There are many causes of eating disorders, and psychologists do not fully understand them all. The easiest explanation is that fashion and culture peddle the image of thinness as beauty; young girls succumb and hurt themselves in the process. That explains part of the matter. But eating disorders are much more than the fallout of fashion opportunism. Some say eating disorders are one way to assert power in a time of seeming powerlessness. They are a voice against oppressive authority, a lifeboat in a storm of transition. Others say eating disorders are a matter of genes unleashing a drive for thinness.
Whatever the reason, all of these forces converge in adolescence. When eating disorders start here, they typically follow a pattern. Stresses mount as new issues come up: I have a crush on John, but he likes somebody else. The old ways, the ways of a child, cannot solve the new problems: I guess I can't throw a tantrum or complain to Mom. A girl takes the problems out on her body: He must not like me because my thighs are too fat. She reduces the problem to something she can manage: I hate my thighs. I'll go on a diet. And for most girls, this is where the cycle stops. But a minority take the next step, and it is a big one. The dieting, exercise, and preoccupation with body move to center stage, taking over girls' lives, propelling them into the realm of eating disorders.
Disease usually emerges as a gradual slide: dieting evolves into perpetual starvation; or dieting forces ravenous hunger, which in turn prompts bingeing. Or bingeing provokes extreme guilt, which leads to vomiting, laxative abuse, or overexercise; or attempts to squelch bad feelings with food, leading to runaway eating. In general, the progression of an eating disorder flows like this: A woman hates herself; her low self-esteem causes extreme concern about her shape and weight; this, in turn, prompts strict dieting. With anorexia it stops here.
With binge eating disorder, the strict dieting leads to binge eating; with bulimia, the binge eating leads to such guilt that it triggers the urge to vomit or purge in some other way. In a reverse flow, vomiting, bingeing, and strict dieting all feed back to make a woman even more preoccupied with her weight and shape, which in turn lowers her already low self-esteem.
Bulimia and anorexia are but two of a wide spectrum of eating disorders. Binge eating disorder falls into the mix as well. There are also more minor kinds of eating and body obsessions. And women can have subclinical disorders, which include the symptoms of eating disorders but not to the serious levels that meet diagnosis.
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