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While many underestimate anorexia nervosa as a lifestyle choice, and hence easily reversed, it is in reality a mental health condition characterized by a severe eating disorder. A person with anorexia nervosa has an intense fear of gaining weight. So even if they are underweight, they try multiple methods of weight loss, from avoiding food or going on extreme diets to exercising too much.[ref]Anorexia Nervosa. U.S. Department of Health & Human Services.[/ref] About 10% of patients with anorexia nervosa die, whether due to starvation, malnutrition, or suicide. It has the highest mortality among eating disorders.[ref]Eating Disorders. The National Institute of Mental Health.[/ref] That’s reason enough to start asking what causes anorexia nervosa so that it can be prevented rather than treated. Look out for the following signs to check if you or a loved one suffer from this condition:
- Your body weight can be over 15% lower than ideal for someone of your age, gender, and height in normal health, with a loss of muscle mass.
- Your skin can turn blotchy or yellow, and fine downy hair may grow across your body.
- Your mouth may feel dry, and you may also be extremely sensitive to cold.
- You may find that your memory is failing you or that you are confused.
- Women may also have missed periods.[ref]Anorexia Nervosa. U.S. Department of Health & Human Services.[/ref]
So what causes or triggers anorexia? While this disorder is often associated with certain social or cultural triggers, experts have discovered that it does also have some biological and genetic causes.
A Close Relative With Anorexia
Someone with an anorexic family member is often left wondering if they are also at risk. Having seen first-hand just how damaging the disorder can be, it is a valid concern. Research shows that if you have a first-degree relative like a parent or sibling with anorexia nervosa, your lifetime risk is about 10 times more than someone without an affected relative.[ref]Pinheiro, Andrea Poyastro, Tammy Root, and Cynthia M. Bulik. “The genetics of anorexia nervosa: current findings and future perspectives.” International journal of child and adolescent health 2, no. 2 (2009): 153.[/ref]
This has led researchers to now explore the possibility that anorexia may not have purely psychosocial origins – there may actually be genetic roots too. Specifically, certain risk genes in the genome that are shared by close relatives on chromosome 1 may be to blame.[ref]A genetic link to anorexia. American Psychological Association.[/ref]
However, a proper genetic profile that can accurately ascertain your risk is still not on the horizon. Until then, having a family member with anorexia may be one way to tell that your risk could potentially be higher.
A Close Relative With Mental Health Problems
Some health problems are connected to an increased risk of anorexia. And having a close relative who’s had these problems could also mean you are more likely to develop these problems, as well as anorexia, than someone without this family history. These include[ref]Anorexia nervosa – Causes. National Health Service.[/ref]:
- Other eating disorders like bulimia
- Substance misuse
Malfunction In The Appetite Center Of The Brain
Another biological link to anorexia has to do with hormonal and brain function changes. If the part of your brain that controls your appetite is affected, it can cause you to eat less than you need to. It could also cause you to feel guilty or anxious when you do eat and make you feel better when you skip meals or exercise excessively. Experts have not been able to clearly establish whether it is these changes that directly bring on anorexia or whether the malnutrition from these changes is to blame.[ref]Anorexia nervosa – Causes. National Health Service.[/ref]
Stress, Depression, Obsession, Or Phobia
Wondering whether depression or other psychological disorders can set off anorexia? There is truth to those claims. Certain psychological factors make it more likely for you to develop anorexia. These include:[ref]Anorexia nervosa – Causes. National Health Service.[/ref]
- Difficulty managing stress
- Being a perfectionist and setting overly demanding goals or high standards for yourself, and being very strict about them
- Being extremely emotionally restrained
- Having a tendency for anxiety or depression; or a history of anxiety of depression
- Being a “worrier,” constantly feeling doubt or fear about your future
- Having a phobia or overwhelming fear of being fat
- Having a compulsive or obsessive personality, even without having full-blown obsessive compulsive disorder
Interpersonal Relationship Issues
Certain experiences or equations you share with people close to you can bring on anorexia or raise your risk. These include[ref]Factors That May Contribute to Eating Disorders. National Eating Disorders Association.[/ref]:
- Trouble in personal relationships
- Difficulty expressing your feelings or emotions in these relationships or to people in general
- Being made fun of for your weight or size by those around you
- Being sexually abused
- Being physically abused
The kind of family relationships you have and how you have been treated also play a significant role in your chances of developing anorexia. Troubled family relationships – like having an overprotective rigid family, an overly critical one, or one where a lot of emphasis is placed on your physical appearance – are associated with a heightened risk. Being abandoned or feeling lonely and not being able to openly talk to your family members can be a factor. Besides this, the death of someone you love or someone who is close to you can cause anorexia. The breakdown of a relationship is also a trigger for some.[ref]Anorexia nervosa – Causes. National Health Service.[/ref]
Certain societal norms or the culture you are brought up in or live in can also cause anorexia or eating disorders. These are red flags[ref]Factors That May Contribute to Eating Disorders. National Eating Disorders Association.[/ref] [ref]Anorexia nervosa – Causes. National Health Service.[/ref]:
- Thinness and having a perfect body are glorified in the environment you live and work in or by society or the culture as a whole.
- Beauty is defined by a specific ideal weight or shape, a narrow view of the idea.
- Certain hobbies are seen as “ideal” like athletics or dancing and these reinforce a certain ideal body image.
- People are judged based on how they look rather than their inner strength or qualities.
- Those who are not of a certain race, ethnicity, weight, or size experience prejudice or discrimination.
- There is bullying, stress, or pressure especially about how you look.
Risk Factors For Anorexia Nervosa
So how do you know if you or someone you know is at higher risk of developing anorexia nervosa? Here is a quick list of the various factors that might heighten your risk of developing this eating disorder[ref]Anorexia Nervosa. U.S. Department of Health & Human Services.[/ref] [ref]Eating Disorders. The National Institute of Mental Health.[/ref]:
- Being a teenager/young adult. While anorexia could manifest in childhood or later adulthood, most instances first appear during teenage or young adulthood. The average age of onset is 19 years.
- Being female increases your risk. Incidence is 2.5 times higher among women.
- A negative self-image means you are more susceptible to anorexia and the feeling of not being the “right size” or of being imperfect.[ref]Anorexia Nervosa. U.S. Department of Health & Human Services.[/ref]
- A family history of eating disorders raises your chances of developing the problem.
- An anxiety disorder in your childhood may increase the risk of anorexia as an adult.
- Eating-related issues in childhood or infancy too may be early warning signs.
- Being in a certain job or society or brought up in a culture that sets certain body image ideas that might demand you to weigh less or be skinny.
- Being very concerned about or giving a lot of attention to your shape and weight is another risk factor.
- A need for perfection or an unusually high focus on rules may up your risk.[ref]