“You’re so boring now; you don’t eat anything good anymore” someone joked when I was at the height of my eating disorder. It was meant to be a lighthearted response to me declining *another* offer to go get ice cream, but it kind of stung. It was true: I used to love going to get ice cream, but I didn’t anymore. The idea of it actually enraged me. But I didn’t choose to feel this way. I didn’t choose to feel my heart race with anxiety at the mere mention of ice cream.  I didn’t choose to have an eating disorder.

There’s a common misconception – not always overtly stated (in my own experience at least) – but one that is implied – that someone chooses to have their eating disorder. That they choose the restricting, the binging, the purging, the obsessive thoughts, the “willpower,” the “discipline.” 

The implications that eating disorders are the result of a decision come in many forms: jokes, compliments on weight loss or a changing body, questions about how you *stay so disciplined,* various expressions of envy, or comments about how you *just need to eat more.* 

A Deeper Understanding of Eating Disorder Development

I found (and find, still, at times) that the societal implications that my eating disorder was somehow my *choice* left me feeling a lot of frustration and shame when I wasn’t able to simply snap out of it. So, I write this to affirm the experiences of those who have struggled with or are struggling with an eating disorder, and to help inform those who have not struggled with one. 

Eating disorders are complex mental illnesses that often involve a range of biological, environmental, emotional, and interpersonal psychological factors that may contribute to their development. Below are some examples of contributing factors that fit into each of the given categories. These are – by no means– comprehensive lists. This is meant to be a reminder of the complexity of eating disorders, that none of us who have one or have recovered from one have chosen to engage in this battle with our own minds and bodies.

Some of the factors that actually do contribute to the development of an eating disorder:

Biological Factors

Research suggests that there are biological and environmental factors that can contribute to eating disorders. Some of the biological factors that have been linked to eating disorder development are:

  1. Genetics: There may be a genetic component to eating disorders, as research has shown that certain genetic variations may increase the risk of developing an eating disorder. Research has shown that 40-60% of the vulnerability to eating disorders may actually be due to genetic factors. Some genes that are thought to contribute to eating disorders are associated with specific personality traits, such as:
    1. Obsessive thinking
    2. Perfectionistic tendencies
    3. Sensitivity to reward and punishment
    4. Emotional instability
    5. Hypersensitivity
    6. Impulsivity
    7. Rigidity
  1. Brain chemistry: Changes in brain chemicals like serotonin, dopamine, and norepinephrine have been linked to eating disorder development 
  2. Hormonal imbalances: Hormonal changes that happen during puberty, pregnancy, and menopause may contribute to the development of an eating disorder. (This is not to say that everyone who experiences fluctuations in hormones will develop an eating disorder; this is to highlight that, for some who do develop eating disorders, hormonal changes and imbalances could be a factor).

Environmental, Interpersonal, and Social Factors

  1. Environmental factors such as trauma, abuse, and neglect can contribute to the development of eating disorders. For example, different types of trauma can greatly impact someone’s ability to cope with emotions, situations, and life circumstances, making them more susceptible to the grips of an eating disorder.
  1. Unstable relationships, break-ups, divorce, or other relationship dynamic fluctuations or shifts can be triggers for the onset of an eating disorder. 
  1. Societal pressure to conform to certain body ideals can also contribute to the onset of eating disorders. The prevalence of unrealistic beauty standards and the constant bombardment of diet culture can contribute to body dissatisfaction, low self-esteem, and disordered eating behaviors.

Psychological and Emotional Factors

  1. Psychological factors such as anxiety, depression, and obsessive-compulsive disorder (OCD) have been linked to eating disorders. Similarly, studies have shown that people with OCD are more likely to fixate on food and eating behaviors, which can lead to the development of eating disorders. 
  2. Low self-esteem or struggles with body image can be psychological contributors, too. 

The Bottom Line:

There are a multitude of factors that can contribute to the development of an eating disorder – more than are listed here. One of those factors is not, however, an active decision to have an eating disorder. If you are a loved one, friend, or acquaintance of someone who has an eating disorder, please remember that eating disorders are often the result of a multi-layered set of factors. Being there for your loved one and showing compassion and empathy are among the most helpful supports you can provide during the recovery process.

And If you have or are in recovery from an eating disorder and have struggled with feelings of shame or frustration when you aren’t able to “talk your way out of” your eating disorder, please know that this is because you cannot talk your way out of a serious illness. And eating disorders are just that: a set of very serious and complex mental illnesses. For many, they are the result of many different contributing factors. Understanding the factors that may have contributed to yours can be a necessary and helpful part of your own journey. Remember, recovery is possible, and seeking help for your eating disorder is a courageous step in the direction of recovery.

By: Erika Muller, Assistant for Wildflower Therapy LLC

All images via Unsplash

Sources: American Psychiatric Association, National Institute of Mental Health, and A Better Understanding of Eating Disorders and Genetics

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We offer services for eating disorder therapy, services for anxiety, and depression, and have practitioners who specialize in perinatal mental health , maternal mental health, therapy for college students and athletes. As well as LGBTQIA+ Affirming Therapy. As you can see, we have something to offer just about anyone in our Philadelphia, PA office. Reaching out is often the most difficult step you can take to improve your mental health. We look forward to partnering with you on this journey!