Family History, Body Image, And Other Risk Factors For Eating Disorders

Eating disorders can lead to serious health complications, potentially involving hospitalization and requiring nutritional intervention to stabilize patients. Even the many people with eating disorders who may never reach that point can experience ongoing feelings of low self-worth and hopelessness. Understanding the risk factors for eating disorders and how eating disorders are treated could help to connect individuals with support. 

What are eating disorders?

Eating disorders are mental disorders that often involve disturbances in eating habits that result in changes to the way one consumes and processes food, typically with serious adverse effects on a person’s functioning and overall health and well-being. Disordered eating is often pursued with the goal of attaining a specific body weight or shape, usually prompted by concerns about body image. Eating disorder behaviors can also be deployed as a coping mechanism to process negative emotions and exert a sense of control over one’s life. 

Common eating disorders

The most prevalent eating disorders include:

• Anorexia nervosa: Anorexia is an eating disorder that typically involves an obsessive focus on weight loss and severe restriction of food consumption in an attempt to lose weight, sometimes to the point where hospitalization is necessary. 
• Bulimia nervosa: Bulimia typically involves binging, or eating large amounts of food in a short period of time, and purging, or engaging in compensatory behaviors, such as vomiting or taking laxatives. 
• Binge eating disorder: Binge eating disorder typically involves binging but not the purging behaviors associated with bulimia. Binges may be an attempt to cope with unpleasant emotions. 

Risk factors for developing an eating disorder

There can be numerous risk factors for developing eating disorders. These may include genetics, family history, and environmental factors. 

Possible genetic components of eating disorders

One risk factor for developing an eating disorder could involve a person’s genetics. Eating disorders can run in families, but it has previously been unclear if there is a genetic component or if children of a person with an eating disorder might develop disordered eating habits because that is what has been modeled for them. One recent study, though, found that genetics may play a role in the presence of certain gut bacteria that could lead to dysregulation of a person’s appetite, which has been linked to developing eating disorders. 

Other mental health conditions

Some additional mental health conditions (sometimes erroneously referred to as “mental health issues”) could be risk factors for the development of an eating disorder. Obsessive-compulsive disorder (OCD) is associated with the same rigid and perfectionistic thinking patterns common in eating disorders, and disordered eating patterns could become an OCD compulsion. Depression, anxiety, and other mood disorders could heighten the risk of engaging in maladaptive coping mechanisms, including disordered eating behavior. Substance use disorders can also frequently co-occur with eating disorders. 

Other risk factors that can lead to an eating disorder

While beauty standards may often be more salient for women, men may also engage in disordered eating to achieve aesthetic appeal, though it may be more focused on accumulating muscle mass than losing weight.

Being shamed for one’s weight or physical appearance can be another risk factor, as can having low self-esteem in general. A prior history of trauma can heighten the risk of many mental illnesses, including eating disorders. 

Can eating disorders be prevented?

Many of the risk factors listed above can be addressed, while some, such as genetics, cannot be changed. Also some factors, such as cultural ideals, may be more difficult to manage. 

Preventing eating disorders through a cultural shift in perceptions of thinness and dieting

In a culture that prioritizes thinness, many people may be at elevated risk of developing an eating disorder. Changing these cultural ideals could be one of the more effective ways of reducing this risk, but it may take time. Small steps could include role-modeling and promoting acceptance of a diverse range of body shapes and sizes, critiquing media portrayals that hold up thinness as the only standard of beauty, and shifting conversations about dieting and losing weight toward health and well-being. 

What groups are most often affected by eating disorders?

Eating disorders may often be thought of as primarily affecting women, and research has indicated that women do have a higher prevalence of eating disorders. Other statistics confirm that eating disorders can be more prevalent in adolescence and young adulthood. However, stereotyping all eating disorder patients as girls and young women can have unintended consequences. 

The negative impacts of eating disorder patient stereotypes

Framing eating disorders as predominantly affecting women can ignore the prevalence and impact of eating disorders in men. Interventions for eating disorders may be designed primarily to focus on achieving a healthy weight (often requiring weight gain), as presentation of the disorders in women may be more associated with dangerous levels of weight loss. However, in men, eating disorders can result in the overconsumption of specific food groups and the use of anabolic steroids to build muscle mass, which may require different types of treatment approaches. 

Mental health impacts of eating disorders

While mental health conditions can increase a person’s likelihood of developing an eating disorder, the cycle can also work in reverse—having an eating disorder can increase the risk of developing other mental health concerns. People with eating disorders often experience a low sense of self-worth and high levels of stress about food consumption and weight gain, which can lead to the co-occurrence of depression and anxiety. 

As mentioned above, substance use disorders and other unhealthy coping mechanisms may also develop in an attempt to quell negative emotions associated with disordered eating. The physical health consequences of eating disorders could also lead to mental and emotional impacts. For example, people who are not consuming enough calories may experience brain fog and difficulties with concentration and memory.

Mental health support for people with eating disorders

The negative thought patterns and rigid eating behaviors associated with eating disorders are often difficult to resolve on one’s own. However, there is help available. Medical intervention and regular counseling with a mental health professional can alleviate eating disorder symptoms. 

Online therapy

Eating disorders are often associated with high levels of shame, guilt, and embarrassment. Some people with eating disorders may be resistant to the idea of acknowledging that there is anything unhealthy about their behavior. All of these situations can be barriers to authentic engagement in therapy. Online therapy may provide a sense of distance that could help someone with an eating disorder become more open to discussions with a therapist. With online therapy, individuals can also reach out to their therapist at any time via in-app messaging, and the therapist will respond as soon as they can. This may be helpful if they experience challenging thoughts or emotions in between sessions.  

Research has indicated that online therapy can be an effective treatment for eating disorders, and that outcomes may be comparable to engagement in traditional in-person therapy. One study examined the use of online therapeutic interventions for people with bulimia and found that online therapy reduced symptoms at comparable rates to in-person therapy.