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What Causes an Eating Disorder and How Do You Treat It?

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Shernide Delva

Over the weekend, I watched the movie To the Bone starring Keanu Reeves and Lily Collins. The film took us inside the life of Ellen, a 20-year-old woman who has consistently struggled with an eating disorder.  She enters a residential treatment program with several other women struggling with eating disorders.

The film received a plethora of controversy as many thought it was triggering.  However, after watching the movie, I felt it did an excellent job of allowing the viewer to understand the urgent and severe nature of an eating disorder. Often, films only focus on how little the patient is eating or how much weight they have lost. Yet, this is only a small component of having an eating disorder. Eating disorders go much deeper psychologically, and weight is simply part of the problem.

While the movie does an excellent job explaining what it is like to have an eating disorder, it does not explain what causes eating disorders in the first place. Eating disorders are complex with a broad range of variables.

Treatments for eating disorders vary in efficacy. There is no one size fit all treatment. This is elaborated in the movie as we watch Ellen transfer from one treatment center to another. Finally, she ends up at a treatment center she connects to and has a great therapist played by Keanu Reeves.

Often patients deny the severity of their condition at first. The lack of seriousness only progresses the disorder further. For example, in To the Bone, the women struggle to understand why their eating behaviors are considered abnormal. In fact, they believe that their compulsive eating behaviors are necessary to their survival. The idea of eating any other way is difficult to grasp.

Furthermore, patients lie about the severity of their condition which hampers their treatment options.

Most clinicians agree eating disorders stem from a variety of factors:

These factors range from:

Biological Contributors:

It is possible there is a genetic link that causes eating disorder. Significant studies on depression and anxiety allow reason to be hopeful.  Many people had anxiety and depression prior to the development of their eating disorder. Eating disorders can be a reaction to mental illnesses, in an attempt to manage symptoms of depression and anxiety.

Anxiety can be controlled through food restriction and purging. Symptoms of an eating disorder can elevate the mood as sufferers rely on their weight to fit in with society. Since depression and anxiety have a genetic component, there could also be a clear genetic connection to eating disorders.

Neurobiological Contributors:

Neurobiology is a branch of biology concerned with anatomy and physiology of the nervous system. When it comes to eating disorder, individual ones like anorexia nervosa over activate the inhibition control networks and under activate the reward systems. When looking at bulimia nervosa, there seems to be a dysregulation of both the inhibition control networks and reward pathways. These abnormalities are common among eating disorder patients. However, it is uncertain whether these abnormalities are the result of eating disorder behaviors, or if these abnormalities were present prior to the development of an eating disorder.

The Psychology of Eating Disorders

Needless to say, there is a strong psychological component to eating disorders. Most of what we read regarding eating disorders discusses the psychological component. Psychological elements of an eating disorder range from familial, relational, cultural and social. Most researchers agree that eating disorders and psychological disorders are co-occurring.

Some treatment processes focus on behavior and cognitive changes. These treatments include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT,) Family Based Treatment (FBT,) and others.  However, there is more research needed on how to treat the behaviors rather than solely focusing on the cause. In addition, families need to understand the root of eating disorders in order to understand how to best respond to them.

Overall, the reality is there is so much to be learned when it comes to eating disorders. Eating disorders are a result of a variety of factors. Furthermore, just like addiction, eating disorders are not a choice. People with eating disorders need treatment. If you are struggling with an eating disorder, mental illness or addiction, please call now. You do not have to do this alone. 

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Are You “Almost Anorexic?”

Are you almost anorexic?

You might think it’s easy to spot someone with an eating disorder when, in reality you can’t tell whether or not someone has an eating disorder just by looking at them. The fact is, most eating disorders don’t fit neatly into diagnostic boxes.

1 in 200 American adults will develop anorexia nervosa in their lifetime, and at least 1 in 20 (1 in 10 teen girls) will struggle with some form of eating disorder that doesn’t meet full diagnostic criteria for anorexia nervosa, bulimia nervosa or binge eating disorder. A generalized eating disorder is described by restriction of food, binging on food and/or purging.

Almost Anorexic

Almost anorexic is a category used to describe the vast majority of people who struggle with food and body image problems and who can relate to an “anorexic mindset,” meaning that they strive to be extremely thin and are obsessed with controlling their eating habits.

Although people who struggle with anorexia nervosa have a low body weight, the majority of people with eating disorders are of a normal weight or even overweight.

Health Risks Associated with Almost Anorexia

Just like with anorexia nervosa, the long-term health risks of almost anorexic include heart problems, osteoporosis, mental health issues (i.e. anxiety and depression), and even death.

Similarly, the mortality rate of among those who are almost anorexic is similar to that of anorexia nervosa and bulimia nervosa.

Current Diagnosis

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), eating disorders such as almost anorexic currently fall under the diagnosis of Other Specific Feeding or Eating Disorder (OSFED). Another term currently used is Eating Disorder Not Otherwise Specified (EDNOS; in DSM-IV). It is important to note that OSFED and EDNOS are, in fact, eating disorders. However, a diagnosis of OSFED or EDNOS, such as almost anorexic is nonetheless as serious as a diagnosis of anorexia nervosa, bulimia and/or binge eating disorder; it just means that the person’s condition doesn’t meet the strict criteria for these already-documented eating disorders.

A New Diagnosis

Previous and current ways of diagnosing eating disorders result in many people being told that they basically have a vague eating problem. With the new diagnosis, conditions such as almost anorexia are now being recognized by the medical community and treatment is available. The benefits of the new criteria for diagnosing eating disorders could have more impact than just a more precise diagnosis – the revised guidelines could also mean that insurance companies will begin to pay for more patients’ treatment.


New research suggests that many of the same techniques, such as family-based treatment and cognitive-behavioral therapy, are useful for the treatment of anorexia nervosa and bulimia nervosa can provide relief for those who are almost anorexic.

People with eating disorders have a hard time getting health insurance to cover the treatment of their conditions. As it stands now, only 23 states in the U.S. have laws that require insurers to provide the same level of coverage for eating disorders that they do for physical illnesses and conditions.

Even in states with those laws, the “majority of people diagnosed with EDNOS were denied insurance coverage because they didn’t “fit into” standard categories such as anorexia and bulimia. Treatment for eating disorders costs around $30,000 a month and that doesn’t include the cost of treatment for secondary health conditions associated with almost anorexia.











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