What Are The Causes Of Anorexia Nervosa?
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Determining the cause of an eating disorder can be complicated. However, acknowledging the symptoms and feelings behind it can often be the first step toward healing.
Today, we’ll discuss potential causes of anorexia nervosa: an eating disorder that’s generally defined by persistent refusal of food and extreme fear of weight gain, among other symptoms.
Read on to learn more about what anorexia is, possible causes and the role that therapy can play in a full recovery.
Understanding eating disorders
Eating disorders are complex mental health conditions involving disordered eating behaviors, intense fear of gaining weight, and distorted body image perceptions. Here are two of the most common types of eating disorders:
Anorexia nervosa is an eating disorder characterized by an intense fear of gaining weight and a distorted body image, often leading to severe restrictions in eating behaviors and a dangerously low body weight.
Bulimia nervosa involves cycles of binge eating followed by purging to prevent gaining weight, which can result in serious health issues such as low blood pressure and other complications of anorexia, bulimia, and similar eating disorders.
The development of anorexia and other eating disorders can be influenced by factors like family members' attitudes toward body weight and image, highlighting the need for family-based support. To manage these long-term conditions, it’s often crucial to find a doctor experienced in treating eating disorders and to engage with support groups that can provide both emotional and practical assistance.
What is anorexia?
Beyond food aversions, restriction, and a distorted body image, people with anorexia may have difficulty maintaining a normal body weight. Anorexia isn’t always a primary mental health condition and may occur alongside orthorexia: which is often defined as an obsessive concern with eating healthy, often paired with excessive exercise.
Health professionals may divide anorexia into two subtypes:
Restricting: Those who live with this type of anorexia may limit how much they eat throughout the day, which may or may not be impacted by their body image.
Eating/purging: People who live with this type of anorexia may consume large amounts of food, making themselves throw up or using laxatives to “get rid” of the food. This may or may not have an emotional component underlying the behavior.
Some people with anorexia may also be diagnosed with other eating disorders, such as bulimia nervosa or binge-eating disorder (BED). A person with anorexia may experience these conditions simultaneously, or at different points in their lives.
Ultimately, eating disorders can be about more than just food — often pointing to unresolved feelings or traumatic experiences that drive a need for self-control and mastery. It takes time, patience, and self-compassion to make a sustained recovery, but with proactive treatment, recovery can be possible.
What are the causes of anorexia?
Researchers and healthcare professionals have yet to identify a singular cause for anorexia. Generally, a combination of genetic, biological, behavioral, psychological, and social factors can increase a person’s risk of developing this disorder.
Below, we’ve summarized how these factors influence the likelihood of developing anorexia, how they can play a role in the progression of this eating disorder, and how understanding these causes can streamline the path to treatment.
1. Genetics
Researchers have studied the role of genetics in eating disorders — and have encountered potentially surprising findings. To date, studies of families and twins have suggested that eating disorders run in families due to common genetic factors. Additionally, recent research indicates that genetic contributors to anorexia are related to both psychological and metabolic factors. This research can potentially allow researchers to identify more genetic factors linked to anorexia and other eating disorders.
2. Metabolic risk factors
One of the largest studies of anorexia, conducted in 2019, was the first to highlight metabolism as a potential contributor to the disorder, based on figures from 16,992 anorexia cases gathered from 17 countries.
For people with anorexia, this can imply that in addition to psychological factors, biological differences in metabolism may also influence extreme weight loss and “relapse”.
Therapy, in this context, along with other supportive strategies, can still be an effective way to address the underlying mindset and thought patterns associated with anorexic behaviors.
3. Cultural pressures
While cultural pressures are not the sole contributor to anorexia, it’s impossible to dismiss the effect of beauty standards and weight stigma on our mental health. Across cultures, many TV shows, movies, social media, and other forms of content present thin bodies as the ideal or standard.
Today, many activists and mental health care advocates speak openly about the enduring impact of weight stigma and fatphobia, in both daily life and healthcare settings. In some cases of anorexia, messaging from a TV show, doctor, or another authority can catalyze or worsen existing anxieties around weight loss.
4. Environment
While a person’s environment includes their culture, it also encompasses family dynamics and relationships that can influence their behaviors around food and weight.
Naturally, individuals respond differently to family dysfunction, dieting, ideals of thinness, and other environmental risk factors for anorexia. The impact of environment also depends on a person’s age, gender identity, personality traits, and other individual factors, which can interact with genetic risks.
As a result, two people – even siblings – can grow up in a similar environment, yet emerge with different mentalities around food, exercise, and body image.
5. Preexisting mental health conditions
People with anorexia may live with other mental illnesses, such as depression, anxiety, obsessive compulsive disorder, personality disorders, or substance use disorders. Studies indicate that between 55% and 95% of people diagnosed with an eating disorder will experience another psychiatric disorder in their lifetimes.
While the co-occurrence of other mental health conditions is common among people with eating disorders, it’s not always possible to determine whether the eating disorder “caused” the other illness, or vice versa. Nevertheless, these additional diagnoses can complicate both the symptoms and treatment of anorexia.
6. Brain chemistry
According to the National Eating Disorders Association, researchers have identified neurobiological differences in the brains of people with anorexia.
Studies show that when people with anorexia are actively experiencing the disorder, they have significantly lower levels of serotonin: a brain chemical that controls everything from learning and sleep to mood and appetite. Even after recovering from anorexia, people tend to have elevated serotonin levels, which can correspond with higher anxiety and obsessive behaviors.
People with anorexia may also have elevated levels of dopamine: a brain chemical linked to pleasure, reward, memory, hormones, and other essential processes. In people with anorexia, researchers believe that the over-production of dopamine can lead to anxiety, harm avoidance, and the ability to go without pleasurable things like food.
7. Brain structure
During puberty, young people experience hormonal shifts and changes in brain structure, which may “turn on” a person’s genetic susceptibility to disordered eating, according to a 2013 study.
While more research is needed to understand the connection between hormones and brain structure, parents and other adults can still model healthy behaviors around food, exercise, and body image, especially during puberty: a critical risk period for anorexia and other eating disorders.
Treatment options for anorexia
Typically, the treatment for anorexia can involve a combination of therapy and restoring the person to a healthy weight and diet. Treatment will vary depending on your specific needs, and history, however — which is best given by a qualified medical practitioner. For many people with anorexia, therapy can be an essential part of the recovery process. Speaking with a therapist can help one to unravel the possible causes of the disorder and potentially pave a path toward a healthier future.
Traditional talk therapy and cognitive behavioral therapy (CBT) are both research-backed options for patients with anorexia. A licensed therapist may use a combination of CBT and other techniques to help patients identify the connection between their thoughts, feelings and behaviors, potentially working toward changing their behaviors around food and exercise.
Online therapy for anorexia recovery: How can it support those living with anorexia?
Today, many people use online therapy to support their eating disorder recovery and other mental health goals. Platforms like BetterHelp can connect patients to licensed therapists, and clients can schedule sessions at a time and place that works best for their schedules. Many BetterHelp therapists specialize in supporting people with anorexia and related mental health concerns.
Online therapy for anorexia recovery: Is it valid?
In general, online therapy is shown to be effective and continues to improve. A 2019 review of digital therapies for eating disorders, including anorexia, suggests that online therapies successfully reduced symptoms as well as anxiety disorder manifestations and depression — based on results from 23 studies.
Takeaway
What is one problem that can be caused by anorexia nervosa?
Anorexia nervosa (AN) can cause many problems in a person’s life, from severely low body weight to multiple medical issues to comorbidity with other mental health disorders.
What is the social cause of anorexia?
Social causes of anorexia include, but may not be limited to, peer pressure to adhere to unrealistic beauty standards and societal preoccupations with slenderness. These factors can contribute to low self-esteem and intense fear of judgment from others.
Who is most likely to have anorexia and why?
While more current research is required for updated information, anorexia appears to be more common in girls and women. According to The National Eating Disorders Association, anorexia most frequently surfaces in adolescence, but children and older adults can be diagnosed, too.
The reasons for this are complex, but several factors may cause the fear of gaining weight experienced by women and girls with anorexia-- including cultural attitudes toward body shape, familial expectations, and media exposure that reinforces the ideal of thinness.
What can individuals suffering from anorexia also suffer from?
People with eating disorders like anorexia may have co-occurring mental conditions like anxiety, depression, and obsessive-compulsive disorder (OCD). Life-threatening physical complications are also possible for people with anorexia, including cardiovascular and gastrointestinal conditions.
What is a problem in treating individuals with anorexia nervosa?
People with AN may feel that their self-destructive beliefs and behaviors around food are not a problem and may even be beneficial. This can create significant challenges for mental health professionals by hindering recovery and treatment adherence.
What is a characteristic of an individual who suffers from anorexia nervosa?
AN presents differently between individuals, so assessing if someone has the disorder may be tricky. But there are some common symptoms of anorexia you can watch out for:
- An intense fear of gaining weight.
- A pattern of abnormal food intake.
- Obsessive thoughts about food and calorie intake.
- Excessive/compulsive exercise to lose weight.
- Using supplements, diet pills, and other methods to prevent weight gain.
- Distorted perception of physical appearance.
You may also notice physical symptoms beyond dramatic weight loss. These may include difficulty controlling body temperature (always cold), abdominal discomfort like bloating and constipation, dizziness and fatigue, or hair loss.
What diseases cause the inability to gain weight?
Some conditions can cause an inability to gain weight or sudden weight loss, such as thyroid disorders, diabetes, cancer, Crohn’s disease, and ulcerative colitis. Mental illnesses such as depression, anxiety, and OCD may also affect an individual’s ability to gain weight.
What is the biological explanation of anorexia?
It is unclear if there is a biological cause of anorexia, but studies out of Colombia University suggest it is possible. In one study, researchers found that when subjected to a reduced calorie diet and exposed to stressful environmental factors, mice with a genetic variant linked to anorexia in humans stopped eating entirely. In another study, MRI brain scans of people with and without eating disorders show differences in brain functioning between people with anorexia and people without, specifically in areas associated with food selection.
What is the first goal of the treatment of anorexia nervosa?
The first and most important goal of treatment for anorexia patients is gaining weight. Physicians work closely with nutrition specialists and psychologists to stabilize the patient’s body weight and teach them to maintain it using proper nutrition and healthy eating habits.
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