What are the causes?
When someone develops an eating disorder, there are usually many factors which have been involved in the cause. There simply isn't one 'trigger': although something may happen which pushes the person into an eating disorder, it has generally been brewing under the surface before that point.
Low self-esteem:
Problems with self esteem are at the root of most eating disorders. Sufferers often feel they are worthless, or find it hard to think of anything about them that is positive. They may focus on what they feel are the negative aspects of their character and many say that they hate themselves as a result. This low self-esteem may lead them to place too much emphasis on what they do or achieve - and often they do come form high achieving families. They do this in a very perfectionistic way however, and feel that any slip ups or 'failures' are proof of how worthless they are. Some seem doomed to come second or third in every test - and therefore feel that they have no value at all because they never come first. Low self esteem also often means that people cover up their 'true' self when they are around other people. They feel a tremendous pressure to please others and to make the lives of those around them perfect and trouble free. They may be the people who solve everyone else's problems. They may deny their own needs in order to pursue the needs of others, and often work to the point of exhaustion to serve other people. Low self-esteem leads the person to focus on their appearance, and see changing their weight as the answer to all their problems. They hate themselves, and this becomes directed towards what they see when they look in the mirror.
Negative emotions:
Negative emotions on their own do not cause eating disorders, but certain patterns in the way people deal with these difficult feelings are often very significant. Sufferers often feel guilty or wrong for experiencing negative emotions like anger and anxiety, and therefore grow up learning to suppress them rather than deal with them in a healthy way. Over time these emotions become overwhelming, and typically strike when the sufferer is alone. They are then swamped with powerful emotions which are often so far removed from their cause that they feel totally out of control. Eating disorders can provide what seems like a solution to this - because the sufferer feels that if they were thinner then they would be more confident, more popular and happier. Negative emotions may also trigger episodes of bingeing, or very powerful feelings of being fat.
Dieting:
Dieting on its own is not a cause of eating disorders - obviously many millions of people diet without going on to develop and eating disorder. But nearly 3/4 of people who do go on to have eating disorders say that the first step was dieting. Dieting can be the first sign of eating disorders because it is a sign that the person is unhappy with the way they look. Dieting, if it is successful, can also lead someone to pursue weight loss as the solution to all their problems. For others, overly strict dieting can form the first stage of bulimia or binge eating disorder, as it sets them up for a time when their control inevitably breaks down. Dieting can lead you to become obsessed with food, calories and what you are eating. This focus can leave people at risk of starting to struggle with their eating. Most of all though, dieting leaves people most at risk of eating disorders if they also struggle with low self-esteem.
Abuse and trauma:
Certain events that may have happened, either in childhood or even in adult life can trigger the start of an eating disorder - although it is important to remember that not everyone with an eating disorder has had something particularly traumatic in their past. Trauma can be linked to eating disorders because of the negative emotions which result, or because it challenges or damages self esteem. Family breakdown, divorce, bereavement, redundancy and even physical illness can be factors that trigger an eating disorder. Abuse in particular, be it emotional, physical or sexual, makes people feel totally worthless and may also lead them to question what made them be the one who was abused. Some who have been abused grow up constantly told how bad they are, and that they deserve what is happening to them. Abuse can also lead to eating disorders because of the overwhelming feeling of being dirty that survivors can be left with. Some sufferers talk of this desire to 'be clean' and find that their eating disorder is fuelled by this desire. Others may find that recalling memories of abuse, or of other traumas, may trigger episodes of bingeing and purging in an attempt to feel better or to avoid remembering.