Eating disorders are a challenging and disturbing multifaceted problem with biological, psychological, and cultural roots. Understanding their complexity is essential for recovery.

While many people think of an eating disorder as an unhealthy quest for "the perfect body," they really have little to do with vanity and weight. According to mental health experts, eating disorders are complex psychological illnesses in which people try to control life's conflicts and stresses by controlling food. The food, weight, and body image issues are merely surface symptoms of more deeply rooted problems that are often difficult to identify.

People who develop eating disorders typically live in a state of perpetual emotional turmoil. They want to be in control but feel they are not. They tie their anxieties, self-doubt, and feelings of failure or inadequacy to the way they look. They become preoccupied, even obsessed, with food and weight. These and other factors, which vary from person to person, can lead to extreme and often dangerous behaviors including self-starvation, bingeing, purging, and compulsive exercise.

While no one is really sure what causes eating disorders, many experts believe that they develop over time and involve a combination of biological, psychological, socio-cultural, and other factors.

Biological factors

• There may be a genetic predisposition in some families for eating and other compulsive disorders. 
• When eating disorders appear to run in families, female relatives are most often affected.
• Scientists are investigating possible links between disordered eating and biochemical changes associated with psychiatric disorders that are common among people with eating disorders.
• Research has indicated that, in some people with eating disorders, there is an imbalance of certain chemicals in the brain.  Such an imbalance may precede the onset of the disorder but starvation, itself, can create brain chemical changes. 
  

Psychological factors

• Low self-esteem.
• Feelings of lack of control in life.
• Feelings of inadequacy.
• Depression, anger, or anxiety.
• Major life events (i.e. loss of a family member or friend, moving, schools or jobs)
• Accumulation of stress without adequate strategies to cope.
• Stress and fear of the responsibilities associated with jobs, parenting, or caring for an aging relative.

Socio-cultural factors

• Portrayal of men's and women's body shapes in the media and other elements of popular culture that are not representative of "real" men and women.
• Cultural and peer pressure to achieve the "perfect body" and stay in shape.
• Valuing of people based on outward appearance, not their inner qualities.
• Mixed messages about health and fast food; confusion about good nutrition and healthy eating.
• Occupations that put emphasis on a certain body shape and size.
• Pressure to achieve and succeed.

Other factors

• Belief that love is dependent on high achievement.
• Poor communication between family members.
• Difficulty expressing emotions and feelings.
• Troubled personal or family relationships.
• Sexual or physical abuse.
• History of teasing or bullying based on weight or shape.
• Ineffective coping strategies.
• "Modeling."  Young girls, in particular, model behaviors on people they admire, such as their mothers, popular peers, fashion models and musicians and actors.