Eating disorders have a reputation for being highly resistant mental health problems. In my private practice, I work with people who are struggling with food restriction, bingeing, purging, overexercising, body obsessions, body dysmorphia, and other patterns of controlling the mind and body. While it is true that people don’t freely give up their eating disorder, it is a myth that full healing isn’t possible. But before we come to a conversation about how to heal, people want and need to know why they are struggling. So, we start by asking the question: “What causes eating disorders?”
Prior to looking at our list, it is important to note that there isn’t one cause for an eating problem. In the past, behavioural therapies believed that food was the sole issue, which led to people being trained (or forced) to eat “normally.” These approaches were largely unsuccessful, and most professionals have given up this concept (although some treatment centres, medical professionals, and naturopaths continue to hold onto these beliefs in subtle ways).
Humanistic, mindfulness, and transpersonal therapy all share a similar view: that mental health problems result from losing touch with our true nature. When our thoughts take over our minds, when we are avoiding or becoming consumed by emotions, when we are ingrained in dysfunction social trends, and when we believe that we are nothing more than our body, we start to get signs that we are out of touch with our innermost self.
All of the causes listed below are interconnected, and when we look at treating an eating disorder, we need to address the whole person: body, mind, and spirit. Here are some of the psychological, social and spiritual causes of eating disorders:
Psychological Causes of Eating Disorders
• Obsessive-Compulsive Patterns: When people experience intrusive, obsessive, fearful thoughts, they may find unhealthy ways of managing fear, including using food or exercise. The body can also become a target of obsession, which masks the underlying fears. It seems like food or fat is the fear, when really it is much deeper than that.
• Addiction Cycles: When people repress emotions and attempt to control their internal world, it can lead to destructive ways of coping such as binge eating or over-exercising. When these patterns are repeated over and over, they are reinforced in the brain and make it incredibly difficult to stop. People also get stuck in patterns of restricting and then bingeing, which confuses the reward and stress systems. And, unlike alcohol and drugs, you cannot avoid eating in recovery.
• Stress Management: When people struggle to face real issues, process emotions, and accept and work with the present moment, they may begin avoiding symptoms of stress and start shutting down inside. This can lead to self-abandonment or self-sabotage in the form of binge eating or over-exercising. Others may try to assert a false sense of control by restricting or fixating on their diet. Typically, people are successful at repressing their stress in one area of their life, but it pops up in another area. Sometimes it becomes hard to see the connection and they are unaware of how their eating disorder is related. They may not even experience stress subjectively because they are so disconnected from their mind and body.
• Anxiety and Depression: Some people use food and their bodies to control other mental health symptoms, including depression and anxiety. For example, a person who feels depressed may use food to self-soothe, or someone with anxiety may avoid fearful or uncomfortable thoughts by hyper-focusing on exercising or controlling their body. While the distraction and avoidance may initially serve a purpose, it eventually becomes its own problem.
• Trauma or Adverse Childhood Experiences: When someone experiences trauma, it affects the nervous system. This means that how they experience fear and stress changes, as does their ability to regulate their emotions and make healthy decisions in times of stress. People sometimes turn to food or other means of controlling the body to regulate themselves. It can feel like a form of self-soothing. In addition, trauma affects how people feel about themselves and others, which can lead to use of food, exercise, etc. to gain a false sense of control or ease.
• Self-Esteem: People who experience low self-esteem may look to their body or food to fill the emptiness they feel inside. Controlling how we look can lead to a false form of enhanced self-esteem. Over time, the patterns can become ingrained as people may feel initially better (i.e. the eating disorder works at first), but then worse in the long-term due to the physical, mental, and emotional impacts of eating problems.
• Perfectionism: Eating disorders can be a consequence of deep-rooted thought processes that involve setting high expectations and then being overly critical and punishing of oneself when you inevitably cannot meet the expectation. For many, this becomes a vicious cycle that creates shame. Typically the person is aware of their rigid or high expectations but unsure of how to free themselves from the pattern.
• Defence Mechanisms: Everyone uses defence mechanisms as a way of easing discomfort, avoiding addressing real issues, or pushing through life. They help reduce feelings of inferiority or increase feelings of superiority, but they also distort awareness. When we aren’t paying attention to the real issues in our lives, the problems don’t go away. Instead, various symptoms begin to arise and alert us that something is wrong. However, when our defence mechanisms are strong (e.g. denial, rationalizing, projection, and so on), we may be unable to see how everything is connected. As a result, the symptoms may persist over a long period of time until they are entrenched. Then, attempting to recover from an eating disorder becomes difficult because the defence mechanisms protect the behaviours.
Social Causes of Eating Disorders
• Body Obsession in Society: People are affected by constant messages about what is a good vs. bad body. We hear comments about weight both through criticisms and compliments. Our society has a special hate for fat people: it is a way that many humans choose to express their superiority over others. Being bombarded by the message that you are only as good as how your body looks contributes to unhealthy ideals. This conditioning is reinforced through social media, which is a constant in the lives of many people today. An example of our obsessions can be seen in trends such as the “What I Eat in a Day” videos where you watch everything a stranger eats in 24 hours. Why would we ever want to know what someone eats all day? Either to have a body like them or to avoid having a body like them.
• Conditioning Around Food: Our environment and upbringing influence how we view food, how we use food (e.g. to celebrate, to soothe, to show love, etc.), when we eat, how we eat, and so on. This learning often happens unconsciously and can therefore create problems without us realizing it. For example, forcing children to eat when they are not hungry leads to confusion and over time teaches the child to mistrust their own bodily signals.
Spiritual Causes of Eating Disorders – The Missing Link
• Awareness: Many people mistakenly believe that awareness means an intellectual understanding of what we do or who we are. However, there is a deeper type of awareness linked to our consciousness that involves being aware of our own awareness. When our awareness is open, we can free ourselves from the defences that keep us stuck. We see our lives from a truly objective standpoint. It is as if we can finally see the truth. This leads to an increased ability to create change in our lives because we are conscious of the deeper dynamics at play and we are able to choose to step out of them. Awareness is non-judgemental, compassionate, and honest. It is deeply healing in itself, but an aspect of traditional therapy that is often missing because many therapists aren’t even aware that it exists. The opposite of awareness is auto-pilot, or being stuck in your own mind. This perpetuates the psychological and social causes of eating disorders listed above.
• Sense of Self: This means being connected to who we are on the deepest level. Some people refer to this as their true self, their spiritual self, or their heart center. When we know who we are, we become free to let go of false identities (the ego) that keep us stuck. Some false identities related to eating disorders include the skinny identity, the sick identity, the perfect identity, the fit identity, the worthless identity, the unique identity, and so on. There are countless variations of false identities that we see in human nature. Sense of self is separate from self-esteem. Self-esteem relies on an intellectual evaluation of ourselves, which is why it becomes rated as high or low. Sense of self is a deep knowing who we are, unrelated to concepts. It is something that we feel experientially when we begin to step out of the thoughts in our minds and connect with our awareness in inner silence.
• Intuition: This is another spiritual concept that involves knowing what is deeply right for you in each moment. It is connected to our innate wisdom, and it can be strengthened with the right practices. Intuition, awareness, and sense of self are interconnected. We cannot practice intuition in one area (e.g. eating), while blocking it out in other areas. We also cannot rely on intuition when our minds are busy or out of control. When we are connected to our intuition, we can make choices that support our well-being rather than ones that lead to self-destructive patterns such as eating disorders.
• Purpose and Meaning: What is life all about? Why am I here? What am I meant to learn from my experiences? Is there something greater that is guiding me? These are philosophical and spiritual questions that plague many people, and our society isn't very focused on helping them find answers. We are taught that if we get the right job, the perfect home, the best partner, the healthiest body, and so on, that we will be happy. And yet, seemingly more than ever, people are struggling with their mental health. When we lose connection with our deeper purpose, we can latch onto unhealthy behaviours and identities, including eating disorders.
Eating disorders are symptoms of psychological, social, and spiritual concerns that have gone unaddressed. They are not simply about weight or looks or food. By learning to look inward and recognize the factors contributing to your own eating disorder, you take the first steps on your path to healing.
If you have concerns about food, weight, body image, or sense of self, connect with me for a free phone consult to see how I can help. I am a psychotherapist in Burlington, Ontario offering virtual therapy appointments.
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