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What Causes Eating Disorders?

August 27, 2015

girl with eating disorderFor 15 years I worked as a research scientist examining the neurobiologic and genetic underpinnings of eating disorders. The number one question I heard (and still hear) is:

What causes eating disorders? Is it nature or nuture?

Some say they believe eating disorders are the result of over-controlling mothers and stubborn children. Others believe eating disorders develop because of difficult relationships, abuse, or trauma. And, still others have stated that eating disorders run in families and are genetic. The truth is, although controlling mothers and stubborn children DO NOT cause eating disorders, there are many variables, such as biology, environment, and experience that can contribute to their development.

Eating disorders are complicated illnesses that develop over a period of time. The interaction of many variables during this time ultimately determines whether or not an eating disorder emerges. As people go through life, genes influence the biology of their bodies and brains, help shape their personalities, affect how they respond to stress, and impact the sports or activities they choose and the friends they make. At the same time, their environment and experiences, such as stress, trauma or abuse, their thoughts and feelings, and how and what they eat can not only change the biology of their bodies and brains, but can also alter the way their genes are expressed and function.

So the answer to the question is:

Nature AND nurture cause eating disorders.

Individuals may have a genetic predisposition to develop an eating disorder, but if their experiences and environment promote health and wellness and do not activate biologic triggers to initiate disordered eating behavior, they may never develop an eating disorder. Alternatively, individuals with no genetic predisposition for eating disorders who are exposed to environmental stimuli that trigger a biologic and emotional response, such as severe stress, may experience changes in body and brain chemistry that influence eating behavior, leading to disordered eating. Disordered eating can further change the individual’s biology, inducing changes in body and brain chemistry that can become conditioned to particular environments, such as specific places or specific emotional states. This interplay among biologic and environmental variables becomes a self-perpetuating cycle of disordered eating resulting in eating disorder illnesses.

It is important to note that there is not one single variable that causes eating disorders. Just as many complex interactions occur to contribute to the development of a disorder, so too must many complex interactions occur to recover from an eating disorder illness. Treatment must address the biologic and environmental contributors to the disorder. Managing biology through proper nourishment, establishing effective coping and communication skills, and identifying and addressing environmental triggers, together, can promote recovery.

Wendy Mathes, MS, PhD, LPCA, NCC