Living in an eating disorder professional world and a culture that is certifiably nuts about its expectations regarding body size and shape, I push myself to read the latest research and whatever else comes to my “in box,” regarding eating disorders. Staying relevant is the key in so many things…
A recent on-line article titled, “Ten Things Parents Wish Educators Knew About Eating Disorders,” by Jennifer Ouellette, Parent Advisory Committee at UCSD Eating Disorders Center, was posted on the Academy for Eating Disorders website (www.aedweb.org,) one of my professional organizations.
So, here we go again folks…those of us who have accepted that eating disorders are “multi-causational,” do or (should, perhaps) take issue with Fact # 1. In fact, I am surprised that the AED allowed for the inaccuracy. I trust it was without intent?
“Facts: certain eating disorders have a mortality rate as high as 20%, eating disorders are up to 80% genetic, and they are biological in nature.” (Ouellette)
Truth is, and you can check the research ad nauseam, there has been NO gene found to date, that causes or even explains eating disorders. The only FACT in this sentence is that the mortality rate for eating disorders is very high – highest mortality for all mental health disorders.
Regarding biological factors influencing causation, the research leans toward inheritability toward anxiety and depression (among other reasons,), which contribute to a person developing an eating disorder. This much, most people can understand. If someone is anxious or depressed, makes sense that an eating disorder would be an attempt to address (comfort, lift, divert, displace, express, contend with) very profound mood states. In a culture that glorifies thinness and has a specific body ideal, anxiety and depression can have an ‘outlet’ through an eating disorder, albeit temporarily. We are also finding some success through research in seeing traits such as ‘perfectionism,’ as having some inhereditability and therefore contributing to stacking the deck toward the development of an eating disorder.
The National Eating Disorders Association states on its website:
“Eating disorders are complex conditions that arise from a combination of long-standing behavioral, biological, emotional, psychological, interpersonal, and social factors. Scientists and researchers are still learning about the underlying causes of these emotionally and physically damaging conditions. We do know, however, about some of the general issues that can contribute to the development of eating disorders. NEDA acknowledges that there may be a difference of opinion among experts and in the literature on this topic, and we encourage readers to explore the topic further, using all reliable sources available to them.”
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No where in NEDA’s statement is the word, “gene.”
The one size fits all approach to causation is as damning as the attempt to fit all people in to one size fits all categories with respect to body size and shape, personality, or who or what constitutes normal and healthy living.
Whenever we think that there is an exclusive or exact explanation for something…. be aware or beware. Most things are never that black or white…all or nothing, as we say in eating disorder circles. Whatever may come our way that compels us to choose either THIS or THAT…most times, the answer is this AND that.
I have never met an individual for whom anxiety or depression were the sole causal factors that determined the development of an eating disorder. It is a constellation and perfect storm of biology (for some or many, perhaps,) psychological and yes, familial issues and stressors, environment and social/cultural/media forces. Determining the specific factors and how they interplay is the work of the seasoned practitioner in conjunction with the person and family seeking help.
Perhaps one day a gene, or combination of genes, will be discovered to explain eating disorders; that would be GREAT. Until then, we have a lot of solid clinicians and researchers who are open to understanding all the causal factors that are before us and in exploring all the options for treating each patient as a complicated, unique and interesting individual.
