Eating disorders are on the increase. Is our obsession with appearance to blame?
Across a 12-month period in 2012/13 more than 2,370 people with eating disorders were admitted to UK hospitals. Eating disorders are becoming more common in both women and men, although women account for around nine out of ten hospital admissions.
What’s going on? Are ‘size zero’ models and celebrities setting impossibly high standards? Or are the stresses of growing up to blame?
Eating disorders are complex behavioural conditions and are being studied in a number of ways. Psychological studies, for example, suggest that people with eating disorders tend to overestimate their weight. In addition, being exposed to an environment that values thinness and encourages dieting appears to increase the risk of developing an eating disorder.
But eating disorders are not simply about wanting to be thinner. They may be a symptom of young people’s desire to exert control over their lives. Perfectionism and low self-esteem are common in eating disorders. These tend to pre-date the eating disorder, although are also often exaggerated by it.
There is some evidence that people with anorexia nervosa have obsessive–compulsive tendencies and that people with bulimia nervosa are more impulsive.
These pre-existing behavioural traits may make some children particularly vulnerable. They may reflect variation in brain chemistry, particularly in the dopamine pathways and serotonin system, key factors in the regulation of mood. Hormonal changes during puberty or social stresses during adolescence may be the triggers that promote disordered eating. The fairly high heritability of eating disorders also suggests biological factors are at work.
Psychological treatments have been developed to address eating disorders. In particular, cognitive behavioural therapy has been shown to be effective for bulimia nervosa and binge eating disorder.
However, more effective treatments are needed for people with eating disorders, especially anorexia nervosa. In 2013 one study appeared to offer a breakthrough treatment based on implanting electrodes that stimulated patients’ brains. But the trial was limited to just six patients with very severe anorexia. There is also the potential to prevent cases by reducing the environmental triggers, such as excessive focuses on dieting.Lead image:
Tim Ellis/Wellcome Images
- Eating disorders: hospital admissions up by 8 per cent in a year
- Relationship between obsessive-compulsive personality traits, obsessive-compulsive disorder and excessive exercise in anorexia
- Brains of bulimia patients wired differently
- Cognitive behavioral therapy for eating disorders (2010)
- Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders
- Forbes: Startling treatment breakthrough for anorexia leads to new understanding of brain disorders
- Deep brain stimulation shows promise for patients with chronic, treatment resistant anorexia nervosa