Causes and Risk Factors of Anorexia

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Anorexia is an eating disorder that causes people to restrict how much food they consume to prevent weight gain. This condition is most commonly observed in women—around 4% of the female population live with this disorder.

Anorexia usually progresses until a person becomes underweight. However, despite the obvious change in appearance, a person with this condition will continue to view themselves as overweight. 

This disorder is a recognized mental illness. It has the highest mortality rate of any mental disorder, making proper management a matter of urgency for anyone with the condition.

Several factors may be responsible for developing anorexia. Eating disorders, including anorexia, are complex and include a range of risk factors, including biological, psychological, and cultural. The risk factors may also interact differently in different people.

Brain and Body Risk Factors of Anorexia

Even though there remains a lot to uncover about the causes of anorexia, the links between eating habits and hormones remain strongly supported.

In particular, estrogens (hormones that grow and develop the reproductive system) have been recognized as directly impacting food intake. For example, estradiol—one of the estrogens responsible for maturing and maintaining the reproductive system—has been known to produce feelings of fullness. This hormone also prevents the need to eat and may cause reduced portions to be consumed.

A person with anorexia might also be operating on a shortage of neurotransmitters like dopamine which controls eating habits and rewards. This deficiency can also affect serotonin which impacts impulse control.

Psychological well-being is also important in the progression of anorexia. People with anorexia often struggle with perfectionism. When doubts spring up about the importance of one’s work, contributions to life, or even their impact on friends and family—these feelings of inadequacy can spur the development of anorexia.

A person may limit how much food they consume as a way of exerting control over something in their life. 

Low-self esteem that develops from bullying overweight or other factors, could also lead a person to regulate how much food they eat. Likewise, anxiety, anger, and loneliness serve as common risk factors for anxiety.

Family History and Genetics

Anorexia’s emergence may also be linked to a history of this condition within the family. Studies show that a person is 7 to 12 times more likely to develop this eating disorder if a family member has previously lived with it.

However, while anorexia may commonly exist among members of the same family, studies on genetic links remain inconclusive.

Notwithstanding, the family environment remains fertile ground for this condition to spring from. Being surrounded by parents/caregivers that wield excessive control over their children, or who have strong preoccupations with appearance, food, image, and/or weight can worsen the chances of developing anorexia.

Lifestyle

In some cases, habits built over the course of daily life may be responsible for developing anorexia. 

People that observe irregular eating behaviors, otherwise known as disordered eating, may be on the path to an eating disorder. Likewise, people that work in image-focused industries such as modeling may feel pressured to maintain their appearance using unhealthy eating habits. The same goes for ballet dancers or sports stars in fields like distance running where leanness is an advantage.

The societal standard of valuing thinner bodies has long been evident in the media. On television and in movies, we've often been presented with thin protagonists—sometimes characters with larger bodies are made fun of or mocked.

Many clothing stores have limited sizing that caters only to thinner bodies. Magazines often tout the latest diets aimed at shedding pounds for "bikini season." These messages all express an importance on being thin—even an implication that to be thin is to be happier and more successful.

Social media’s obsession with appearance can also encourage an impressionable mind to limit their diet to fit into a beauty ideal.

How Is Anorexia Diagnosed?

A person that lives with this eating disorder usually displays a number of identifiable traits. Physically, a person with anorexia will appear underweight or to have lost a significant amount of weight within a number of weeks/months.

However, it's important to note that a person does not need to be underweight in order have anorexia.

Atypical anorexia, for instance, is a diagnosis that shares the psychological and behavioral symptoms of anorexia nervosa, including restrictive eating; however, people with atypical anorexia have a variety of different body weights.

Worrying progressions like memory loss, irregular periods, low blood pressure, muscle weakness, brittle nails, sleep problems, and even purple coloring on the hands and feet often accompany anorexia. A person will display an unusual preoccupation with weight, food, diets, and may engage in purging behavior. 

Anorexia may also lead to depression and obsessive-compulsive traits.

To properly diagnose this condition, a doctor will evaluate an individual's thoughts and behaviors surrounding food, their eating patterns, their body weight and shape, and their perception of their body.

Familial history of eating disorders as well as mental health disorders will also be evaluated. Tests may also be carried out to determine how severe the condition is, as well as its effects on well-being.

Ultimately, a person’s attitude toward weight and food, as well as their weight classifications determine whether an anorexia diagnosis will be made.

Other Conditions Similar to Anorexia

While anorexia has its unique identifiers, not every case of low body weight or nonchalance towards food should be considered an eating disorder. Similar conditions are discussed below.

Cancer

One of the first signs of cancer is unexplained weight loss. Around 40% of people suffering from various forms of cancer report this loss after receiving their cancer diagnosis. This condition is known as cachexia—a change outlined by fatigue, loss of skeletal muscle and appetite, as well as a lower quality of life.

Hyperthyroidism

When the body makes an excessive amount of thyroid hormone, this can result in weight loss and an underweight appearance. This is usually caused by an increase in the rate the body uses energy.

Celiac Disease

When a person develops gluten sensitivity, this can have implications for weight loss. A change in body mass may be tied to a celiac crisis. Here, the body experiences diarrhea, dehydration, and changes in how it processes food, all of which contribute to weight loss.

Other conditions that may produce symptoms similar to anorexia include malabsorption and irritable bowel syndrome.

How to Treat Anorexia

When managing anorexia, target areas will cover weight increase, improvements in eating habits, and corrections to mental/emotional patterns that can encourage unhealthy eating behaviors. This can be achieved using the following listed below.

Therapy

There are different therapeutic approaches for improving a person’s attitude towards their appearance and nutrition. Acceptance and commitment therapy (ACT) can be adopted to change actions like fasting and purging, which can keep weight down. Also known as "new wave CBT" or "third wave CBT," ACT is a form of cognitive behavioral therapy (CBT).

Cognitive-behavioral therapy (CBT) may also change negative views about appearance, food, and self-worth. It can also teach healthier attitudes towards these areas.

Other techniques include psychodynamic therapy, family-based treatment, and interpersonal therapy. Family-based treatment is one of the most widely used treatments for children and adolescents with anorexia.

Medication

While medication isn’t the first line of treatment, this measure becomes important for patients who are very ill. Olanzapine is often recommended to manage depression and anxiety that might co-exist with the eating disorder. It has also been demonstrated to promote weight gain.

Hospitalization

When a person’s body weight reaches very low levels, professional care may be required for a period of time. After enough nutrients have been consumed and improvements are noticed, a referral may then be made to an inpatient facility to continue the recovery process.

A Word From Verywell

Anorexia is a serious condition, but it is treatable. The earlier someone receives treatment for anorexia, the better the outcomes. If you are struggling with an eating disorder, there are resources available.

Try reaching out to a mental health professional. You can ask your primary care doctor for a referral to someone who specializes in eating disorders. With treatment, time, and patience, you can overcome anorexia.

If you or a loved one are coping with an eating disorder, contact the National Eating Disorders Association (NEDA) Helpline for support at 1-800-931-2237. For more mental health resources, see our National Helpline Database.

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11 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021;34(6):515-524. doi:10.1097/YCO.0000000000000739

  2. Morris J, Twaddle S. Anorexia nervosa. BMJ. 2007;334(7599):894-898. doi:10.1136/bmj.39171.616840.BE

  3. Baker JH, Girdler SS, Bulik CM. The role of reproductive hormones in the development and maintenance of eating disorders. Expert Rev Obstet Gynecol. 2012;7(6):573-583. doi:10.1586/eog.12.54

  4. Moore CA, Bokor BR. Anorexia Nervosa. [Updated 2021 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. 

  5. Cleveland Clincic. Anorexia Nervosa. Reviewed June 27, 2019

  6. Dring G. Anorexia runs in families: is this due to genes or the family environment?. J Fam Ther. 2014;37(1):79-92. doi:10.1111/1467-6427.12048

  7. Garber AK, Cheng J, Accurso EC, et al. Weight loss and illness severity in adolescents with atypical anorexia nervosaPediatrics. 2019;144(6):e20192339. doi:10.1542/peds.2019-2339

  8. Cancer.net. Weight Loss. Approved April 2020.

  9. Ríos-Prego M, Anibarro L, Sánchez-Sobrino P. Relationship between thyroid dysfunction and body weight: a not so evident paradigm. Int J Gen Med. 2019;12:299-304. Published 2019 Aug 23. doi:10.2147/IJGM.S206983

  10. Bul V, Sleesman B, Boulay B. Celiac Disease Presenting as Profound Diarrhea and Weight Loss - A Celiac Crisis. Am J Case Rep. 2016;17:559-561. Published 2016 Aug 5. doi:10.12659/ajcr.898004

  11. Moore CA, Bokor BR. Anorexia Nervosa. [Updated 2021 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.