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The Psychological Roots of Eating Disorders

Theories abound from many different streams of psychology to explain the underpinnings of Eating Disorders. Few of these theories have been validated with empirical research, and it is difficult to discern a common, unified model to account for the development of Eating Disorders in all affected individuals [ref, ref, ref].

One thing that does seem clear is that these individuals usually have other psychological difficulties as well, and their Eating Disorders are often just one manifestation of various other underlying issues. For instance, studies have found that there are certain personality traits that are typical among people with Eating Disorders, such as Neuroticism, Obsessive-Compulsivity and Perfectionism [ref].

Neuroticism is defined as a tendency to be quick to experience negative emotions, like anxiety, worry, sadness and irritability.

Obsessive-Compulsive traits include doubting, checking, and the need for symmetry and exactness.

Perfectionism is when individuals set very high and often unrealistic standards for themselves, and then strive to meet these standards despite adverse consequences.

The combination of these traits may mean that such individuals try to compensate for their frequent negative emotions by striving for control and perfection in one area of their life, this being the obsessive-compulsive management of their weight and eating habits.

A similar construct involving this constellation of behaviors is the trait of Narcissism, which describes individuals who strive for perfection in their physical appearance, status, and their general outward presentation, have a strong need for external validation, are very sensitive to interpersonal rejection and are prone to having low self-esteem. This trait has been shown to be present among individuals with Anorexia Nervosa and Bulimia Nervosa more than in other psychiatric conditions [ref]. This could explain why these individuals focus their energies on their physical appearance and why they tend to value their ability to control their weight as a very significant achievement and something that marks them as special and unique. This model of trait Narcissism fits with some of the principle conceptions of Eating Disorders that are current in both Cognitive Behavioral Theory [ref] and Psychodynamic Theory [ref].

One personality trait that has been found to differentiate between individuals with Eating Disorders who binge-eat and purge, versus those who only restrict their diet, is Impulsivity. This trait refers to the tendency to act quickly and impulsively without thinking things through, and is related to the trait of Sensation-Seeking, which describes the tendency to take risks in order to experience strong and novel sensations. Impulsivity and Sensation-Seeking have been found to be common features among individuals with binge-eating and purging behaviors, such as in Bulimia Nervosa, Anorexia Nervosa Binge-Eating/Purging Type, and Binge-Eating Disorder, but are uncommon among individuals with Anorexia Nervosa Restricting Type [ref]. This phenomenon may be explained partly by the fact that women with Eating Disorders with binge-eating and purging behaviors have high rates of reported childhood sexual abuse compared with women with Anorexia Nervosa Restricting Type and with women in the general population [ref]. Having endured childhood sexual abuse is known to increase one's chances of developing Impulsive personality traits [ref].

Some psychodynamic theorists have drawn attention to the need to maintain absolute control over one's body as a central theme in Anorexia Nervosa and Bulimia Nervosa [ref]. The idea here is that the obsessive drive to master one's own weight, body shape and food intake offers some individuals the opportunity to claim authority over one small but important part of their lives. This could be valuable for those individuals who feel dominated, intruded upon and harshly controlled and who have trouble knowing who they really are outside of such circumstances.

All of the above models could apply equally to men and women, and so the question remains as to why Eating Disorders are far more common in women. One hypothesis is that, in society's eyes, a woman is more wholly defined by her body than is a man. This notion leads into the topic of the social factors that contribute to Eating Disorders.

 

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Biological Factors

Course & Prevalence