Eating disorders havemultiple causes. There appears
to be a genetic predisposition in some people toward
developing an eating disorder. Biochemistry also seems
to play a role. Neurotransmitters in the brain, such as
serotonin, play a role in regulating appetite. Abnormalities
in theamount of some neurotransmitters are thought
to play a role in anorexia, bulimia, and binge-eating disorder. Other disorders have not been studied enough
to draw any conclusions. Interestingly, serotonin also
helps regulatemood, and lowserotonin levels are thought
to play a role in causing depression.
Personality type can also put people at risk for
developing an eating disorder. Low self-worth is common
among all people with eating disorders. Binge
eaters and people with bulimia tend to have problems
with impulse control and anger management. A tendency
toward obsessive-compulsive behavior and
black-or-white, all-or-nothing thinking also put people
at higher risk.
Social and environmental factors also affect the
development and maintenance of eating disorders and
may trigger relapses during recovery. Relationship
conflict, a disordered, unstructured home life, job or
school stress, transition events such as moving or
starting a new job all seems to act as triggers for
some people to begin disordered eating behaviors.
Dieting (nutritional and social stress) is the most common
trigger of all. The United States in the early
twenty-first century is a culture obsessed with thinness.
The media constantly send the message through
words and images that being not just thin, but ultrathin,
is fashionable and desirable. Magazines aimed
mostly at women devote thousands of words every
month to diet and exercise advice that creates a sense
of dissatisfaction, unrealistic goals, and a distorted
body image.
Diagnosis
Diagnosis involves four components: a health history,
a physical examination, laboratory tests, and a
mental status evaluation. Health histories tend to be
unreliable, because many people with eating disorders
lie about their eating behavior, purging habits, and
medication abuse. Based on the health history and
physical examination, the physician will order appropriate
laboratory tests. Mental status can be evaluated
using several different scales. The goal is to get an
accurate assessment of the individuals’s physical condition
and her thinking in relationship to self-worth,
body image, and food.
