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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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Here is a link to a Time magazine article that came out today called "A Genetic Link Between Anorexia and Autism" http://www.time.com/time/health/article/0,8599,1904999,00.html?xid=rss-topstories
""[Anorexia is] highly heritable, it runs in families, and it's clear now that it's affected by a cluster of [early life] vulnerabilities like anxiety and perfectionism. If you don't have those vulnerabilities, you are very unlikely to develop anorexia," says Dr. Walter Kaye, director of the eating-disorders program at the University of California, San Diego.'

"Essentially, Treasure and her colleagues have abandoned the idea that family dysfunction causes eating disorders and instead enlist the family to help guide patients' recovery. Most recently, the Maudsley method has also incorporated a new type of cognitive behavioral therapy, based on the autism connection, which aims to broaden the narrow thinking routines of people with anorexia. "

"Treasure's colleagues at the Maudsley Hospital say current treatments are equally obsolete. In the late 1980s, the British researchers published the earliest studies describing what has become known as the Maudsley method of treating anorexia in teens — and it remains the only therapy that has proved effective in controlled trials. Unlike traditional treatment, which assumes that anorexia is caused by environmental factors and low self-esteem and often involves intense therapy at residential treatment centers, the outpatient Maudsley method does not focus on psychological therapies or on "parent-ectomy" — removing the teen from the home."

My D had anorexia and has a different ED now. My sister's S has autism. As far as we know, no one in our family before us or contemporary with us has had an ED or autism. Don't know where these disorders came from, but one thing is very clear -- we have both done everything in our power to love, support and help our kids, and we have never in any way been either neglectful nor have we inflicted pervasive boundary penetration on our children.

June 19, 2009 - 12:35pm
EmpowHER Guest

Sorry, I didn't mean to repeat post the above. Not sure how to undo it now.

June 19, 2009 - 12:26pm
EmpowHER Guest

OMG, say it's not so!

Joanna has a book coming out.

From her Twitter blog:

"Tweaking my book contract with publisher. Yes, my eating disorder recovery book sold and will come out in 2011. Hooray!"

Heaven help us!

Well, she has garnered some publicity for her book, for sure, but I am not sure that it is really the type of publicity that a professional would want.

June 18, 2009 - 11:42am
EmpowHER Guest

Anne, great info! Thank you for posting that.

June 18, 2009 - 10:12am
EmpowHER Guest

Here are two pertinent quotes off the Mayo web site concern their Maudsley treatment approach:

"Children who have eating disorders are typically from loving families. They are very responsible, accomplished, and well-behaved. That's what makes their eating disorders so baffling to the people who love them," says Leslie Sim, Ph.D., clinical director of Mayo's Child and Adolescent Eating Disorders Program. "We don't know what causes eating disorders, but we do know that parents play a huge role in helping their children recover."


"For those who commit to family-based therapy, the treatment success rate is excellent. Nearly 96 percent of patients treated with FBT at Mayo since 2004 (about 50) have successfully recovered. Less than 5 percent have needed to re-enter treatment programs. This compares to a long-term recovery rate of about 50 percent for patients in standard treatment programs, which commonly include multiple hospitalizations and long-term treatment. The FBT program often eliminates the need for follow-up programs and helps patients adjust more quickly to their outpatient program."

I commend Mayo for offering parents this treatment option. I hope others follow suit.


June 18, 2009 - 9:57am
EmpowHER Guest

For those of you who continue to suffer from ED, you need NOT be subjected to therapists who feed into your 'victim' mentality.

Erin Gates, a recovered anorexia sufferer, talks openly and candidly about her journey through ED and to recovery and a successful life.


This, too, can be you.

Do not waste your time trying to find 'cause' and placing 'blame'.

Getting the right help early on seems to be the key to successful recovery and a fulfilling life free from ED.

June 18, 2009 - 8:29am
EmpowHER Guest

While I know nothing about the program other than it exists, Mayo Clinic uses Maudsley and reports a very high success rate.


Also, I totally interpreted the comment to Shelley about daughters differently than you all apparently did. I did not interpret any hint regarding her being an abusive mother, period. I took from the question that the writer was asking because of the genetic risk of passing on traits that predispose towards these illnesses. That, certainly, no one is in control of or blamed for. When I read it, I felt the writer was simply trying to make a point about genetics, not accuse anyone.


June 18, 2009 - 4:44am
EmpowHER Guest

Carol-THANK YOU! You summed up what i wanted to say so succinctly that I'm not going to bother responding. You're right and thank you for standing up for many voiceless people.

Shelley-I've been enjoying your contributions to the discussion. For the record, I think you sound like a wonderful mother (definitely NOT abusive) and if you had had daughters, I believe that you would have raised them well and been able to keep them out of the whole ED mess.

I'm disgusted by whoever it was who said that an eating disordered mother is "abusive" by virtue of having an ED. Shame on you. An eating disorder does not make an abusive person, rather eating disorders are likely to be responses to abuse. People do what they have to in order to survive abuse and sadly that can include an eating disorder. A person with an eating disorder is more than likely a survivor, NOT an abuser. An abuser is someone who would throw around such inflammatory and false comments about mothers with eating disorders. I have known mothers who suffer from eating disorders and they are wonderful, caring parents who would do anything to prevent their sons/daughters from falling into EDs and have been successful. These parents are not only more likely to notice early signs of depression/EDs/mental distress in their children but also more likely to believe their kids and take quick action. Their kids feel that they're able to confide in their parents and find acceptance and understanding. All of these mothers I have known have been actively seeking healing and how inspiring is that for a child to witness. A child eventually has to accept the humanity of their parents-to be able to see them as flawed, see them cry/feel scared or vulnerable/struggle with problems-and come to terms with it and see them as people as well as Mom or Dad. Similarly, parents must come to terms with and accept the humanity and personhood of their kids. A parent who struggles with an ED or mental illness shouldn't lie about it or go to great lengths to deny it despite evidence to the contrary because the kid knows something is wrong and its better for them to know the truth. Watching this parent struggle and move forward is probably one of the best lessons they could ever learn and if it keeps them from falling into that path or prompts them to come forward and ask for help if they became depressed themselves then all the better.



June 17, 2009 - 11:33pm
EmpowHER Guest

Mayo Clinic

Causes of Anorexia


It's not known specifically what causes some people to develop anorexia. As with many diseases, it's likely a combination of biological, psychological and sociocultural factors.


Some people may be genetically vulnerable to developing anorexia. Young women with a biological sister or mother with an eating disorder are at higher risk, for example, suggesting a possible genetic link. Studies of twins also support that idea. However, it's not clear specifically how genetics may play a role. It may be that some people have a genetic tendency toward perfectionism, sensitivity and perseverance, all traits associated with anorexia. There's also some evidence that serotonin — one of the brain chemicals involved in depression — may play a role in anorexia.


People with anorexia may have psychological and emotional characteristics that contribute to anorexia. They may have low self-worth, for instance. They may have obsessive-compulsive personality traits that make it easier to stick to strict diets and forgo food despite being hungry. They may have an extreme drive for perfectionism, which means they may never think they're thin enough.


Modern Western culture often cultivates and reinforces a desire for thinness. The media are splashed with images of waif-like models and actors. Success and worth are often equated with being thin. Peer pressure may fuel the desire to be thin, particularly among young girls. However, anorexia and other eating disorders existed centuries ago, suggesting that sociocultural values aren't solely responsible.


For those of you who are interested in causes of eating disorders, it is best to check with EXPERTS on the subject.

June 17, 2009 - 9:51pm
EmpowHER Guest

Here's a research article well worth reading:

Family therapy in the treatment of adolescent anorexia nervosa: current research evidence and its therapeutic implications. June 2008
Cook-Darzens S, Doyen C, Mouren MC.

Department of Child and Adolescent Psychiatry, Hôpital Robert Debré, Paris, France. solange.cook@free.fr

From the outset, the systemic and family movement has expressed an interest in eating disorders, more specifically anorexia nervosa, establishing causal links between family functioning and aetiology and advocating family therapy as the treatment of choice for this disorder. Because of high consistency between its explanatory and therapeutic dimensions, this model continues to dominate our conceptualizations and clinical practice, IN SPITE OF A LACK OF EMPIRICAL EVIDENCE. This article summarizes present empirical evidence concerning both family functioning (explanatory dimension) and the effectiveness of family therapy (therapeutic dimension) in anorexia nervosa, and describes resulting changes in theoretical and clinical perspectives. A model of evidence-based family therapy is presented and several unresolved issues are raised. Overall, this overview of the literature supports the use of therapeutic models that are more flexible and normative, less guilt-inducing, more diversified (eclectic and integrative), and more rooted in the empirical literature.

PMID: 19169071 [PubMed - in process]

Caps are mine because I can't underscore or italize


June 17, 2009 - 8:34pm
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