The precipitating factor for every eating disorder is a diet. It’s not a coincidence that the number of eating disorders in this country skyrocketed when dieting became a nationwide fad in the late 1960’s and early 1970’s. As dieting continues to be regular practice for people in so many communities, eating disorders have become a larger public health problem.
Dieting over an extended period of time triggers a powerful genetic mechanism in all of us to survive famine. The human species has persevered in part because of our biological ability to adapt to limited availability of food for extended periods and utilize times of abundance wisely.
Dieting mimics famine for our biological constitution. Thus, what we now describe as a disorder actually reflects a built-in adaptation to the lack of food. For some, prolonged dieting will trigger anorexia: the ability to survive on extremely small amounts of food and simultaneously shift all conscious awareness towards searching for and hoarding food. For others, dieting triggers a version of binging, hoarding food by eating long past the feeling of fullness and storing extra energy in our bodies. And many people diet for a few days or a week and just give up.
The main difference between eating disorders and famine is that these adaptive measures are triggered by conscious decisions to diet rather than external environmental factors. Nonetheless, the behavioral and psychological symptoms are the activation of programmed survival mechanisms currently triggered by maladaptive means.
The lack of this basic knowledge about eating disorders frequently leads family members, friends and clinicians to blame people for their eating disorders. Rather than understand the medical explanation of an eating disorder, people become frustrated with such irrational, nonsensical behavior and simply implore the person to eat a hamburger or drink a milkshake.
Instead, recovery needs to involve an extended period of normal eating that will reassure one’s body and mind that regular nutrition is on the way: the famine is over. Once that period of eating lasts long enough, the psychological component of the eating disorder will diminish over time, with consistent psychological and emotional support.
However, it’s critical people don’t forget the only clear risk factor for developing an eating disorder: dieting.