What causes anorexia?

The cause of anorexia nervosa is not known. Anorexia usually begins as innocent dieting behavior, but gradually progresses to extreme and unhealthy weight loss. Social attitudes toward body appearance, family influences, genetics, and neurochemical and developmental factors are considered possible contributors to the cause of anorexia.

Persons who develop anorexia are more likely to come from families with a history of weight problems, physical illness, and other mental health problems, such as depression or substance abuse. Further, often persons with the disorder come from families that are challenged by appropriate problem solving, being too rigid, overly-critical, intrusive, and overprotective. Persons with anorexia may also be dependent, immature in their emotional development, and are likely to isolate themselves from others.

Other mental health problems such as anxiety disorders or affective disorders are commonly found in persons with anorexia.

Lisa Palmer
Marriage & Family Therapy

The common belief behind the symptom of anorexia is "fat phobia" and need for control. But, it is so much deeper, and that's why solutions aren't simple. After ruling out a physical health condition, we have to consider the many different rationales for food refusal that few are even aware of.

Believe it or not, there have even been studies showing that non-Caucasian women may not actually present with the same rationales for food refusal such as "fat phobia" as Caucasian women.  It is always important to realize that there are many differing reasons based on culture, gender, and race. Those looking for a "cause" of anorexia may stumble over current biomedical, psychological, and cultural understandings, but there has been no single paradigm established for the "real" origin of the disease.

Those from the biological view look at metabolic and hormonal disturbances.  Learning theories suggest that the avoidance of weight gain is promoted and awarded by society and the family. There are also medical explanations and excuses--stomach bloating and lack of hunger and appetite. Psychological states analyze the individuals perception of themselves and how food restriction is used as a coping mechanism and craving attention. There is also thinking negative thoughts about the food itself. Sometimes food restriction is used to obtain a sense of stability and structure in everyday life, or to avoid negative emotions and difficult experiences by concentrating on food. Sometimes it is a way to achieve a child-like appearance, or reject sexuality. It's also been thought of as failure to connect to or accept one's own needs, a rejection of feelings, or practice control over one's feelings and desires through the body, so it becomes a way to self-assert.

Food restriction is also thought to be reaction to family problems and conflicts, or sexual abuse or incest. Family disturbances involving overprotection, rigidity, conflict avoidance, enmeshment, reduced communication or expressiveness, and focus on perfectionism are also considered.

There are sometimes religious reasons why people restrict food. Cultural assimilation and adjustment issues may also be a trigger. There are other more commonly recognized explanations having to do with societal impacts regarding psychological struggles of modern day women in transition, stereotypes that women are taught to live up to, and messages we receive about food itself as to whether it is "good or bad".  

There is no single known cause of anorexia. Eating disorders are real, treatable medical illnesses with causes in both the body and the mind. Some of these things may play a part:

Culture. Women in the U.S. are under constant pressure to fit a certain ideal of beauty. Seeing images of flawless, thin females everywhere makes it hard for women to feel good about their bodies. More and more, men are also feeling pressure to have a perfect body. Families. If you have a mother or sister with anorexia, you are more likely to develop the disorder. Parents who think looks are important, diet themselves, or criticize their children's bodies are more likely to have a child with anorexia. Life changes or stressful events. Traumatic events (like rape) as well as stressful things (like starting a new job), can lead to the onset of anorexia. Personality traits. Someone with anorexia may not like her or himself, hate the way she or he looks, or feel hopeless. She or he often sets hard-to-reach goals for her or himself and tries to be perfect in every way. Biology. Genes, hormones, and chemicals in the brain may be factors in developing anorexia.

This answer is based on source information from National Women's Health Information Center.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.