Why Do Eating Disorders Happen? Delving Into Leading Theories
It’s a really complex question, but one that I’ve contemplated for the last decade: Why do eating disorders happen? I’ve always been curious about who gets eating disorders, where they come from, why they show up, and how they show up. Although there is no clearcut answer to this deeply complicated and nuanced topic, there are a few dominant theories that help us to better understand the development of eating disorders. Although we refer to these ideas as “theories,” they are all well-researched and widely accepted. I will delve into a few them here!
Self-Esteem Theory - Decades of research have identified low self-esteem as a risk for eating disorder development. This theory posits that people who have low self-esteem are more likely to be critical of their appearance and more likely to struggle with body image distress. For that reason, these individuals tend to engage more with maladaptive eating disorder behaviors. But this theory may leave us with even more questions than answers… Namely, what causes low self esteem?
Interpersonal Theory - This theory suggests that dysfunctional eating is a maladaptive response to stress. In other words, if an individual is experiencing high stress in their life, they may turn to eating disorder behaviors as a way to cope with the emotional pain. Shame has been identified as one of the most physically painful and stressful emotions tied to eating disorder development.
Emotional Regulation Theory - Similar to Interpersonal Theory, this theory deals with emotional responses. This theory highlights the view that individuals who struggle with regulating their emotions are vulnerable to developing eating disorders, and the eating disorder becomes a way to regulate.
Transdiagnostic Theory - This theory suggests that the cause of eating disorder pathology is the same across every eating disorder diagnosis. In this view, it doesn’t matter if you struggle with binge eating, purging, restriction, over-exercising, or all of the above. This theory posits that the core cause of eating disorders is being overly influenced by body size and shape. I know my mind immediately goes to media and social media when I think about this theory… what comes up for you?
Executive Function Theory - This is the view that the primary deficit in those with eating disorders is actually a deficit in executive functioning. Executive functioning refers to a set of mental skills that help you plan, focus, and execute your day-to-day life. In this theory, individuals struggle with eating disorders as a result of lacking executive functioning skills like cognitive flexibility and inhibitory control. (This includes being overly controlled!)
Social Neuroscience Theory - I’m so intrigued by this theory because it delves in the neurological differences between individuals who are vulnerable to developing and individual and those who are not. We already know that genetic differences account for 40-60% of variability in eating disorders, but there is some evidence that individuals who have eating disorders actually interact with people differently on a daily basis. Namely, their brains may be activated differently in social appraisals. I am looking forward to more research in this area!
Theory of Mind - The final theory I will mention for today is based on Theory of Mind. Individuals who are aligned with this theory believe that people with eating disorders have a different capacity for understanding other people’s perspective. To be specific, individuals with eating disorders may over-value the opinions of others and may be anxious and hypervigilant in interacting with other individuals, which may be linked to the development of eating disorders.
It’s important to remember that no one theory explains it all, and there are many theories in addition to the ones I’ve listed in this blog post. For some individuals, one theory may be more relevant than another, but it is likely that all of these schools of thought are important in understanding how eating disorders develop.
If you or somebody you love is struggling with an eating disorder, please feel free to reach out to me at eada@morningbirdtherapy.com!
Edward-Gayfield, P. & Kim, N. (2024, July 1-September 30). Overview of Eating Disorders [Conference presentation]. iaedp Foundation 2024 Virtual Symposium.