Eating Disorder Triggers

Eating disorders arise out of complex factors. Events that seem to lead to disordered eating or speed eating disorder development are commonly called triggers. Triggers are normally not enough to cause eating disorders by themselves: Often, a person is vulnerable due to a combination of genetic, biological and psychological circumstances. The triggering event focuses attention on the body. If the person comes to believe that the body is what makes her vulnerable, she may deal with the vulnerability through her treatment of her body.

Verbal Eating Disorder Triggers

Words may seem innocent enough, but to an adolescent (or someone who simply doesn't like herself), they have great power.

Comments From Authority Figures

Imagine a successful gymnastics coach working with a twelve-year old girl. The coach has her respect; she hangs on every suggestion he makes. During a group workout, the coach makes a comment about how the size of the girl's legs makes it hard for her to compete in a certain exercise.

At twelve, the girl is concerned about how her body is developing compared to those of her peers. This comment says, "Your body isn't doing the right things...and you can't get my praise unless it does." Even if the coach is generally supportive, this vulnerable time gives his comments great force. Some girls will manage to shrug off the coach's comments. But another girl may skip lunch the next day for the first time. If the empty feeling feels positive in some way, she may continue the behavior.

Or, consider a father who says he doesn't like the way his daughter looks, and that he'll give her ten dollars for every pound she loses. The daughter's thoughts may be angry. But it may not feel safe to express anger to the father. How can she express it? She may make a vow to herself: "He wants me to be thin? I'll show him thin."

The father may be pleased at first, but if his daughter loses too much weight, he might feel foolish or angry. One way to think about this is that the daughter has communicated her anger without openly confronting her dad.

Teasing

Don't discount teasing from peers. Adolescents are trying hard to figure out where they fit in the world, and they can take comments from anyone to heart. Looking different in any way is often not acceptable, and this is a time in which bodies are changing. Teasing only makes the teaser feel better for a short time, but it can affect the person she teased for a lifetime.

Sexual Abuse, a Powerful Trigger

Not every person with an eating disorder has a history of sexual abuse, but abuse is not uncommon in the pasts of those with eating disorders. One study of an inpatient setting reported that 48% had a history of childhood sexual abuse. Another found that bulimic behavior was 2.5 times more likely for those experiencing an instance of sexual abuse, and nearly 5 times more likely in those who had experienced multiple instances of sexual abuse.

Regardless of the time at which sexual abuse occurs, its effects are profound for those who are vulnerable to eating disorders. A fourteen-year-old girl who was abused at age six will be more prone to view her body as bad because of the shame that arises from the abuse. When the body feels like a source of problems, it's natural to try to fix it, and radical eating behaviors affect the body quickly.

Some of the ways I conceptualize abuse influencing the expression of eating disorders:

Sexual abuse affects parts of the body that are capable of generating pleasure. But the abuse is horrifying and dark. The result is an internal battle: "My body is able to do things that seem good, but the result is unbearable."

Bulimia nervosa (and anorexia nervosa, purging type) sometimes express this struggle in a unique way. Eating involves enjoyment. A binge, however, creates enjoyment while going numb (note that abuse victims are frequently numb to the abuse as it happens). Purging food later is a way to express rejection of enjoyment and remove the sense of self-disgust that comes with enjoying something.

Other Traumatic Eating Disorder Triggers

Anything that brings trauma can trigger an eating disorder if the person is vulnerable to it--a car accident, the death of a relative, the loss of a friend, or divorce. Even positive changes, like taking a new job or graduating from school, can be triggers. An eating disorder is a way to take a big problem and focus it on a smaller scale. Often, the eating disorder itself then becomes a big and difficult problem.

Back to What Causes Eating Disorders

Sources:

Anorexia Nervosa and Related Eating Disorders, Inc. 2005. "What Causes Eating Disorders?" http://www.anred.com/causes.html (link defunct). Accessed 2 February 2006.

Carter JC, Bewell C, Blackmore E, Woodside DB. The impact of childhood sexual abuse in anorexia nervosa. Child Abuse & Neglect 30 (2006): 257-269.

Sanci L, Coffey C, Olsson C, Reid S, Carlin JB, Patton G. Childhood sexual abuse and eating disorders in females: findings from the Victorian Adolescent Health Cohort Study. Archives of Pediatric Adolescent Medicine 162 (2008): 261-267.