How Does Anorexia Start? Identifying the Causes and Eating Disorder Treatments for Anorexics

Identifying the causes of anorexia nervosa can help with the treatment of this eating disorder. Here is new information about how anorexia starts, plus insight into how a person with anorexia thinks.

Why Finding the Cause of Eating Disorders is Important

“Currently, we don’t have very effective means of treating people with anorexia,” said Walter Kaye, MD, professor of psychiatry and director of the Eating Disorders Program at the University of California, San Diego. “Consequently, many patients with the disorder remain ill for years or eventually die from the disease, which has the highest death rate of any psychiatric disorder.” Once the cause of anorexia is known, psychologists and psychiatrists are better able to treat it.

In a review paper published online in Nature Reviews Neuroscience, Kaye and colleagues describe how dysfunctions in certain neural circuits of the brain may help explain how anorexia starts.

How Anorexia Nervosa Starts

According to Kaye, childhood personality and temperament may increase a person’s vulnerability to developing anorexia. Perfectionism, anxiety, or obsessive-compulsive tendencies may come before an eating disorder (but these traits don’t cause anorexia in all cases).

“Adolescence is a time of transition, when individuals must learn to balance immediate and long-term needs and goals in order to achieve independence,” says Kaye. “For such individuals, learning to cope with mixed societal messages and pressures may be overwhelming, exacerbating underlying traits of anxiety and a desire to perfectly achieve.”

Once anorexia starts and develops, starvation and malnutrition cause profound effects on the brain and other body systems. These changes include neurochemical imbalances, which may make the preexisting traits more dominant. This creates a downward spiral into severe anorexia or other eating disorders, and can even accelerate the disease process.

“Anorexia is very complicated, and there needs to be a paradigm shift in understanding its underlying cause,” said Kaye. “We’re just beginning to understand how the brain is working in people with this disorder.”

How People With Anorexia Think

“Individuals with anorexia tend to report that dieting reduces anxiety, while eating increases it,” says Kaye. “This is very different from most individuals, who experience hunger as unpleasant.” This drive to reduce anxiety can lead to an out-of-control spiral resulting in weight loss, severe emaciation, and malnutrition in people with anorexia nervosa.

Also, people with anorexia nervosa tend to not live “in the moment” or experience pleasure. People with anorexia often have exaggerated and obsessive worry about the consequences of their behaviors, looking for rules when there are none, and are overly concerned about making mistakes.

Symptoms of anorexia include distorted body image and diminished motivation to change, and could be related to their thought patterns.

Once the cause of an eating disorder is identified, treatments may be more effective and permanent. And Kaye offers good news! In his experience, many individuals who recover from anorexia do well in life.

To learn more about eating disorders such as anorexia nervosa, bulimia, body dysmorphic disorder, emotional eating, or sleep eating disorders, visit Articles About Eating Disorders.

Aug 9, 2009 11:39 AM

Guest :

Yes, many people die from this illness. Yes, it is very difficult. What needs to be emphasized is, CHANGE IS POSSIBLE. Sufferers do not hear this enough. They get very discouraged by the reality that it does cause the most deaths of any psychiatric illness. There are many inspiring stories of change and triumph and they never get told. People are overcoming this illness every day. People can do it and people can change. Great article.

Aug 9, 2009 5:05 PM

Laurie Pawlik-Kienlen :

Thank you for your comment and encouragement!

Here's information from a recent study in psychology about the treatment success rates of anorexia:

In the first nationwide outcome study anorexia of conducted to date, anorexia is a common, often severe, but highly transient illness. Its outcome is generally good: up to 70% of women with anorexia recover before age 30 according to collaborating scientist at Columbia University and University of Helsinki, Finland.

On average, the duration of anorexia was three years; about 25% recovered within a year, about 33% within 2 years, and about 67% within 5 years from the onset of their symptoms.

Recovery from anorexia was usually slow and gradual. First, lost weight was regained and menstruation resumed. Attitudes about body shape and weight took a much longer time to resolve. The Finnish study was conducted among pairs of female twins. Twins with anorexia nervosa were compared to their healthy co-twins and to healthy women from the general population. Within five years from weight restoration, women with anorexia nervosa were virtually indistinguishable from their healthy co-twins in terms of psychological symptoms and self-esteem. However, learning to deal with body shape and weight related concerns took usually much longer, 5-10 years.

This study didn't discuss the causes of anorexia -- but it does show how successful treatments can be.

The study is reported in detail in the American Journal of Psychiatry (issue Aug 1st, 2007).