Anorexia Nervosa & Bulimia Nervosa: Root Causes & The Road To Recovery

Eating disorders are serious, potentially life-threatening, but treatable mental and physical illnesses.  Research shows an estimated 20 million women and 10 million men in America will have an eating disorder at some point in their lives.

Anorexia Nervosa and Bulimia Nervosa are the most prevalent eating disorders and are defined as follows:

Anorexia Nervosa

An eating disorder characterized by weight loss, difficulties maintaining an appropriate body weight for height, age, and stature, and, in many cases, distorted body image.  Those with Anorexia Nervosa generally limit the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.

Bulimia Nervosa

Bulimia is characterized by a cycle of binging and compensatory behaviors such as self-induced vomiting, misuse of laxatives, diuretics, or other medications, fasting, or excessive exercise designed to undo or compensate for the effects of binge eating.

What Causes Anorexia Nervosa & Bulimia Nervosa

No one knows exactly what causes these eating disorders.  The most recent research has been and continues to be very progressive.   As with other mental illnesses, a growing consensus suggests that it is a complex mixture of biological, psychological, and sociocultural factors which contribute to anorexia nervosa and bulimia nervosa.

These factors will interact differently with each individual, so two people with the same eating disorder can have very diverse perspectives, experiences, and symptoms.  Although the disorder most frequently begins during adolescence, an increasing number of children and older adults are also being diagnosed.

Genetics & Biology

Certain people may have genes that increase their risk of developing eating disorders. Biological factors, such as changes in brain chemicals, may play a role in eating disorders, as are having a close relative with an eating disorder.

Like other mental illnesses such as anxiety, depression, and addiction that can often run in families, the same applies to anorexia nervosa and bulimia nervosa.

Psychological & Emotional Health

Psychological and emotional problems such as low self-esteem, perfectionism, behavioral inflexibility, impulsive behavior, and troubled relationships are huge contributors to eating disorders.  Body image dissatisfaction plays a big role, as sufferers are more likely to report higher levels of body image dissatisfaction and internalization of the appearance ideal.

Additionally, research has shown that a significant subset of people with eating disorders, including two-thirds of those with anorexia nervosa, showed signs of an anxiety disorder (including generalized anxiety, social phobia, and obsessive-compulsive disorder) before the onset of their eating disorder.

Social

In the age of social media, the pressure to look a certain way (particularly thin!) has never been higher.  The messaging that skinnier is better bombards our culture, and constant exposure can increase body dissatisfaction.

Additionally, being teased or bullied – especially about weight – is emerging as a risk factor in many eating disorders.  The harmful effects of bullying have started a critical national conversation, and ironically enough, 60% of those affected by eating disorders said that bullying contributed to the development of their anorexia nervosa and bulimia nervosa.

Additional Risk Factors Include:

• A history of dieting and starvation:  Both affect the brain and influence mood changes, rigidity in thinking, anxiety, and reduction in appetite.  A history of dieting and other weight-control methods are often associated with the development of binge eating.
• Stress:  Whether it’s a family or relationship issue, major life change or applying to college, change can bring stress, which may increase the risk of an eating disorder.
• Adolescent-Onset:  Studies show that most eating disorders typically onset during adolescence, potentially due to the onset of puberty and the vast changes occurring in the body and brain at the same time.  Adolescence is a complicated time both physically and emotionally, which could have the power to trigger emotions that may lead to anorexia nervosa and bulimia nervosa.
• Type 1 (insulin-dependent) diabetes: Recent research has found that approximately one-quarter of women diagnosed with type 1 diabetes will develop an eating disorder. The most common pattern is skipping insulin injections, known as diabulimia nervosa, which can be deadly.

Proactive Prevention Strategies

There are no sure ways to prevent anorexia nervosa and bulimia nervosa, however, adults can lead the way to help their children develop healthy eating behaviors and positive relationships with food.  Some strategies include:

• Avoid dieting and being obsessive about food around your child. Family dining habits may influence the relationships children develop with food, so it’s important to cultivate a positive outlook when it comes to eating.
• Talk to your child and correct any misconceptions they may see online and in the media.  There are numerous websites that promote dangerous ideas, such as viewing anorexia nervosa as a lifestyle choice rather than an eating disorder, and it’s important to educate children before they become misinformed.
• Regardless of his or her body shape and size, cultivate and reinforce a healthy body image in your child.  Do this by expressing acceptance, healthy self-esteem and avoid criticizing your own body in front of your child.
• Enlist the help of your child’s doctor. At well-child visits, doctors may be able to identify early indicators of an eating disorder by asking questions about their eating habits and satisfaction with their appearance. These visits should also include checks of height and weight percentiles and body mass index, which can alert any significant changes.

Ways to Overcome an Eating Disorder

The root causes of anorexia nervosa and bulimia nervosa are complex, but the good news is that there are many programs and professionals that can help with recovery.  With consistent treatment, support, and various self-help strategies, one can find healthier ways to cope with negative feelings to gain true self-confidence.

Here are a few steps that can help overcome anorexia nervosa and bulimia nervosa:

Admit that you/your loved one has a problem.  The road to recovery starts with one step, and this is the admission that a problem exists.  Often this first step is the most difficult, but change can’t happen without it.

Reach out for support.  Whether it’s a family member, close friend, teacher or spiritual leader, opening up about the problem and seeking counsel and comfort is a crucial step toward getting healthy.  Remember that you are not alone and with the right support and guidance, you can take the appropriate steps needed to overcome the eating disorder.

Assemble a treatment team.  Nothing is more important than your well-being and it’s important to gather a team of professionals that can help address the emotional, medical, and nutritional consequences that may have resulted from the eating disorder.  This support team can address every aspect of the problem and it’s important to focus on finding the right fit – people who make one feel safe, comfortable and accepted.

Create a long-term treatment plan and stick to it.  Once the eating disorder-related health problems are under control, a long-term recovery plan should be created.  This plan will differ based on each individual’s needs, and may include:

• Individual or group therapy
• Family therapy
• Nutritional counseling
• Medical monitoring by a doctor
• Psychiatry
• Creative arts therapy
• Exposure activities
• Residential treatment for more serious cases

Develop self-help strategies.  A big part of healing is learning personal strategies to find inner peace and cope with the disorder. This may include:

• Establishing healthier skills when facing negative emotions and dealing with life’s challenges
• Understanding triggers and how to figure out what’s really going on inside
• Focusing on the things/hobbies/people that provide joy
• Developing a balanced, healthy relationship with food, which doesn’t involve dieting
• Journal writing and other creative outlets

The video below showcases the success story of Kristina Saffran, who used her personal struggles with anorexia nervosa to create Project HEAL, a non-profit organization which raises funds to help eating disorder suffers afford treatment.

The road to recovery is not just about adopting healthier habits but is also contingent on consistent attention to both the physical and mental aspects of anorexia nervosa and bulimia nervosa.  It’s important that both the sufferer and his/her support system are constantly monitoring the progress in order to prevent relapse.

Also, remember that recovery is a process, which often includes setbacks. True recovery from an eating disorder involves learning to:

• Listen to your feelings
• Listen to your body
• Accept yourself
• Love yourself

The American Brain Society is proud to support two Anorexia Nervosa research projects.

Taste Preferences, Brain Reward Circuitry Activation, & The Neurobehavioral Effects Of Weight Restoration In Anorexia Nervosa

Taste Preferences, Brain Reward Circuitry Activation, & The Neurobehavioral Effects Of Weight Restoration In Anorexia Nervosa
View Project

Role of Oxidative Stress in Patients with Anorexia Nervosa
View Project

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