Eating disorders are both dangerous and difficult to understand. Knowing how an eating disorder started can be a key factor in healign and recovery.
How and why do eating disorders start? And what keeps them going? An idea of what made it start can help to guide treatment and any work you do with a therapist or dietitian. Also, knowing the factors behind the development of an eating disorder helps alleviate a lot of shame and self-blame we can feel about the idea of having an eating disorder.
Seeing eating disorders realistically
How we eat is commonly seen as a choice. If it is a choice we can wonder if it’s ‘my fault for having the problem’. But choices are multilayered and even in seemingly simple choices there are a lot drives and impulses going on behind the scenes. Things that we are not aware of that guide choices. Treatment and dealing with eating disorders is about bringing these kinds of impulses and drives to light – bringing awareness into those things we have been unaware of.
5 issues in the development of eating disorders
Everyone is different and unique, and yet there are some commonalities in the development of eating disorders when you break it down. You might identify with one or more of these. They are not mutually exclusive. And often the more we can identify in our life and experiences, the more it makes sense that an eating disorder has developed. Why do they start – here’s 5 things that can be involved:
1. Trauma or Overwhelming Life Events
There are a great deal of people who suffer eating disorders who report trauma in the past. Things like abuse, particularly physical or sexual abuse is more common among people who suffer eating disorders compared to the general public. Experiences of bullying are also common. Not everyone who has an eating disorder has experienced trauma, but nearly all have some sort of overwhelming event that seems to kick of the eating disorder. Some sort of extreme stress or something that they had to deal with that felt like a lot.
It is not always obvious that the trauma or overwhelming things starts the eating disorder. Eating disorders are things that develop over time, so it may not be a noticeable problem until months or even years later.
Why would trauma or overwhelming events lead to an eating disorder? There may be a number of factors but they usually converge around the use of food or the body as a way to feel different. A desire to feel better. An example is restricting food – not eatinf enough – can create a sense of purpose or control. This might be a conscious choice and feel related to a diet or body related goal. Or it may arise unintentionally due to stress. In whatever way it develops, restricting food provides a way to change the state of the nervous system, to redirect emotions and thoughts and shift focus.
Likewise, eating more food than usual, like in binge eating disorders or the over-consuming phases of bulimia, often start as a way to feel calmer, to get some relief or to create nice feelings in the midst of difficult experiences. When we have more food our nervous system calms and switches to a resting, digesting mode. We also get the nice feelings that come with ‘binge-friendly’ foods and the relief of a shift of focus away from something overwhelming.
Too much food, not enough food or any combination of dysregulated eating (including purging behaviors like vomiting or overexercising after eating) all change the state of the nervous system and shift the focus. The drive is to feel different, to feel better when something has been overwhelming.
2. Illness related weight changes
Sometimes an illness makes it difficult to eat and we lose weight unintentionally. A physical illness or deep depression are often associated with less desire to eat. Some people trace the start of their eating disorder to an unintentional weight loss, such as this. Neurobiological eating disorder experts point to changes in brain function during times of starvation or restriction. They suggest that the changes in the brain might be enough to kick off an eating disorder, making it difficult to return to normal eating when the illness is over. I have often seen clients who did not think much about their body image before they hit an illness. Afterwards they became focused more on body and struggled with food control. Sometimes they had comments from people about the physical changes and this contributed to beliefs about body that fed into an eating disorder.
3. Neurodivergancy
Differences in the way we process information means that we experience sensations, like hunger and food textures differently, too. Challenges that some neurodivergent people face around time management and planning also play into eating disorders. A good example is someone who suffers ADHD not noticing they are hungry, being distracted, not eating enough throughout the day and then being so hungry at night that they binge eat. Or people on the autism spectrum that don’t feel attracted or drawn to the feeling, the sensation of food. It can get forgotten or seen as not necessary compared to other things and they fall into an unintentional pattern of restriction.
4. Relationships and Family Dynamics
Like most things, some of our most deeply entrenched ideas begin in the family. Our most influential relationships with family, friends and partners form the basis for what we think about ourselves, the world. These relationships can also influence the beliefs we have about bodies and health.
There are a huge range of situations here that can influence eating disorders later on down the road, from seemingly innocent comments about diets and bodies all the way to cruel criticisms about looks and appearance. Even in good, healthy relationships, we are engaged in a constant curiosity about how others feel about us, and how they feel about the way we look.
Our eating habits are also heavily influenced by those around us. We might have observed a parent being on diet and expressing dislike for their body. How our parents talk about themselves is almost as influential as how they talk about us. It can leave an impression.
Another area we are heavily influenced is how the family uses food to comfort or celebrate. If they overeat, under-eat as well as how they cook and what ranges of foods they are comfortable with all have an impact on us later in life. Having less confidence in the kitchen – cooking and cleaning – can make it more difficult to develop a healthy relationship with food. And if cooking, cleaning is not something your family did, it’s difficult to start yourself.
5. High achieving or perfectionistic mindsets
Eating disorders of all types share in some form of unrelenting high standards that make it difficult to accommodate uncertainty, failure and self-compassion. These mindsets are characterized by all-or-nothing thinking. Something is either all good or all bad. And the body, food, the diet are also evaluated by these unrealistic ideals.
People can often see how they or their loved one who is restricting food, exercising heavily and counting every calorie has unfair, unrealistic standards. What can be more difficult to understand is how the uncontrolled, over-eating fits into this. However, the perfectionistic mindsets are the common factor, the common roots of nearly all eating issues. The outside behaviors – the fruit of the mindset – just look different.
When overeating or binging happens the person is often overcome with guilt and shame. This shame is a by-product of standards that demand no failure, no mistakes and have difficulty accommodating the fact that messing up is human. It leads to a one of these two ways of making the shame go away. 1) Ignore/avoid – which leads to further binges and more guilt. 2) Remove the shame – purge it through vomiting, laxative misuse, over-exercise or future food restriction.
A note on the differences and similarities of eating disorders
It’s important to note that although we make these distinctions between eating disorders, most people who suffer an eating disorder don’t fall easily into one category forever. Instead, what usually happens is that the eating disorder has one primary way of expressing itself that shifts over time. So someone can start of heavily restricting, after a period of time they might binge. This can often happen because the body is crying out for nutrition and it overrules the willpower. This can kick off a new phase of the same eating disorder, it just looks different.
What about body image?
What’s not on the list but underlies all of these in some way is body image. Body image might map onto any of the above in various ways – like getting a sense of control after something traumatic that happened to the body. Or perfectionistic standards for the body. While poor body image is a factor in many eating issues, it can be unhelpful for it to be seen as the primary cause. Although I do work on body image with my clients, I find it’s more useful to shift the focus to the reasons why we feel we need to use our body in this way.
Our body is supposed to live, breathe, digest, sense things and move us through life. The idea that we have to love it, we have to approve of it’s appearance is a dysfunctional idea that comes from how images of bodies are used to manipulate us. We have been trained to believe that appearance leads to happiness. And that the right product or behavior will make us feel better and finally love our body, accept ourselves. The reality is that we can’t love our bodies enough to make the world feel better, relationships feel safer or success feel easier. Typically those are things that really drive the idea that I need to approve of my body. Because if I approve, others will and then all this good stuff will happen. Instead, we need to free ourselves from the prison of believing that our body is something to be judged. We need to learn to see and experience it as it is.
Reach Out For Help
Eating disorders can be dangerous and potentially deadly. So, if you identify with any of these, reach out for help. It can feel overwhelming to begin to focus on the problem, and finding solutions can feel impossible; however, you are not alone. If you need help, talk to a supportive friend or doctor, or find a therapist. Therapy offers a place to deal with the emotional issues that drive these problems. Working with a therapist can help you find confidence in your ability to cope and have a healthy relationship with food.
Eating Disorder Therapy in Katy, TX
If you are ready to take control of your eating disorder, you can reach out to me via my contact page.