Causes of Eating Disorders
Eating disorders have three specific causes, all of which have to be present.
The underlying, antecedent, cause is genetic. It’s the way some of us are made.
The contributory cause, waking up the genetic potential, is trauma.
The precipitant, immediate, cause is exposure to something that has a mood-altering effect. This lifts the – otherwise inexplicable – sense of inner emptiness.
Many people have dietary fads, habits or peculiarities. That does not mean they have eating disorders. Frequently they may simply be copying what their peers do.
Many teenage girls self-induce vomiting. This does not mean they have bulimia nervosa. It means they want to be slim. They want to be a size 10 or even size zero. Putting on a few pounds in weight would be a personal and social disaster for them even though it would be of no medical significance.
The genetic predisposition means that there is compulsive behaviour of one kind or another in previous generations in the family. Looking back in a family may be confusing at first. Families tend to be reluctant to talk about addiction. They may see it as a weakness of will, a disgrace or even a depravity. I don’t.
My mother had an eating disorder. Her mother died from alcoholism, as did my father’s father. They had addictive disease, which I see as a defect in neurotransmission – the way one brain cell talks to another – in the mood centres of the brain.
I’ve got that myself. Through my own eating disorder, my weight used to vary by 50 pounds. I also have the common cross-addictions that other people with eating disorders often have. I used to shop excessively, not just for the things I need. I spent money I hadn’t got. I ran up large debts. I took on work that I didn’t even want to do. I ran a marathon for no very good reason other than to lose weight – and then put it all back on again.
The emotional trauma that sparked off my eating disorder was being sent to boarding school in England while my parents continued living in India. I didn’t see them or have any contact with them – other than by letter – for almost all my childhood. The abandonment and abuse I suffered was not particularly worse than what other boys in British private schools endured. But I had the genetic predisposition; they didn’t.
And then I discovered the mood-altering effects of sugar and refined flour. They hit the spot. Mercifully, I didn’t discover alcohol or drugs. They weren’t around in my homes or schools. So my eating disorder was well and truly established long before I went to university and on into the big wide world. And I had no need for other mood-altering substances and processes, although compulsive gambling – first on poker and then on property ventures – took its toll.
I see all addictive behaviour as being the same process. We want something ‘out there’ to fill in the emptiness we feel ‘in here’. And when we discover it we don’t see why we should ever give it up.
Ultimately the cause of my eating disorder is in me. Not in the way I was brought up or in any other part of my environment. I have the eating disorder. The sexual abuse and bullying I endured merely stimulated it. They didn’t cause it primarily. My genes did that.
If people are frightened of developing an eating disorder – or feel worried that someone close to them might do so – the first thing to do is to look at the family. My family are riddled with addictive or compulsive behaviour of one kind or another. We’re very good at it.
And this is fundamentally important because it means that we have a chronic, rather than acute, illness. I can’t escape it. Like short sight, I wore specs for many years but at the end of that time I was still short-sighted. Nowadays I have plastic lenses inside my eyes. There is no equivalent operation for my eating disorder. I wouldn’t want one if there were. I’ve binged and starved, put on weight and taken it off again, and done all the other things that people with eating disorders tend to do. I’ve treated over 1,500 of them as in-patients in my former rehab and I still work with them as out-patients today.
People with eating disorders are my people. I understand them instinctively.
I know from my own experience, as well as from my daily work with patients, that our problem is not in shops or restaurants or in foods themselves – other than in those that lead us to crave for more. That’s why I don’t eat sugar or white flour or drink alcohol. Once I start I don’t know when to stop. I avoid those substances and any foods that include them. They’re not good for me.
Weights and scales have no fears for me now. People eating or drinking all around me don’t distract me from my abstinence. My eating disorder is essentially a people disorder with only one person involved: me.
During my childhood development, eating whatever I fancied, people told me all sorts of things would be good for me or bad for me. But they had no understanding of what it feels like to be me. Their suggestions were therefore no help to me. They didn’t understand compulsive disorders. They saw them merely as bad habits, as a development disorder. Or they saw me as having a personality disorder. I have an addictive nature but I have my own personality, thank you very much.
Nowadays my weight is steady. It has been for over 30 years. More importantly, food doesn’t rule my life in the way it used to. Even though I still have my genetic predisposition – my eating disorder – it no longer drives me to disordered eating. I have three meals a day, with normal portion sizes. And I get on with living.
If people want to know how I do that, they are welcome to telephone me on 07540281820. I don’t hide away as I used to. Helping people with any form of compulsion is what I do.