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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

Thank you, thank you, Carol and Hannah!

You both expressed exactly how I was made to feel by many (not all) of the comments posted on this blog. Yes, the anxieties I felt were caused by the many extremely disrespectful comments made directly to me, that did indeed cross my personal boundaries. No one deserves to be attacked in this conversation. We all have a personal right to our own opinions. It's always so much more constructive when disagreements are handled in a polite and respectful manner. Attacking someone only makes the attacker appear to be insecure with themselves, and their own opinions.

There've been some very, very good and interesting comments posted (on both "sides") on what has turned into a "debate." However, there have also been some very ugly and hurtful comments personally directed at me. Talk about kicking someone when they're already down! Knowing I still suffer from EDs, being so rude to me with words, crossing my boundaries verbally - well that's what bullies do. I would feel extremely ashamed of myself if I'd acted like that, towards anyone.

I've repeatedly tried to be so consciencious in the way my words come across, so as not to be mis-construed by anyone reading them. Contrary to many negative comments directed at me, I have intentionally attempted to show my compassion and sympathy - while trying to tell my very personal story of my own struggles with EDs, which I seems to have fallen on deaf ears.

I was planning on not commenting to anyone else on this blog, but I wanted to thank you both for stating exactly how I was made to feel by so many (not by everyone, but by many of the other posters).

Bless you Both!!!

June 11, 2009 - 2:12pm
EmpowHER Guest

For some reason I feel like much of this whole conversational debate could have been avoided if Joanna had included some reference to the current research. Maybe talked about genetic predisposition and malnutrition as triggers coupled with psychological stressors. All the boundary violations in the world happening daily won't cause an ED unless one is predisposed to it. It just sounds WRONG, given all the research that's going on right now, to put up this theory that excludes biology from the mix.

June 11, 2009 - 11:43am
EmpowHER Guest

Hi Hannah, Carol and Shelley--

I realize this topic is emotion-ladened for all--parents and sufferers alike. Parents reacted because the article, the way it was written, sounded as though it was blaming the family environment of sufferers 'in general' and that it was true in all cases (e.g. 'with every person suffering an ED').

From a parent's perspective, this is hurtful, harmful and--even if none of us are perfect parents (and we aren't)--it is most often not true. That is not to negate anyone's individual feelings about their families, but our perceptions and understanding of this illness are colored by our own personal experiences. Recent research is shedding so much new light on ED's. No one need feel 'to blame'. When blame is eliminated, it frees everyone to concentrate on recovery.

I didn't want a family new to the experience of having an eating disorder in their midst, to read this article and instantly feel tremendous guilt and shame. I wanted families to know there was a way--a treatment method--that would help them reach out and help heal their very much loved one. I also didn't want anyone suffering from an ED to feel blamed or be forever searching for causes when they could get on with healing their body and mind. This is not to say talk therapy is never useful--it can very much be for co-existing anxiety and depression. Do families never have personal issues that need resolving? Of course not. Do most families want to function well and see their loved one healthy? Of course. FEAST believes nutrition has to be first and foremost and that what supports the family will support the person suffering. I also believe that coming from a position of blame helps no one move forward.

So, I want to reach out and say I am sorry if any of you are feeling blamed. It is not the intention of anyone to project that towards sufferers or family members affected by an ED in their family.

To the contrary, we very much understand how that feels, and the Maudsley approach blames no one. It is an illness, the same as you would view other illnesses.

If nothing else, this exchange demonstrates the upset that the perception of feeling blamed can cause (and I doubt, really, that that was even the intent--but how one sends a message, and how one receives it can be two different things!). I might add, the reason I wrote some words in caps in past posts is because I couldn't figure out how to underline or italicize on this blog. I was not intending to yell (except for the one comment about 'the emperor'), but to emphasize. I can't do it in a real 'voice', other than change the lettering.

I, also, am leaving this conversation at this time as I have expressed what I felt I needed to.



June 11, 2009 - 11:38am
EmpowHER Guest

The more I read, the more I have to agree with Carol – not because I believe that parents cause an ED, but because the parents in this thread basically make it about them, and them only, thereby completely invalidating anyone else's opinion. I find it kind of disheartening, even though I understand that having your own child succumb to such an illness must be terrible. It's just that it seems so … familiar. It's always about someone else, about what they do, about they help. All of which is appreciated, all of which is also exhausting, all of which is stifling me in the end.

Oh well, maybe I am manipulating or unable to cope here or whatever form of judgment I'll have to face now. It's the same kind of farce that always seems to happen – everyone's good intentions ultimately just lead to a lot of bickering about how to best proceed, but no real progress is ever made, and it all goes right over my heads and the only thing I get is that I am somehow responsible for turning everything into such a bloody mess. It always makes me want to apologise, for not being perfect, for not being like everyone else… and here we go. It's a funny thing, a family.

No offense intended, none taken. I mean it.

June 11, 2009 - 9:41am
EmpowHER Guest

Where is the evidence to support this theory that "boundary issues" are the number one cause of eating disorders?

I have never read or heard that from eating disorder experts/medical information anywhere.

No scientific evidence to support this theory coming from a person who practices therapy specializing in treating people with eating disorders.

And you wonder why people are upset to read this article?

June 11, 2009 - 8:15am
EmpowHER Guest


Sorry if you find some comments RUDE.

What many are saying is that PARENTS are NOT THE "Number One Reason" Why People get Eating Disorders.

Any therapist who holds that point of view stands alone among what 21st century professionals/experts know about causes of ED.

Any therapist who tells you that is doing YOU and others more harm than good.


I wish you well, too.

June 11, 2009 - 5:57am
EmpowHER Guest
Anonymous (reply to Anonymous)

Hey there Anonymous,

You just proved Carol's point. The article says boundary violations are a prevailing theme in the lives of people with eating disorders. The article never says, in your shouting caps or in small type, that parents are the number one reason.

The article discusses varying kinds of boundary violations and their consequences.

Did you identify with those boundary violations? Is that what is so upsetting to you?

Any why would you attack Carol and try to undermine her recovery work?

Do you try to undermine others, perhaps even your child, when they say something that you disagree with or something that points to a possible flaw in your beliefs?

Just wondering......

June 11, 2009 - 6:20am
EmpowHER Guest
Anonymous (reply to Anonymous)

To the person who questioned my reference in bold caps to "Number One Reason", did you even bother to read the TITLE of Joanna's article???

Just wondering ...

June 11, 2009 - 7:08am
EmpowHER Guest
Anonymous (reply to Anonymous)

From the opinion piece above: "Early in their lives, people with eating disorders have experienced, on a sustained basis, relentless boundary invasion on every level."

Who is it suggested did this supposed "boundary invasion", WHO is the most likely causative factor according to this statement?

Just wondering....

I wish you well in your recovery.

June 11, 2009 - 6:54am
EmpowHER Guest

I think this entire conversation validates Joanna Poppink's conclusion from years of practice with eating disordered adults that boundary violations are a common theme in those who develop eating disorders. Those of you who are dogmatic, vociferous proponents of the "Maudsley Method" and F.E.A.S.T have violated the boundaries of those of us who did experience these boundary violations and did develop eating disorders. It is not surprising to me that the mothers completely deny that they may have in any way contributed to their child's issues, except to concede some kind of genetic predisoposition. Your disrespect for those of us who are/were children who had/have eating disorders that is at some level connected to our parent's relationship with us only reinforces Joanna's point. You can't know what you aren't willing to acknowledge in yourself.

Any treatment modality that states that parents are never to blame completely denies the experience of what I can only imagine are millions of women and men who suffer from eating disorders.Maybe you just need to drop the word blame - it's too loaded and doesn't even begin to address the nuances of a complex relationship that involves love and compassion as well as mistake and injury. You condescendingly deny and question my reality which leads me to the conclusion that you don't respect boundaries and that you have to be right.

I'm not willing to read this arm-twisting, narrow-minded, rude conversation any more. I wish your children well....


June 10, 2009 - 10:36pm
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