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What Is The Most Important Predictor Of An Eating Disorder

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Eating Disorder Risk Factors

There are still many unanswered questions about eating disorders. Previous studies have shown that there are a number of risk factors that have been linked as possible causes of eating disorders. Eating disorder risk factors are characteristics that are more common in individuals suffering from eating disorders than among the general population. The presence of any of these eating disorder risk factors does not necessarily predict that an individual will develop an eating disorder. However, the more of these eating disorder risk factors that are present, the more likely it is than an individual will develop an eating disorder. If you or a loved one is suffering from an eating disorder, contact McCallum Place to learn about eating disorder treatment programs in St. Louis and Kansas City.


While eating disorders can occur in both men and women, females are as much as ten times more likely to develop anorexia or bulimia and 2.5 times more likely to experience binge eating disorder. This means simply that women and girls are at a higher risk for developing an eating disorder.


Eating disorders can occur in individuals of any age from children to older adults. However, studies show a peak in the occurrence of eating disorders during adolescence and early adulthood. Therefore, teenage girls and young women have the highest risk factor for developing eating disorders based on age.

Weight Concerns, Dieting, and Negative Body Image

Psychological and Emotional Disorders

Social Or Environmental Risk Factors

Social or environmental risk factors in the development of an eating disorder may include: 

  • being teased or bullied
  • a belief that high expectations from family and others must be met
  • major life changes such as family break-up, or the accumulation of many minor stressors
  • peer pressure to behave in particular ways
  • a parent or other role model who consistently diets or who is unhappy with their body
  • media and advertising images of the ideal body size and shape as slim and fit
  • a cultural tendency to judge people by their appearance.

Eating Disorders Among Students

Amidst the stress of school, peers and social media, many students struggle to maintain a healthy body image and eating habits. The pressure to be thin or to strive to achieve the ideal body type causes some students to develop eating disorders.

Current statistics on eating disorders in college students and among high school students include:

  • An estimated 11 percent of high school students were diagnosed with an eating disorder, according to a 10-year study by the National Association of Anorexia Nervosa and Associated Disorders
  • According to the National Eating Disorders Association, eating disorders typically develop between the ages of 18 and 21. Many college students are between these ages.
  • A 2015 survey of college students reported that transgender students were more likely to report being diagnosed with eating disorders than any other student demographic
  • A national study of colleges found that among sexual minority students, 3.5 percent of women and 2.1 percent of men struggled with eating disorders
  • One study of more than 2,000 university students found that 3.6 percent of male students had positive screenings for eating disorders
  • Among college-aged women, up to 19 percent struggle with bulimia

How Can I Stop My Child Developing An Eating Disorder

Adolescents are particularly susceptible to worries over weight and diet. Heres what parents can do to stop these fears becoming serious health issues

If you want your child to be a healthy weight, dont use the D word. Talking about diets or even weight is bad for all adolescents, the American Academy of Pediatrics said this week. The academys latest guidelines aim to prevent not only eating disorders but also obesity. They are particularly aimed at preventing teenagers who are trying to lose weight from tipping into eating disorders such as anorexia nervosa. Neville Golden, professor of pediatrics at Stanford University Medical School and lead author of the guidelines, said that 40% of those admitted for eating disorders are dieters who got out of control. Scientific evidence increasingly shows that, for teenagers, dieting is bad news, he said.

Teenagers in the US who diet in ninth grade are three times more likely than non-dieters to be overweight by 12th grade. But dieting is also the most important predictor for developing an eating disorder. Hence the academys new one-size-fits-all guidelines. Wellness is the word preferred to weight. But wellness needs to be managed, too. Eating disorders can start with teenagers wanting to eat healthily and eliminate bad foods. This can slip into skipping meals and severely restricting foods. Likewise, exercise can become compulsive especially after people praise teenagers for losing weight.

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Boys And Girls Experience Eating Disorders

Eating disorders are more likely to affect females than males. However, about 25 per cent of cases in adolescents occur with males. Girls and boys can experience different social pressures about how they should look. Primary school-aged children are not immune to these pressures, and their attitudes and behaviours reflect adult concerns.Like many adult females, some girls want to lose weight and be thin. Like many adult males, some boys want to lose body fat, but increase muscle mass. Some boys try to meet unrealistically thin ideal standards.

Eating Disorders In Children And Teens

Many children and teenagers struggle with eating disorders like anorexia and bulimia. Eating disorders in children and teens can stem from a variety of issues, including body image and peer pressure.

In America, statistics on the current prevalence of eating disorders in teens, adolescents and children include:

  • Approximately95 percent of eating disorder cases occur in people ages 12 through 25
  • One study of 14- and 15-year-old teens revealed that dieting was the leading predictor of the development of eating disorders
  • Among adolescent girls, eating disorders are the third most common chronic health condition
  • Approximately 25 percent of children who have anorexia are male
  • Up to 2 percent of adolescents and young adults struggle with bulimia
  • Fewer than 1 in 5 adolescents who have eating disorders receive treatment

How Culture Of Dieting Can Exacerbate Eating Disorders

The linking of supermodels and societal pressures with being thin has had a negative consequence on young women with diagnosed eating disorders for years, and its just as easy to draw the connection between social media and orthorexia.

Open Instagram, and within minutes, its easy to follow hundreds of accounts that post multiple pictures per day of beautiful, presentable, clean foods.

A recent study from the Netherlands found that cultural phenomena are linked to the development of orthorexia specifically Western culture and the influence of the internet and media . As the study states:

In 2017, during an investigation on the link between the use of Instagram and , it was discovered that a more frequent use of Instagram is significantly linked to a higher risk of developing ON symptoms .

It is possible that the ability to follow the lives of others, including celebrities, can contribute to the engraining of the beliefs regarding the importance of certain diets.

Gene And Environment Interplay

Neither genes nor environment cause eating disorders on their own. Eating disorders are likely the result of a complicated interplay of these factors. Even when a precipitating factor can be identified, there is almost always a combination of other contributing factors. The precipitating factor is most likely the trigger that tripped a cascade of events.

Genetic susceptibility may influence their response to certain stressors. For example:

  • A person who is genetically susceptible to an eating disorder may be more sensitive to weight-related teasing and have a heightened reaction to it .
  • A person who is genetically vulnerable may continue dieting much longer than peers who diet and then stop.
  • A person who has the temperament that commonly underlies anorexia nervosa may seek out the types of social environments that contribute to the onset of dieting.

Eating Disorders Among Athletes

Athletes are under enormous pressure to perform well and be physically in shape. However, this pressure can lead to disordered eating habits and the development of eating disorders.

Available data on the prevalence of eating disorders in athletesinclude:

  • A study cited by the National Eating Disorders Association reported that more than one-third of female Division 1 NCAA athletes held attitudes and symptoms of anorexia nervosa
  • In a study of female Division II athletes, 25 percent struggled with disordered eating
  • Of athletes in weight-class and aesthetic sports, approximately 33 percent of men and 62 percent of women struggle with disordered eating
  • One multi-university study of 204 female collegiate athletes in 17 different sports reported that 2 percent had an eating disorder and more than 25 percent exhibited eating disorder symptoms

Causes And Predictors Of Eating Disorders

As with many forms of mental disorder, there is no one universal reason for the development of an eating disorder. Under the same set of circumstances, one person may develop an eating disorder while another may not.

Researchers in mental health have isolated several contributing factors that may increase the likelihood of eating disorder development, including:

  • Temperament, or the impact of specific personality traits. Those with obsessive thought patterns, an addictive personality or impulsivity, for example, may be at a heightened risk for an eating disorder.
  • Genetics and biology
  • , such as physical or sexual abuse that predates the inception of an eating disorder. This can be common for people with binge eating disorders in which food is used as a coping mechanism.
  • Societal expectations, like bullying at school and the pressure to lose weight to fit in.

To Treat An Eating Disorder We Need To Know What Emotion Fuels It

Pinpointing how different emotional states and neural pathways influence our eating behaviours could pave the way for better ways to tackle eating disorders and obesity.

Eating disorders such as anorexia and bulimia can have life-threatening consequences. They affect around 20 million people in the European Union, with an estimated cost of 1 trillion per year. The exact cause of an eating disorder varies from person to person and is influenced by factors such as biology, psychology and environment.

People with an eating disorder often use unhealthy behaviours such as dieting, self-starvation, bingeing and purging to cope with overwhelming emotions and stressful situations.

Although the idea of emotional or stress eating is widely known, it’s surprisingly complex, says clinical and health psychologist Professor Jens Blechert from the University of Salzburg in Austria. There’s a relationship between stress and eating, but it can have a different direction for different people, he said.

As part of a project called , Prof. Blechert is investigating how psychological factors known to interfere with eating result in unhealthy patterns and behaviours. His team is working with people who are healthy; have eating disorders such as anorexia, bulimia, binge eating disorder; or who are obese. They hope to improve the treatment of eating disorders and address overeating in the general population.

Eating behaviours


Reward system

What Causes Eating Disorders

A Culture of Dieting and How It Can Perpetuate Eating ...

No one fully understands what gives rise to these painful and confounding illnesses. Eating disorders likely emerge from a complex relationship between genetics, personality traits, and environmental influences such as childhood experiences, social comparison, stressful or traumatic events, and cultural beauty standards. Although the roots of disordered eating will likely remain a mystery for some time, treatment can help those suffering embark on a successful recovery.

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What Are The Risks Associated With Disordered Eating And Dieting

The risks associated with disordered eating are severe. People with disordered eating may experience: A clinical eating disorder such as anorexia nervosa, bulimia nervosa, binge eating disorder or other specified feeding and eating disorders Osteoporosis or osteopenia: a reduction in bone density caused by a specific nutritional deficiency Fatigue and poor sleep quality Gastrointestinal problems such as constipation and/or diarrhoea Headaches Feelings of shame, guilt, and low self-esteem Depressive or anxious symptoms and behaviours Nutritional and metabolic problems

Eating Disorders In Women

According to the National Institute of Mental Health, eating disorders are more prevalent among women than men. Approximately 20 million American women experience eating disorders at some point in their lives.

from the Substance Abuse and Mental Health Services Administration reveal that some of the most common eating disorders in women include:

  • Anorexia nervosa: Up to 95 percent of people who have anorexia are female.
  • Bulimia nervosa: Approximately 80 percent of people with bulimia are women.
  • Binge eating disorder: Rates of binge eating disorder are approximately the same among men and women.

Which Personality Traits And Attitudes Are Linked To Eating Disorders

Eating disorders are connected to perfectionism, obsessive compulsive tendencies, and sensitivity to negative emotions. Low self-esteem and body dissatisfaction are risk factors, as well as mental health challenges such as anxiety and depression.

One of the strongest predictors of eating disorders among girls, research suggests, is the value peers place on weight and eating. This tendency is heightened in college, a community of individuals the same age with few older adults to provide broader perspective. The influence of peer perception may contribute to the proliferation of eating disorders on college campuses.

Foster A Healthy Relationship With Food

You can encourage older children and adolescents to develop a healthy relationship with food if you: 

  • Try not to label foods as ‘good’ or ‘bad’ this sets up cravings and feelings of guilt when the ‘bad’ foods are eaten.
  • Avoid using food as a reward, or for bribes or punishment.
  • Accept that children are likely to have different eating habits from adults for instance, adolescents may require more food more frequently during the day or may go through periods of liking or disliking particular foods.
  • Avoid going on diets and do not try to put your child on a diet.
  • Allow your child to eat when they are hungry and stop when they are full. Do not force your child to eat everything that is on their plate.

Building Hope Through Connection To Others

Hope is also cultivated through connection to others. Relationships with others can indirectly and directly affect hope. Similar to the process in the therapeutic relationship, significant others in clients lives may hold hope for their recovery, which generates client hope. Through somewhat of an osmotic effect, clients can absorb hope through their relationship with hopeful individuals, which can ultimately enhance their own capacity for hope. Relationships with others also have a direct impact on hope in client recovery by decreasing shame. Individuals who operate from a shame-based perspective are more likely to make internal attributions for negative life events and are more likely to believe that future negative events will occur . Authentic connection with others provides empathy and compassion, which neutralizes shame . Through this process, individuals are reminded of the common humanity of their experience, which may be another avenue of revealing exits to their suffering. Ironically, during the process of suffering, individuals are often drawn to isolation in an effort to hide their shameful experiences. This tendency paradoxically magnifies shame and shrinks hope. As therapists, we can assist clients in recognizing this tendency and the deceivingly protective nature of isolation. We can help clients have compassion for their protective isolating, while helping them recognize its long-term negative impact on their disconnectedness, hopelessness, and shame.

Eating Disorder Risk And Maintaining Factors: An Overview

Eating disorders are highly prevalent psychological conditions characterized by abnormal eating behaviors that may lead to serious health problems and even cause death . The existing diagnostic classifications of EDs include anorexia nervosa , bulimia nervosa , eating disorders not otherwise specified , avoidant/restrictive food intake disorder , pica and rumination disorder. Additionally, the Diagnostic and Statistical Manual of Mental Disorders-5 supports binge eating disorder as a correct diagnosis on par with AN and BN.

In the framework of the European Study of the Epidemiology of Mental Disorders project, a lifetime prevalence rate of 0.93% for AN, 0.88% for BN, and 1.92% for BED have been found for females . In a large population-based survey in the United States, Hudson and colleagues have reported a lifetime prevalence of 0.9, 1.5, and 3.5% for AN, BN, and BED, respectively. More recently, a national survey has found a lifetime prevalence of DSM-5 defined AN, BN, and BED of 0.80, 0.28, and 0.85%, respectively. Individuals with lifetime BED were found to have a later age of onset of ED and longer ED episodes duration .

Some studies have found that the levels of EDs are highest in younger individuals . Women with EDs with later age of onset might report less severe eating symptomatology compared with women with the typical age of onset .

Encourage Older Children And Adolescents To Feel Good About Their Bodies

There are lots of ways to help your children feel good about their bodies, including: 

  • Show an acceptance of different body shapes and sizes, including your own. 
  • Make a positive effort to portray your own body as functional and well-designed.
  • Demonstrate healthy eating and engage in physical activity for health and enjoyment.
  • Don’t criticise or tease your children about their appearance.
  • Encourage your children to ‘listen’ to their bodies and to become familiar with different physical feelings and experiences.
  • Encourage sport and regular exercise to help maintain your child’s health and fitness and foster their body confidence.

What Is Weight Restoration And Target Weight And Why Are They Important

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Weight restoration is the most robust predictor of remission from anorexia nervosa and is necessary if not sufficient for recovery. Refeeding refers to the process of weight restoration. Most experts agree that a minimum target body mass index of 19-21 is needed for long term recovery from anorexia nervosa. Despite the importance of weight restoration, about 50% of inpatients with anorexia nervosa who reach target weight relapse, and may require repeat admission. The highest risk for relapse is during the first year following weight restoration . Treatment of anorexia nervosa should therefore be thought of as having two phases: weight restoration and normalization of eating behavior, and relapse prevention . Risk of relapse has been shown to follow a dose response curve, such that the closer to target weight a patient is at discharge from an intensive treatment program, the lower their risk of relapse and readmission .

Doctors May Be Overlooking Minorities

Healthcare professionals must not overlook eating disorders in minority populations and should also realize that treatment-seeking behavior is different in ethnic minority groups, with Mexican American women, for example, less likely than Caucasians to seek treatment for their eating disorder.

Ruling out any potential ethnicity-bias can be helpful in better identifying eating disorders among minorities, particular in cultures in which eating disorders are stigmatized and/or generally underestimated. This can also be an important step toward early intervention and awareness among various ethnic cultures, both which are needed to continue challenging the stereotypes of eating disorders among minorities.

Interestingly, Mexican American women become more likely to seek treatment as they become more acculturated . Outreach to these populations may be necessary if early intervention is to be achieved.

This may also include the inclusion of different ethnicities in educational resources about eating disorders.

Understanding cultural differences may also be helpful in identifying more effective approaches for assessing and screening for eating disorders in various ethnicities and minorities.

Why Are Disordered Eating And Dieting So Dangerous

Disordered eating behaviours and in particular dieting are among the most common risk factors for the development of an eating disorder. Eating disorders are severe and life-threatening mental illnesses. An eating disorder is not a lifestyle choice.

Restricting the amount of food you eat can be a very dangerous practice. When the body is starved of food it responds by reducing the rate at which it burns energy and this can result in over eating and binge eating behaviours. Dieting is also associated with other health concerns including depression and anxiety.

Disordered eating can have a negative impact on a persons life and has been linked to a reduced ability to cope with stressful situations. Feelings of guilt, shame and failure are common in people who engage in disordered eating. These feelings can arise as a result of binge eating or breaking a diet. A person with disordered eating behaviours may isolate themselves for fear of socialising in situations where people will be eating. This can contribute to low self-esteem and social withdrawal.

Having An Eating Disorder Is A Choice

FALSE. Though dieting is thought to be the No. 1 predictor of developing an eating disorder, once one has an eating disorder it not a choice.

Berglund said eating disorders can begin with specific behaviours like dieting, but they are not a choice.

Its really not a choice, she said. Its a serious brain-based illness that requires ulti-disciplinary support for treatment.

Are Health Professionals Aware That Non

Whether or not we accept the Westernization theory, the key message is that people with ethnic minority backgrounds suffer from eating disorders.  It is important that healthcare professionals are aware of this because of data from the 1996 National Eating Disorders Screening Program.

Latina and Native American participants specifically were less likely than Caucasians to receive a referral for further evaluation or care no matter how severe their symptoms .

This program showed that ethnic minority participants with self-acknowledged eating and weight concerns were less likely than Caucasians to have been asked about eating disorder symptoms by a doctor.

Prevalence Of Eating Disorders

Approximately 30 million Americans struggle with eating disorders. At least one person dies from an eating disorder every 62 minutesin America. Eating disorders can affect anyone regardless of gender, age, ethnicity or culture. There are many different types of eating disorders. Some of the most common in America are anorexia nervosa, bulimia nervosa and binge eating disorder.

According to the National Institute of Mental Health, the lifetime prevalence rates of eating disorders in Americans ages 18 and older include:

  • Binge eating disorder: 2.8 percent of American adults.
  • Bulimia nervosa: 1 percent of American adults.
  • Anorexia nervosa: 0.6 percent of American adults.

Except for anorexia being disproportionately high among non-Hispanic Caucasians, the prevalence of eating disorders across the United States is similar among the Hispanic, non-Hispanic Caucasian, African-American and Asian populations. Regardless of demographic, the high rate of eating disorders in America means that reliable, effective treatment options are necessary.

Types Of Eating Disorders

The main types of eating disorder include: 

  • anorexia nervosa characterised by restricted eating, loss of weight and a fear of putting on weight
  • bulimia nervosa periods of binge eating , followed by attempts to compensate by excessively exercising, vomiting, or periods of strict dieting. Binge eating is often accompanied by feelings of shame and being ‘out of control’
  • binge eating disorder characterised by recurrent periods of binge eating . Feelings of guilt, disgust and depression can follow binge eating episodes. Binge eating does not involve compensatory behaviours
  • other specified feeding or eating disorder feeding or eating behaviours that cause the individual distress and impairment, but do not meet criteria for the first three eating disorders.

Dieting And The Diet Cycle

Dieting is one of the strongest predictors for the development of an eating disorder. Weight loss and fad diets do not take people’s individual requirements into consideration and can result in a person feeling hungry, experiencing low moods, lacking in energy levels and developing poor mental and physical health.

The diet cycle explains how many eating disorders can develop and are maintained.


The dieter limits the amount of food or type of food eaten.


When food intake is restricted, the body responds both physically and mentally. The metabolism slows down to conserve energy, appetite increases and the craving for the restricted foods increases. At this stage, people may feel deprived, irritable and fatigued.

Break diet rule:

The diet rules are almost inevitably broken, with the body wanting and needing the food that has been restricted. Overeating can often follow as dieters think, Ive broken my diet, so I may as well have the lot.


When breaking the diet rule, people are often left with feelings such as guilt, low self-esteem and negative body image. People may feel that they have failed and that they lack willpower.

Unhappy with weight or shape:

With these feelings comes a resolve to do better. People are often led back to the diet or restriction, and the diet cycle begins again.

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