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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. In reality, it's the final self-protective act, to destroy their bodies and their lives completely. Then they can truly escape the complexities of being alive.

The bulimic will binge grotesque amounts of food. She will assault herself with more food than her body can tolerate.

The compulsive overeater will, at last, have to stop eating if only because of the pain in her distended stomach. Her body sets a final limit. The bulimic has no such limit. She experiences (in her mind) no consequences of the food assault on her body. When her body cannot bear more, she will vomit it all out. Then she will resume her binge. She may reach her body's limits many times. Each time she does, she can throw up again and continue.

Eventually she stops, because she is completely exhausted, or she is in danger of being discovered. "Enough" has no meaning to her. There are no limits and no consequences for her disregard of her boundaries.

Realistically, of course, there are plenty of consequences. Her behavior inflicts serious damage to her body. And each time she attacks herself with a binge-and-purge episode, she destroys more of her spirit, soul, self-esteem, sanity, health, and value to herself and others.

Each violation deepens her ritualistic behavior, and she becomes more entrenched in her disorder. The consequence is increasing anguish and despair. Yet the eating disorder is not the cause of that anguish and despair. The eating disorder exists to numb her from her already existing psychological agonies.

For a while, maybe a few years, the eating disorder successfully blocks her awareness of pain too difficult to bear. But eventually the protective device of the eating disorder becomes just another boundary invader, this time self-induced, that weakens and damages her even more.

What do I mean by a history of boundary violations? Blatant and extreme boundary violations involve sexual molestation, sexual abuse, and physical abuse. Much has been written about these areas now, especially in material exploring Post Traumatic Stress Disorder (PTSD) and Dissociative Identity Disorder (DID). Use your search engines to find some quality information posted on the Internet in these subject areas.

However, there are other kinds of boundary violations, and these are less dramatic, less discussed, more prevalent, and just as devastating to a persons psyche. When, in the name of caretaking, people in authority take over a young person's life, it constitutes boundary invasion.

When others deny her privacy, read her diary, borrow or take her things without permission, or use their ideas or goals or personalities to overwhelm her efforts in school or sports, that is a violation of her boundaries.

When others disregard or disdain her choices or deny her any control over her personal life, clothes, food, friends, and activities, they are invading her boundaries.

An invasion of boundaries also takes place when, in the name of caretaking, people give her no responsibilities of her own and attach no consequences to her actions. When the child or adolescent can have all the things she asks for without putting forth effort to earn such gifts, she learns nothing about personal effort, limits, consequences, or the meaning of enough. If she wants something, she gets it. That's all. If someone picks up her clothes, does her laundry, fixes her car, pays her bills, lends her money or things without expecting them returned, she experiences no boundaries and no limits.

If she doesn't have to keep her promises, if she doesn't reciprocate with caring actions for people who care for her, she learns nothing useful about herself in relationship to other people. The only thing she learns with certainty is that there are no limits to her behaviors or desires.

These boundary invasions are not loving acts, nor are they "spoiling" a child through overindulgence. Quite the contrary, they are acts of neglect. The child's taste, mind, capacity to learn, and ability to grow and function as an independent agent in the world remain unacknowledged.

When others, even well-meaning others, ignore her identity as a unique, developing, and competent individual and flood her with their personal agendas, she feels as if a steamroller had flattened out her psyche. She may learn to please, to manipulate, to compete, or to control, but she is unable to learn to be fully present in the world as her genuine self.

She doesn't learn that she has meaning and value. She doesn't learn that she can put that meaning and value within her to work to accomplish goals.
For example, if she breaks something, whether it is a lamp, a car, her word, or someone's heart, it is possible and healthier to give her the responsibility for making necessary repairs using her own resources and her own creativity. In such a process, she learns what effort means. She learns what responsibility and consequences for actions mean. She learns reasonable limits and reasonable expectations. She develops resources to make healthy and caring decisions in the future.

Without such lessons, she learns are the tricks involved in adapting quickly to the expectations of others or being manipulative to get what she wants. These are poor and insubstantial tools to rely on when building an adult life.

Somewhere inside, over time, she may gradually realize this. But without a sense of boundaries, she will only become bewildered and anxious. She will accelerate her practice of using her eating disorder as a way to numb her feelings of anxiety. She will use her manipulating skills to get what she wants from whomever she can exploit.

As time passes, fewer people in her life will allow themselves to be manipulated. The quality of her circle of associates will decline as she seeks people she can control with her inadequate methods of functioning in the world. She will find herself in bad company.

This becomes all the more reason to rely on eating disorder behaviors for comfort. The people around her are less reliable all the time. And finally, they tolerate her presence only because they can manipulate her.

She arrives at the total-victim position. Her manipulative skills backfire. People exist in this world who are better at manipulating and using than she. She has found them. She becomes their target and then their prey. Her dependence upon her eating disorder becomes her most valuable and trustworthy relationship.

Early in her development, she learned through massive boundary invasions (which perhaps seemed ordinary and unimportant at the time) that she was helpless to assert herself. She learned that she had no private or sacred space to cherish and respect. She could not acknowledge, even to herself, that she was being thwarted, invaded, controlled, manipulated, and forced to deny large aspects of her natural self. She had no recourse except to comply.

To succeed at being unaware of her natural tastes, curiosities, and inclinations and her pain in restraining her natural tendencies, she developed an eating disorder. Now that she's older and her manipulation skills are failing her, she only has her eating disorder to rely on. This may be the most crucial time in this person's life.

If her pain and despair are terrible enough and she is certain she cannot bear this way of living anymore, she still has choices. She can continue to rely on the eating disorder and by so doing take the path to self-destruction. Or she can reach out and get help.

This is a tough position for her. She's never known what enough was. Yet to choose to get help, she has to recognize that she has had enough pain. She's never known what a limit is. Yet she has to recognize that she has reached her limit and must choose between death and life. She has only known about pretense and manipulation. Yet she has to be honest to reach out for genuine help.

She feels massive anguish and pain before she stretches beyond her life pattern into what might bring her healing and recovery. She's reaching for something she can't imagine. It's difficult for a person with an eating disorder to decide to get help. She would have to allow herself to trust someone with knowledge of her real personhood.

She doesn't yet know that people who do respect and honor boundaries actually exist in this world. She doesn't yet know that there are people who can and will honor and cherish her most private and sacred inner spaces. She doesn't yet know that someday the trustworthy, respectful, steadfast, and competent caretaker she needs so badly can be herself.
Her first move toward recovery requires all the courage she can muster. Her recovery begins when with fear or rage, she rallies her courage to reach out for help.

Difficult, yes. But what she doesn't know yet is that she has been courageous all her life. She makes a grand discovery when she learns that she can apply her strength and courage to her own health. She can use her gifts to, at long last, be free of her eating disorder, be her genuine self in the world.

Professional Resources for Finding Help
Academy for Eating Disorders (AED)
American Anorexia and Bulimia Association (AABA)
Anorexia Nervosa and Related Disorders (ANRED)
International Association of Eating Disorders Professionals (IAEDP)
Joanna Poppink's Eating Disorders Resource List In-Patient Treatment Programs
National Eating Disorders Association (NEDA)
Joanna Poppink, Los Angeles psychotherapist, licensed since 1980 (MFT #15563), is deeply committed to bringing recovery to people suffering from eating disorders.

Her specialized psychotherapy practice is designed to allow clients to progress through anxiety situations to ongoing recovery from bulimia, compulsive eating, anorexia and binge eating. Her primary goal is to provide people with a way to achieve thorough and long lasting healing.
Eating Disorder Recovery book in progress through Conari Press
10573 West Pico Blvd. #20
Los Angeles, CA 90064
[email protected]

Add a Comment206 Comments

EmpowHER Guest

Actually, no I've never been in therapy even though I obviously need it (not everyone can afford expenive therapy or fancy treatment centers). I just see a psychiatrist and she tends to push the biological theories, although she did refer me to some therapists. I believe in the BIOPSYCHOSOCIAL model of mental illness, not a strictly bio-bio-bio approach or a strictly psychosocial model. Don't assume I'm a brainwashed tool. Please, I'm not that stupid. I am capable of thinking critically and doing research and I don't discriminate when it comes to criticizing people. And you have NO idea what my childhood was like.

November 1, 2009 - 11:09am
EmpowHER Guest

To the person who posted above this, you sound like you have anger issues.

Perhaps you have spent too much time in therapy/treatment with the misguided people.

Time to rethink your future recovery approach?

I am a recovered restrictive anorexic who does not blame my parents in any way for my issues with arorexic and depression.

I came to that conclusion on my own.

Best of recovery success to you!

November 1, 2009 - 10:02am
EmpowHER Guest

I must agree that any scientific information can be construed the way the reader wants the information to be interpreted. Statistics right? Mathematics that you can draw your own conclusions to.

I have never had an ED although several very close friends of mine have. Two things that anonymous wrote are spitting images of what my two friends contributed their EDs to which was abuse and Post Traumatic Stress Disorder (PTSD). Both friends of mine had horrible and traumatic upbringings that you would think were only in the theater. Both friends were drugs addicts later in life and had EDs although one has changed her life for the better at the ripe age of 36. I commend her.

I believe that anonymous has a strong point here and people from the outside (like myself) should consider all the issues surrounding the person dealing with this disease.

November 1, 2009 - 9:59am
EmpowHER Guest

It's interesting how most of the commenters are PARENTS and not ED sufferers themselves. I wouldn't necessarily say I had "boundary" violations, whatever the F that means. "Boundary violations" sounds like some New Age liberal white hippie term. That being said, I did have some abuse issues going on. I find it VERY telling that the parents of children with EDs are screaming so loudly and shrilly here. Why not allow some ED sufferers to have a voice? I wonder why it's the PARENTS who are being so publicly loud and histrionic while the ED patients are messaging this author privately to have discussions. Do you people have attention or ego issues?

I think eating disorders are caused by a combination of biology and environment. I FIRMLY believe that genetics is ONE important factor, but NOT the ONLY factor in eating disoders. I think some people are genetically more vulnerable to being more anxious, depressed or obsessive and that stress (which does not necessarily have to be rooted in bad parenting, btw) can trigger an ED or some other mental illness. And to the snotty parents who dismiss the psychosocial factors and talk about how "science" proves that EDs are biologically based illness, I would like to say, ever heard of EPIGENETICS. There is so much SCIENTIFIC research showing that LIFE EXPERIENCES can leave PHYSICAL imprints on the brain. Ever heard of PTSD? The brains of PTSD patients look very different from the brains of "normal" controls. There are so many other scientific studies out there.

It's funny how you lambast this author for being a crackpot who ignores science yet some of you seem to conveniently ignore the science yourselves or you interpret scientific journal articles to your own liking.

November 1, 2009 - 9:34am
EmpowHER Guest

Is this still going?

October 31, 2009 - 5:43pm


I'm sure you do your homework when it comes to representing your clients; I encourage you to do the same when it comes to this very serious disease. The research on the biological basis for eating disorders is very clear. One place to start would be this literature review from Massachusetts General Hospital : http://www2.massgeneral.org/harriscenter/about_an.asp

Several other good links appear in the comments on this article. Criticism of Ms. Poppink's thesis is in no way intended to invalidate the experience of her patients or others who have commented on this post, but treatment must be evidence-based which her article is not.

October 31, 2009 - 3:53pm

Dear Ronin,

Thank you for presenting your perspective and your experience. I am glad you wrote and appreciate your response very much.

Since this article came out on Empoweher it has evoked a stormy public reaction from parents. I am concerned for the people suffering from eating disorders who feel overwhelmed by this parental outcry. Women with eating disorders have written to me privately for support. I have also received private posts from people voicing their agreement with what you say.

Your post is clear and public. To me that means that people with an eating disorder in their history can find what you've written and be reassured that if indeed they experienced boundary violations, they can be heard, believed and understood.

Thank you again.

best regards,


October 31, 2009 - 2:43pm

I have a friend with anorexia and her boundaries as a child/teen/adult have been repeatedly and aggressively violated by her parents, her father in particular. As a criminal defense lawyer with 20 years of experience, I have represented hundreds of clients with mental health issues. In each and every case, the parents failed their son/daughter. And every young woman I've represented with a mental health problem had an unhealthy relationship with her father. I, therefore, have difficult time believing that anorexia is a biologically based disease. Many parents that fail their children would like to blame a psychiatric condition on genetics or some other such nonsense. It I suspect that the negative reactions from the parents responding to this article are based mostly on denial.

October 31, 2009 - 2:22pm

Eating disorders can be many things but they are always extreme. It is thought that most eating disorders surface during adolescence but more recent data has indicated that it could be much earlier or later. One important fact About Eating Disorders is that almost all cases are females with males accounting for well under 10%. Similar to addiction, eating disorders are also a disease but they are treatable. They are caused from very complicated psychological and biological underlying causes. For more related information visit the link below,
May be it is useful for the readers.

October 22, 2009 - 11:03pm
EmpowHER Guest

Considering Ms. Poppink's article and the debate it has generated, this is a timely and dispassionate article:
I hope everyone reading and posting here will take time to read it.
Very best wishes,

June 19, 2009 - 8:52pm
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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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