Some causes of eating disorders, like genetics, are out of your control. But there are some ways you can prevent an eating disorder from getting worse.

If you notice signs or symptoms of eating disorders in yourself, consider telling someone you trust and seeking support as soon as possible. The earlier you seek help, the better chance you have at a full recovery without lasting health complications.

If you have risk factors for developing an eating disorder, you may also want to consider taking an online screening for eating disorders. You can also talk with a doctor about the possibility of early intervention programs in your area or virtually.

Without treatment, eating disorders can lead to severe health complications, including death.

Health complications of eating disorders include:

• heart problems — including low blood pressure, heart attack, and heart failure
• severe digestion slowing (gastroparesis) in anorexia
• potential stomach rupture in binge-eating based disorders
• food obsession that create dysfunction in everyday life (ie., you can’t think of anything else beyond what you are about to eat, what you already ate, what you can’t eat, etc.)
• sleep problems from being excessively hungry or uncomfortably full
• hormonal changes leading to body temperature dysregulation, missed menstruation, lack of sex drive, hair loss or fur-like growth, and type 2 diabetes
• overall malnutrition (ie., dry skin, brittle nails, vitamin deficiency, low energy, bone loss)

Anxiety, depression, substance misuse, and suicidal thoughts are all more common in people with eating disorders. Research says there’s a strong link between eating disorders and alcohol use disorder, with the most common co-occurrence being between bulimia nervosa and alcohol use disorder (AUD).

Early treatment has been recommended as a way of preventing health complications associated with eating disorders, including grey matter damage in people with anorexia.

Standard treatment options for eating disorders include:

• Cognitive behavioral therapy (CBT): helps a person develop and practice coping tools in recovery
• Family therapy or interpersonal therapy: helps the family team unit recover together
• Nutritional therapy: may include working with a dietician to develop an eating plan that suits your current needs
• Antidepressants: for binge eating and symptoms of anxiety and depression

The causes and risk factors of eating disorders are complex. Causes include any combination of genetics, environment, and epigenetics. Risk factors are plenty and include things like early puberty, body dissatisfaction, dieting, and mental health conditions.

Symptoms of eating disorders affect every body system, from the brain to the heart to the digestive tract. Eating disorders can lead to severe malnutrition, suicidal ideation, and death.

Prevention may include recognizing risk factors and entering an early intervention program, if possible. Prevention of serious health complications is achieved through early treatment, which can include therapy and medication.