Introduction

An eating disorder is any disorder characterized primarily by a pathological disturbance

of attitudes and behaviors related to food, including anorexia nervosa, bulimia nervosa,
and binge-eating disorder. Other eating-related disorders include pica and rumination,
which are usually diagnosed in infancy or early childhood.

Eating disorders are complex mental health conditions characterized by abnormal

eating behaviors, thoughts, and attitudes toward food and body image. Their causes are
multifaceted and involve a combination of biological, psychological, and sociocultural
factors.

Factors influencing eating disorders

Biologically, genetic predisposition and neurochemical imbalances, such as serotonin

dysregulation, have been linked to the development of these disorders (American
Psychiatric Association, 2022).

Eating disorders have been linked to biological factors that influence susceptibility.
Genetics play a significant role, with studies showing that individuals with a family
history of eating disorders are at higher risk. Brain structure and neurochemical
imbalances are also critical; for instance, dysfunction in the hypothalamus, which
regulates appetite, can contribute to abnormal eating behaviors. Neurotransmitters like
serotonin and dopamine, which influence mood and reward pathways, are often
dysregulated in individuals with eating disorders, exacerbating behaviors like bingeing
or restriction. Additionally, hormonal imbalances, particularly during puberty, may
interact with genetic predispositions to trigger these conditions. Such biological
underpinnings emphasize that eating disorders are not solely driven by environmental
or cultural factors but are complex conditions involving a combination of genetic and
neurobiological influences.

Psychological factors, including low self-esteem, perfectionism, and a distorted body

image, often exacerbate vulnerabilities, making individuals more susceptible to eating
disorders.

Psychological factors play a critical role in the development of eating disorders. Low
self-esteem, perfectionism, and body dissatisfaction are common traits associated with
these conditions. Individuals with eating disorders often struggle with distorted body
image, feeling an intense fear of weight gain despite being underweight. Emotional
regulation difficulties, such as using food as a coping mechanism for stress, anxiety, or
depression, are also significant contributors. Moreover, individuals with histories of
trauma, abuse, or neglect may develop disordered eating as a means to regain a sense
of control. Co-occurring mental health conditions, such as obsessive-compulsive
Introduction

disorder (OCD) and anxiety, further exacerbate the risk. These psychological
vulnerabilities interact with environmental and biological factors, creating a complex
etiology for eating disorders.

Sociocultural influences are also significant, with societal pressure to conform to

unrealistic beauty standards promoted by media and social platforms being a major
contributor, particularly among adolescents and young adults.

Sociocultural factors play a significant role in the development and perpetuation of

eating disorders, as they shape individuals' perceptions of body image and beauty.
Cultural ideals emphasizing thinness and unrealistic body standards, often perpetuated
by media and social networks, place immense pressure on individuals to conform. This
pressure can lead to body dissatisfaction, which is a strong predictor of disordered
eating behaviors (Stice, 2002). Additionally, societal norms and expectations regarding
gender contribute to differences in how eating disorders manifest. For example, women
are often subjected to a cultural emphasis on slimness, while men may face pressures
to achieve a muscular physique, influencing their specific eating behaviors and attitudes
(Murray et al., 2017). Peer influence, including teasing or praise about appearance,
further reinforces these standards, creating an environment where individuals feel
compelled to alter their eating patterns to align with perceived societal expectations.
Thus, sociocultural factors, including media, peer interactions, and cultural norms, are
critical in understanding the prevalence and nature of eating disorders.

Family dynamics, peer pressure, and cultural norms surrounding dieting and body
image can heighten the risk.

Environmental factors significantly influence the development and progression of eating

disorders by shaping individuals’ behaviors, attitudes, and perceptions about food and
body image. Family dynamics, for instance, play a critical role, as overcritical or
controlling parenting styles, family conflict, and emphasis on appearance can increase
vulnerability to disordered eating (Hildebrandt et al., 2012). Additionally, exposure to
environments that prioritize appearance, such as modeling, athletics, or performing arts,
often heightens body dissatisfaction and pressure to maintain specific body standards
(Thompson & Sherman, 2014). Peer environments can also contribute, with weight-
related teasing, peer comparisons, and shared dieting behaviors exacerbating the risk.
Furthermore, socioeconomic factors, such as access to food and cultural differences in
body ideals, shape eating behaviors and perceptions of self-worth.

Together, these environmental influences create a complex web of factors that interact
with individual vulnerabilities, increasing the likelihood of developing eating disorders.
Introduction

Other Contributing Factors

Dieting: Extreme or prolonged dieting is a significant risk factor, as it can lead to

preoccupation with food and binge-eating episodes.

Life Transitions: Stressful events like moving, starting a new job, or relationship
changes may act as triggers.

Athletics: In sports that emphasize weight or appearance (e.g., gymnastics, wrestling),

athletes may develop disordered eating habits.

These factors interact in unique ways for each individual, creating a multifaceted risk
profile that underscores the importance of addressing eating disorders from a holistic
perspective.

Common eating disorders

Anorexia nervosa is a severe eating disorder characterized by intense fear of gaining

weight, distorted body image, and persistent restriction of energy intake, leading to
significant weight loss or failure to maintain a healthy weight. It is often associated with
psychological factors, such as perfectionism, low self-esteem, and a need for control,
which contribute to the development and maintenance of the disorder (American
Psychiatric Association [APA], 2022). Physical symptoms include extreme thinness,
brittle hair and nails, and, in severe cases, organ damage. The disorder predominantly
affects adolescents and young women, although it can occur in all genders and age
groups. Socio-cultural pressures to achieve thinness, combined with genetic
predisposition, further exacerbate the risk of anorexia nervosa (Zipfel et al., 2015).
Treatment typically involves a multidisciplinary approach, including nutritional
rehabilitation, psychotherapy, and medical monitoring, although recovery can be
challenging and relapse rates are high.

Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge

eating, followed by compensatory behaviors such as self-induced vomiting, excessive
exercise, or misuse of laxatives to prevent weight gain. Individuals with bulimia often
experience a sense of loss of control during binge episodes, accompanied by feelings of
guilt, shame, or distress. Unlike individuals with anorexia nervosa, those with bulimia
typically maintain a body weight within or above the normal range, making the disorder
less visibly detectable. Bulimia is strongly associated with body image disturbances,
where individuals overvalue physical appearance and internalize societal beauty
standards. This condition can lead to severe physical complications, including
electrolyte imbalances, gastrointestinal issues, and dental erosion due to frequent
Introduction

vomiting, as well as significant psychological distress, including anxiety and depression.

Early intervention through a combination of psychotherapy, nutritional counseling, and,
in some cases, medication, is essential for effective treatment and recovery (American
Psychiatric Association, 2022).

Subtypes:
Restricting type: Weight loss primarily through dieting, fasting, or excessive exercise.
Binge-eating/purging type: Weight loss through a combination of dietary restriction and
purging behaviors (e.g., vomiting, laxative use).
Clinical Manifestations: Low body weight, amenorrhea, lanugo, bradycardia,
hypotension, electrolyte disturbances.

Binge Eating Disorder (BED) is a serious eating disorder characterized by recurrent

episodes of consuming unusually large quantities of food in a short period,
accompanied by a sense of loss of control. Unlike bulimia nervosa, individuals with BED
do not engage in compensatory behaviors such as vomiting or excessive exercise.
These binge episodes are often associated with eating rapidly, eating until
uncomfortably full, eating alone due to embarrassment, or feeling disgusted, depressed,
or guilty afterward. BED is the most common eating disorder in the United States and is
often linked to psychological factors such as stress, depression, or low self-esteem. It
can lead to significant physical health consequences, including obesity, diabetes, and
cardiovascular issues, as well as psychological distress. Treatment typically involves
cognitive-behavioral therapy, nutritional counseling, and sometimes medication,
focusing on developing healthier eating habits and addressing emotional triggers
(American Psychiatric Association, 2022).

Other Specified Feeding or Eating Disorder (OSFED) is a diagnostic category used to

describe eating disorders that cause significant distress or impairment but do not fully
meet the criteria for other specific eating disorders like anorexia nervosa, bulimia
nervosa, or binge eating disorder. Individuals with OSFED may exhibit a range of
disordered eating behaviors, such as atypical anorexia nervosa (where weight remains
within or above a normal range), purging disorder (engaging in purging behaviors
without binge eating), or night eating syndrome (consuming excessive food during the
night). OSFED is the most commonly diagnosed eating disorder and can be just as
severe as other eating disorders, with similar physical and psychological complications,
including nutritional deficiencies, emotional distress, and body image disturbances.
Early recognition and intervention are crucial for effective treatment, which often
includes therapy, nutritional counseling, and addressing any underlying mental health
issues (American Psychiatric Association, 2022).
Introduction

Pica is a feeding and eating disorder characterized by the persistent consumption of

non-nutritive, non-food substances for at least one month, which is inappropriate to the
individual’s developmental level and not culturally or socially normative. Commonly
ingested items include dirt, chalk, paper, soap, hair, or ice. Pica can occur in individuals
of all ages but is more frequently observed in children, pregnant women, and individuals
with developmental disabilities. The disorder poses significant health risks, including
poisoning, gastrointestinal obstruction, and nutritional deficiencies, depending on the
substances consumed. While the exact cause of pica remains unclear, it is often
associated with nutritional deficiencies, such as iron or zinc deficiency, or co-occurring
mental health conditions. Treatment typically involves addressing underlying medical
issues, behavioral interventions, and, in some cases, psychological therapy to manage
the compulsive behavior (American Psychiatric Association, 2022).