What causes eating disorders?
While we think of eating disorders as a modern phenomena– and at the explosive rates we see them at today they certainly are– they are also brain based diseases that existed long before anyone considered being thin aspirational. Remember, food scarcity was the problem for most of human existence, so an aspirational body was historically a visibly well fed body.
The earliest documented cases of what we now call anorexia nervosa occurred in Europe in the Middle Ages.
Back then it was called “anorexia mirabilis” or “holy anorexia” (yikes y’all). Then, as now, the symptoms were primarily observed in women. The people afflicted with this disease saw it as a means of purifying themselves before God by refusing all temptations of the body, including food. St. Catherine of Siena (1347–1380) died at the age of 33 after chronically refusing food and making herself vomit in the name of religious purification. When her church leaders ordered her to stop fasting, she said she could not— that her compulsion to continue starving was “an affliction”.
Why am I telling you all this?
What historical accounts show us is that eating disorders pre-date modern society and the pursuit of thinness for aesthetic purposes. While eating disorders have their many alibi’s (religious purification, seeking control, getting more attention on instagram) they are a part of the human species throughout history.
That being said, the modern prevalence of eating disorders is staggering compared to the historical cases we know of and is closely tied to the introduction of the thin beauty standard in the 1960’s (well, the flapper made thin the “in” thing in the 1920’s; thin was less celebrated in the 1940’s-50’s until it had a major resurgence in the 1960’s… more on this in another blog post) and saturation of Western media to all corners of the globe in the past 30 years.
Given that the media and subsequent eurocentric, thin beauty standards have reached some of the most remote places on earth, the bigger question is: why doesn’t everyone develop an eating disorder? If Western media & social media lead to huge increases in the rates of eating disorders, wouldn’t it follow that everyone exposed would develop one?
Part of the answer is that there is something different about the brains and temperaments of people who develop eating disorders.
Eating disorders are brain disorders. Recent research tells us that the people who develop eating disorders have very different reactions to their environments and internal stimuli than people who do not develop eating disorders. They tend to be more risk-averse. They like to do things just right. Their brains perceive the pain of rejection and failure more intensely. They are more sensitive. They may have a different reaction to the experience of starvation than someone who does not develop an eating disorder. They are more likely to have a history of trauma.
The best theory we have is explain eating disorders is called epigenetics.
While our DNA, our genetic code, is stable and fixed (like musical notes), epigenetic markers are the signals that tell our bodies how to read our genetic code (like the notations on sheet music that give emphasis and timing to said musical notes). DNA is fixed, epigenetic markers are not. Epigenetic markers can be altered by a variety of things, including stress. Epigenetic markers can cause changes in a person’s health outcomes by modifying gene expression.
This means that people who develop eating disorders have a propensity towards developing eating disorders written in their genetic code. Without an appropriate trigger or epigenetic marker, the vulnerability lays dormant. When triggered, that genetic vulnerability is activated, and an eating disorder forms.
There’s still a lot we don’t understand about eating disorders.
While epigenetic theory continues to gain reputability, at the end of the day, we don’t really understand why some people develop eating disorders and others do not.
We do know that these disorders have existed throughout time and are exacerbated by the media. We know that the brains of people who develop eating disorders are different. We know that people with genetic predispositions to these disorders are being increasingly triggered by our environment.
We cannot predict who will develop an eating disorder. We do not know why some people with all of the above mentioned vulnerabilities do not develop an eating disorder.
One thing we know for sure?
Healing from an eating disorder is possible.
No matter what caused your eating disorder, you deserve to heal. A full recovery is possible. I would love to help you get there. If you feel stuck, I can help. Reach out today.
The contents of this blog are for informational purposes only. This blog is not intended to be a substitute for professional advice, diagnosis, or treatment that can be provided by your own mental health practitioner. If you have any specific concerns about your mental health, you should consult your doctor and you should not delay seeking medical advice, or treatment for your mental health, because of information on this blog.
Megan Bruce
Megan Bruce is a licensed therapist specializing in eating disorders, anxiety and perfectionism, and quarter life challenges. She is based in San Francisco and sees clients in-person and virtually in the greater California area.
