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Number One Reason for Developing an Eating Disorder

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Hundreds of people have asked me why someone develops an eating disorder. Of course many issues are involved, but from my exploration of this field over the years, I have concluded that there is one outstanding theme that runs through every person with an eating disorder whom I have encountered.

Early in their lives, people with eating disorders have experienced, on a sustained basis, relentless boundary invasion on every level.

When their physical, emotional, psychological, intellectual, sexual, and creative boundaries are consistently ignored and penetrated, people experience total boundary invasion. With no control and no way to end, protest, or, often, even acknowledge such invasions, these persons feel helplessness, despair, and a certainty that they are worthless to themselves or anyone else.

The consequences of such total invasion are vast. One consequence is an eating disorder. Having had so many boundaries disregarded, a person has no knowledge or skills in recognizing or honoring boundaries herself. She will eat or starve for emotional relief.

She may eat vast amounts of food for comfort value alone. She may deprive herself of food until her life is in danger. She has no internal regulator that tells her when she has reached her limit and experienced enough. Being oblivious to any boundaries means being oblivious to limits of any kind.

The compulsive overeater eats whenever and whatever she likes. She bases her choices on self-medication issues, not feelings of physical hunger.
The anorexic will not eat. There is no limit to her not eating. She will starve herself to death in search of relief from her emotional pain. She knows nothing of the experience of having enough. She couldn't say, "Enough," to an invader of her boundaries, and she can't say it to herself. The concept of enough has no meaning to her. She often feels that if she "disappeared," she might find some permanent relief.

I have heard countless anorexic young women talk ethereally, with a lost-in-a-beautiful-world-of-angels smile, of how wonderful it would be to become a vapor or a light dancing spirit in the clouds. Ah, such spiritual bliss, they imagine.

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(reply to Anonymous)

What I find interesting about your comment is that you've addressed young men, a group I think often forgotten or ignored in our rush to judge or treat young women.

June 3, 2009 - 4:49pm
EmpowHER Guest

Look, there are a lot of 'theories' out there about what cause eating disorders. Its very confusing to parents. Is it a choice? Or an illness that is 'not a choice'? How you view what causes an eating disorder will determine how you treat it.

Human beings are complex, no question. Dr. Walter Kaye's research has shown that people who develop eating disorders typically suffer from childhood anxiety pre-eating disorder. Does this mean their 'boundaries were invaded' in a relentless and sustained way? No, not necessarily. Cynthia Bulik has described sufferers as having certain personality traits .

"...A childhood tendency that Bulik calls neuroticism may be an indicator for parents, doctors, and teachers to screen for children who are genetically predisposed to anorexia before they become sick.

“These kids are emotional Velcro,” Bulik says. Troubles that roll off other children’s backs really stick to them, and sometimes so subtly that their parents can’t tell. They tend to be well behaved and smart, but anxious and depressed, often about things over which they have no control—a dead animal in the road, for instance..."

Does this mean that others, parents included, have violated their boundaries? NO. To the contrary, these children may be well supported by their families, yet just plain highly sensitive. You do great damage to others in the family with these suppositions. Are the families of eating disordered patients perfect? Heck no. I'd never claim that. But neither are the families of children with cancer, diabetes, autism, schizophrenia or any other host of ailments.

Yes, I have lived through this difficult illness twice now...a sister and a daughter. I've also worked in a facility that treated young anorexics back in the '80's. I also have an undergraduate degree in social work and a master's degree in a related field and have worked directly with children for the past 25 years. I am in a 'related field' so to speak. My personal experience with this illness, twice over, has certainly affected my own attitudes toward mental health and families. First do no harm. And, my feeling is, the present very common approach to treating eating disorders is often quite hurtful to and exclusive of families. It often "listens" to eating disordered patients, sometimes lending credence to some of their cognitive distortions, which at times include distorted beliefs about families, friends, etc. Families, who one would think just might have clearer insight (not being starved or eating disordered, mind you) are often brushed asided, their contacted limited with their family member (if inpatient), their views questioned. At best, they are seen as expendable; at worst, they are excluded.

With my own daughter, I often found her thinking irrational and distorted at the height of her illness. It was a puzzle to me why I was told to 'listen to her' as though she were a fully functioning teen capable of making good decisions. At the time, she was clearly not. I loved her, but I knew she was not well or her usual self.

My points are pretty simple. This is a biologically based illness (Dr. Thomas Insel, head of NIMH, has said so himself), food is first and food is medicine, families are an ally in helping ill members back to wellness, treatment for anxiety and depression should take place (if needed, and they aren't always) once full nutrition has been re-established. Families should never be blamed. There is no evidence that families cause eating disorders and implying this can cause lasting damage (I also suffered PTSD over my daughter's long illness and recovery--a significant factor being the blame I felt for this illness). Is another family member's mental health worth less than the ED patient's? An approach that respects and supports the whole family is needed--and can be hard to find.

I am speaking up because I've had enough. I don't believe families are at fault--or any worse than other families. I am yelling that 'the emperor has no clothes.'


June 3, 2009 - 2:45pm
EmpowHER Guest

There are many different ways to go about getting help for an eating disorder, but receiving the proper advice and treatment is extremely important. Eating disorders are very dangerous, and should not be left untreated due to the fact that over time the disease will only continue to worsen. Eatingdisorder.com is a very useful and helpful informational site about the different types of eating disorders, their symptoms and causes, treatment options that are available and more. I think this site is something that should be looked at by those who are in need of help with an eating disorder.

June 3, 2009 - 6:57am
EmpowHER Guest

I could hardly finish reading your commentary, I was so appalled. Your personal opinion and experience on what causes eating disorders hardly constitutes evidenced based best practice. What about real research? What about the high heritability of eating disorders being documented by research? What about evidence-based best practice that states putting families squarely in charge of their loved ones meals is the most effective path back to wellness? If more older anorexics and bulimics had had this approach used at an early stage of their illness, more might be in good health today. More lives might have been saved along the way. This is NOT boundary invasion. This is love of the deepest sort. This is stepping in, stepping up and confronting a deadly and frightening illness. This illness denies, distorts and kills. Too many families, spouses and friends are told to back off, it's not about the food, it's all about contro, boundaries and feelings. Enough. This is WRONG. This is an illness that is most certainly ABOUT FOOD, where families need to be supported to step in, helped to understand the disease and to understand the true lack of control. This is an illness where food, time and love is the medicine. You can't reason with a starving person. Their brain is not functioning well. Their are many cognitive distortions. Yes, there is a time and often a need to deal with anxieties, but AFTER food and full nutrition, AFTER the brain has really had a chance to heal. Real love is seeing and knowing the boundaries and WHEN to step over them. Because, with eating disorders you MUST step over them, even when it feels uncomfortable and abnormal to do so, even when others are telling you not to--in order to save a life. Its often the only way to pull an ill loved one back from the edge.

So, don't tell me--don't tell any family--that their 'boundary violations' caused an eating disorder. Shame on you. You can't know that. It's hurtful, it's disrepectful of other family members who are often in trauma over their loved one, it can create tremendous guilt, and from MY experience its just plain untrue. Worse, it can stop a family from aiding their ill loved one when they need it most, leading to a terrible outcome.

For families: www.maudsleyparents.org


June 2, 2009 - 7:30pm
EmpowHER Guest
Anonymous (reply to Anonymous)

Thank you so much for writing your comment to Joanna Poppink's article on eating disorders. We spent seventeen years trying to save our daughter from dying from anorexia, and this article made me feel sick and dirty. My daughter did die two years ago, and this article has brought up all the self doubt that we didn't do enough. It took over our lives for 17 years, and we failed isn't that enough to live with. I'd like to know why that woman is smiling when she has just hurt so many people. Mary S

July 28, 2009 - 5:59am
EmpowHER Guest
Anonymous (reply to Anonymous)

Dear Anne,

Thank you for speaking your opinion so plainly.

In my experience I see deep psychological healing is necessary
for solid and long term recovery from an eating disorder. Normal
brain and emotional development gets stalled when an eating disorder begins.

When the eating disorder behavior begins to diminish the psychological and emotional deficits in the person become more clear and also, thank goodness, become more available for healing and healthy growth.

The research in affect regulation and the new findings in neuroscience show that brain structure physically changes during deep psychotherapy. These changes enhance the person's ability to think, feel and behave in a more healthy way. (see the work of Allan Schore, Ph.D. and Daniel Siegel, M.D.) These statements are based on evidence based research.

I agree with you. Lack of proper nourishment distorts a person's cognitive and emotional capacities. Diminishing the acting out of an eating disorder is essential in the beginning of treatment, but it is not all the treatment. Love is an essential aspect of treatment as well.

What's also essential in the complex experience of genuine healing from the ravages of an eating disorder is a willingness and ability to look at self, to appraise without criticism or punishment, to own one's deficits and their consequences. It takes courage for a person with an eating disorder to heal. And it takes courage for a family to understand and support someone in recovery.

You speak of your experience in capital letters. Would you like to share your experience here?

best regards to you,


June 2, 2009 - 9:55pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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