Eating Disorders

Causes of eating disorders

Eating disorders are typically caused by a mix of biological, psychological and sociocultural factors versus one single cause. These include:

• Genetics: Research suggests that genetics can play a significant role in eating disorders.
• Brain chemistry: Changes in brain chemicals or neurotransmitters, which carry messages between brain cells, may influence mood, appetite and eating behavior.
• Sociocultural factors: Peer pressure and the value cultures place on looking a certain way can impact a person’s body image and eating behaviors. These include “ideal” body types portrayed in the media, societal norms about weight and appearance, and attitudes from family members.
• Personality traits: People with certain personality characteristics, like having a tendency towards perfectionism, being highly anxious or having low self-esteem, are more likely to have an eating disorder.

Types of eating disorders

There are several types of eating disorders, including:

• Anorexia nervosa: Anorexia nervosa, or anorexia, is an eating disorder that causes a person to have a distorted body image and see themselves as overweight — no matter what size their body is. People with anorexia are preoccupied with losing weight and may eat small amounts of food, avoid food altogether or exercise compulsively.
• Bulimia nervosa: Someone with bulimia goes through cycles of eating large amounts of food (binging) and ridding themselves of what they’ve eaten (purging). Purging can be done by vomiting; using laxatives, enemas or water pills; burning off calories with excessive exercise; or refusing to eat food.
• Binge eating disorder (BED): People living with a binge eating disorder often can’t control what or how much they eat. Often these foods are high in sugar and fat. While someone with BED doesn’t purge, they feel uncomfortably full and may struggle with shame after a binge.
• Orthorexia nervosa: Orthorexia is a lesser-known type of eating disorder that involves a fixation with “clean” or “pure” eating. People who have orthorexia follow very restricted eating behaviors, often to the point of obsession. Because it’s focused on “healthy” eating, this disorder may go unnoticed.

Who is at risk for eating disorders?

Around 20 million girls and women and 10 million boys and men in the United States have an eating disorder. While eating disorders affect people of every age, weight, race and gender, there are certain factors that increase your risk.

• Certain activities: People who participate in activities that emphasize physical appearance, like modeling or gymnastics, have a higher risk of developing an eating disorder.
• Family history: If a close relative has a history of an eating disorder, addiction or certain mental health issues, such as depression, your odds of developing the condition increases.
• Age: Eating disorders can develop at any age, but most diagnoses occur in teenagers and young adults.
• Trauma or stressful life events: Experiencing traumatic or stressful life events, such as abuse, divorce or even changing schools, can increase a person’s risk of developing an eating disorder.
• History of mental health conditions: Having other mental health disorders, like anxiety, depression or obsessive-compulsive disorder (OCD), can increase the likelihood of an eating disorder.
• Medical conditions: Some physical health conditions, including diabetes, increase the risk for eating disorders.

Eating disorder treatment options

At Main Line Health, our eating disorder specialists will work with you to determine the best treatment for you. Your care may include one or more of the following treatments:

• Therapy: Working with a trained therapist can help you understand your eating disorder and change destructive thought patterns that influence your behaviors. This may include cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT) or dialectical behavioral therapy (DBT).
• Medication: Many people who have an eating disorder also have psychiatric symptoms, such as anxiety, depression, self-harm or substance misuse. Taking anti-anxiety or antidepressant medicines, and other approved medications for binge eating, may improve those symptoms and, therefore, improve your eating disorder.
• Nutritional therapy: You may work with a registered dietitian/nutritionist who specializes in treating eating disorders.

Diagnosis and testing for eating disorders

In order to diagnose an eating disorder, your behavioral health specialist will conduct an evaluation through tests that may include:

• Exam: You'll discuss your symptoms and medical history with your doctor to rule out any medical conditions for weight loss or gain. They’ll also examine your body for any complications caused by an eating disorder.
• Psychological assessment: Your doctor will ask questions to learn about your eating behaviors and beliefs.
• Blood work: Your doctor may order blood work or other tests to check for certain indicators of an eating disorder, such as anemia, low hormone and thyroid levels, low blood cell counts and low potassium.