Eating disorders: cause and effect

Eating disorders are a big problem in our society, especially among young women. Recorded cases have doubled in the U.S. since the 1960s. A recent article in Scientific American, “Through a Glass, Darkly“, discusses some of the causes.

It’s hard to know exactly how many people suffer from eating disorders. The article claims about 4% of women will suffer from clinical anorexia nervosa or bulimia nervosa in their lifetime. Another 2 to 5% of Americans will have a binge-eating disorder in any 6 month period.

And what causes these problems? A lot of people rightly blame media for promoting malnourished waifs as the ideal body image. This sets impossible goals, for women to look like the thinnest 5% of society. Yet while many women are influenced by those external images, recent studies say that those who suffer from eating disorders are more affected by their own faulty self-image.

A faulty body image–rather than an exaggerated ideal–is crucial to the development of eating disorders.

What lies behind a distorted body image? To answer this question, Vocks’s team took photographs of 56 people suffering from eating disorders and 209 healthy subjects used as controls. The scientists then asked the test subjects to adjust their images on a computer screen until they “recognized” themselves. Additionally, they asked both groups to give their virtual “me” the figure that they wished they had.
Whereas all the respondents had similar notions of an “ideal” figure, the bulimics and anorexics all significantly overestimated their real body mass. In contrast, the subjects who were not suffering from eating disorders believed that they were slimmer than they actually were.

Another trigger for eating disorders is “frequent and extreme dieting”. This confuses the body’s “hunger-satiety system”, leading to faulty perceptions and behavior. Ironically, dieting is also the best predictor of future weight gain. Dieting is worse than useless.

A child’s upbringing can also increase risk. Eating disorders often occur in well-off, well educated families. Yet when parents set high standards, the children feel pressure to excel, to be “model students” and lead perfect lives as adults. That’s always an unattainable goal. Conversely, a good relationship between parents and children balances security and independence. This promotes a healthy self-image. Without that positive influence, children are at greater risk of eating disorders and drug addiction.

What’s the prognosis? Not so good. About 5% of anorexic women die from the disease. Fully one quarter remain chronic anorexics for the rest of their life. A third regain some weight, but continue to have badly distorted body self-images. Only about 30% of anorexic women recover fully.

The situation is a bit better for bulimics. Half of those who get treatment recover from the disease. The other half continue to binge and purge for the rest of their life, which often causes chemical imbalances, digestive tract damage, and increased risk of heart attacks.