WEIGHT PROBLEMS: WHY DO EATING DISORDERS ARISE?
That’s the sixty-four-thousand-dollar question. Experts answer it differently, depending on their area of specialty.
The Biological Perspective
Biologists see eating disorders as a foul-up in the body systems that regulate hunger and eating, particularly the hypothalamus. This cluster of nerves in the brain controls many body functions, including intake of water and food.
By releasing hormones, the hypothalamus also regulates the onset of puberty-an important connection to eating disorders. Although we don’t know exactly what “pulls the trigger,” puberty may begin when the body reaches a preprogrammed weight and achieves a certain percentage of body fat. Starving makes both weight and body fat decrease. If the weight-to-fat ratio falls too low, metabolic changes-including the loss of menstruation, a kind of regression from puberty-occur.
Biologists also look for problems in the way the body converts food into neurotransmitters-chemicals that carry signals between cells. The brain “knows” when the body needs certain foods to make the neurotransmitters that are in short supply and tells us what we should eat next. Eating disorders may arise from a malfunction in this feedback system.
Other evidence of the biological basis of eating disorders comes from studies on twins. Identical twins, who grow from a single egg and share an identical genetic blueprint, have a higher incidence of anorexia nervosa than fraternal twins, who grow from separate eggs.
If we can identify the biological breakdown or the genetic glitch that causes an eating disorder, then perhaps medicine can correct the problem and offer hope for treatment.
The Psychological Perspective
Most experts feel biology alone can’t explain eating disorders. The question then becomes, “What factors provoke abnormal eating in one person but not another?”
The answer, they believe, lies in a person’s life experiences and the thoughts and feelings those experiences arouse. A loss or rejection, a death in the family, the act of leaving home, can all start the ball rolling. The anorexic may feel she is somehow not good enough, that she is a disappointment to everyone. She is a “failure” in every capacity except one: her ability to be thin.
In bulimia, some of the same psychological factors are at work. A bulimic also equates thinness with self-worth (although in this case the degree of thinness is less extreme than in anorexia). There are other pressures as well. As biologists suspect, there may be a physical urge to binge. Bingeing also serves as a kind of distraction, allowing a woman to push aside unpleasant feelings and focus instead on intense physical sensations. By overeating, a woman rebels against the limits society tries to impose. She conquers fear by withdrawing into the comfortable, dependable world of bingeing. (Patients occasionally refer to bingeing as their “friend.”) Bingeing has much in common with the abuse of drugs or alcohol. By definition, however, a bulimic feels her behavior is beyond control. Purging thus becomes her way of regaining balance. She tells herself: “I overeat, but it’s okay because I throw it up anyway.” Bulimia lets her control at least one aspect of her life-eating-to make up for lack of control elsewhere.
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