What “causes” eating disorders?

[@jessicastunden5562]

👏🏻👏🏻👏🏻 Thank you. I swallowed the control BS regarding my own ED for years and I still hear it all too often. I’m not saying it’s not a ‘contributing factor’ also but it’s so psychoanalytical and quite frankly, antiquated. I don’t believe any person with a restrictive ED didn’t first have an energy deficit. The motives for said energy deficit are important but there is far too much focus on that rather than refeeding being a priority. This is so so helpful. I do wish your message was around 11 years ago and I knew it was ok to feast eat until I was well again.

[@amysafko8817]

This is perhaps the best summary of the causes of eating disorders I have ever heard. Thank you for putting this out there.

[@marketadobesova6644]

I just love the idea that to get anorexia you must be in energy deficit because I suffered from very bad depression and I lost a lot of weight but during that time I WAS NOT anorectic at all! It was just a beginning of it and it took a long time to develop an eating disorder ....Now it makes a perfect sense to me thank you!!! ♥♥♥

[@YazzyYaz1910]

My mum had an eating disorder in her late teens. I developed one after wanting to loose some weight when comparing myself to others. I was under eating and over exercising for a few years (except during holidays etc) and eventually tried intermittent fasting when I wasn't getting any smaller. I have never reached being 'under weight' by bmi standards. This is when I started getting into a restrict-binge cycle. It took me a few months to realise I had a problem and thankfully I knew what I needed to personally do to over come it

[@harmonyhope1709]

This explanation is so helpful!!! It also explains why relapse happens due to energy defecit sometimes, even though conscious restriction hasn't taken place, but a different cause of energy defecit has triggered it, such as physical illness. Also explains why some people have definite trauma issues, some people have been trying to diet, some lost weight at uni due to stress or self catering for the first time... So many different contributing factors but the same route cause. Energy defecit and genetic makeup!!

[@Sully123-s8c]

i relapsed even tho i was eating enough but lost weight due to stress.. i quite quickly ( 2 weeks ) realised it cos my body changed and mental state became really bad again..

[@ellynash4922]

I wish you could shout this out to the whole world!!! However Tabitha, how advanced is the science to actually know the genetic marker that determines predisposition!! In future could the potential for an ED be predicted with doctors' advice to eat, eat , eat!! Yeah!! Thanks for your idiosyncratic and brilliant way of delivering the message. Elly x

[@racheltheshadesoforange8700]

Thank you... I SO appreciate hearing this because I wasn't someone who went on a diet. I went on a fertility drug that made me too sick to eat and I stayed on it too long out of desperation that the drug might work. Once I was in that energy deficit state, I suddenly found myself with all the symptoms of ED with huge fears of food and weight gain. It took a long time to diagnose myself because I mistakenly thought only people who dieted could become anorexic.

[@tobey8023]

TRANSCRIPT (was writing this up anyway and thought I would post it here. If you turn on community contributed closed captions I would be happy to put this there instead. ♥️ Thank you very much for the video) [Begin transcript] Alright so: What causes eating disorders? That's a question that, um, I think a lot of people get a little bit confused about. Um… So. From my point of view, eating disorders are caused by genetics plus energy deficit. And so energy deficit is when you do not eat enough food for a prolonged period of time and the amount of energy that your body needs is not met on a daily basis for a prolonged period of time, and so therefore your body enters a state of energy deficit. And genetics… Well, that is having the genetic predisposition to have an eating disorder. So. The reason that this is sometimes a little bit confused is because people say "well doesn't diet culture cause eating disorders" and "doesn't trauma cause eating disorders" and "doesn't a desire to be thin cause eating disorders" and all of those things are contributing factors to an eating disorder. And they're contributing factors because they can contribute to prolonged energy deficit, so if somebody goes through trauma, um, one of the symptoms I think of trauma is often a lack of appetite, and a desire not to eat very much and so therefore that can cause a person to go into prolonged energy deficit. And if that person has the genetic predisposition for an eating disorder, then they'll develop an eating disorder. The trauma alone isn't cause for an eating disorder, because if a person doesn't the genetic predisposition then the trauma that causes the energy deficit wont result in an eating disorder. So we cant say that trauma causes eating disorders, but we can say that trauma is a very strong contributing factor to an eating disorder, as is diet culture. So somebody could be influenced by diet culture and desire to- this thin ideal, and that can cause them to go on a diet which then puts them in energy deficit which then, if they have the genetic predisposition for an eating disorder, results in an eating disorder. But we cant say outright that diet culture causes eating disorders. It's a contributing factor. And i think that people get the contributing factors to energy deficit, and then they get that muddled up and they say "cause". And the reason thats important is because we want to treat the causes - when we're treating an eating disorder, we want to treat the causes. And so the cause there is always gonna be energy deficit; that energy deficit absolutely has to be amended so restriction has to stop and the person has to be eating unrestricted. Um, but the reason that's important is because sometimes when its thought that say, uh, trauma or diet culture or body image problems are the cause, then, um, a therapist might try and treat those things and not address the energy deficit. And so that doesn't work in recovery we have to amend the energy deficit. I'm not saying that the contributing factors should not be considered - they absolutely have to be considered, and if a person has a contributing factor that, say, is trauma, then that absolutely has to be treated. But the cause of the eating disorder, the energy deficit, also has to be treated first and foremost. And then I think this helps people understand why, uh, eating disorders don't only affect a certain type of person because its not only people who have body image problems that develop eating disorders: Any person that has the genetic predisposition to develop an eating disorder who also goes into energy deficit for a prolonged period of time… they are likely to develop an eating disorder. So for example I didn't have any negative body image problems when I was a teenager. I really didn't. I was quite happy with my bod… Yet I developed an eating disorder. And the reason I did so is because i went into prolonged energy deficit. And the reason I went into prolonged energy deficit is because I tried to lose weight to ride a horse. I was a racehorse training jockey - I'm too tall to be a jockey. But I needed to be 5 pounds lighter to ride a relatively small horse and so thats why I went on a, uh, on a diet. Not even for a very long time, but it was long enough and the energy deficit as deep enough- prolonged enough for it to trigger the genetics that I have which are anorexia. And so we can't assume that people who develop eating disorders have done so because they were necessarily because they were affected by diet culture or they had body image problems. And that helps us be able to see that actually any person, just about anybody, its not even to do really with the personality type, anybody can be affected by an eating disorder if they go into energy deficit for a prolonged period of time for any reason. That could be being ill, you could be having a long long bout of the flu or something. It can be many many different reasons why a person may go into energy deficit. And I think that when we can understand that that better then we start to be able to expand our view of the type of person that gets affected by an eating disorder. So the only type of person that gets affected by an eating disorder is somebody that has the genetic predisposition to have that and who goes into energy deficit.

[@lisakulak3495]

Tobey C me too this was a wonderful explanation Tabitha !! Thank you for this video and the transcript !

[@TabithaFarrar]

Thank you Tobey for writing that transcript.

[@girlalmighty9255]

What if you have an eating disorder like pica (eating inedible objects e.g. rocks, erasers, paper etc.)? Is that caused by genetics? Is that caused also by an energy deficit? Or is that a time when trauma is the cause and not a contributing factor?

[@lenajazuk4231]

I know for me it started by wanting to slim down just a little bit but I got hooked on seeing progress and fear of gaining weight if I would start eating again was very overpowering bc loosing weight wasn’t an easy task for me as I liked food I’m a bit confused what the difference between ED and life long dieting not yo yo dieting but just being on a constant food watch in order to avoid weight gain I know a lot of women around my age 45 were and are having a lot of eating rules and restrictions to stay slim so do they all have ED?

[@TheBinski]

Ah it all clicks into place with this video. Cheers! Love to the cats, dogs and horsies. :)

[@selinajanagil1466]

Thankyou it's hard to recover when at times diet culture is always to blame. But when your 4 years old and can clearly remember having eating disorder thoughts from strange behaviour of throwing my lunch away at school lunchtimes. Trauma and diet culture contributed factors to make my eating disorder worse which at my worse I welcomed. Not any one can get an eating disorder. Any one with he behaviour and genetics can.

[@selinajanagil1466]

Realising this in recovery helped me stop blaming myself

[@lodenco691]

Thank you Tabitha! What do you think about OCD causing ED’s?

[@ericabriscoe]

So so very interesting thanks x

[@txk032]

Hi Tabitha, So would you think that it when trying to recover from am eating disorder where trauma is a contributory factor that it can be more problematic as aside from nutritionally rehabilitating yourself and the neural rewiring you inevitably have to do you need to address the thoughts that are wanting the perceived control you are craving that led to suppression in the first place or do you think they will become insignificant once rehabilitated? Hope that makes sense!

[@富岡忠宏]

Could there be something like an energy deficit caused by emotional stress? And also how does proana come into the "game"? My first time having an eating disorder was very much influenced by that. I know that I had had a very very bad depression at the same time. I might have been undereating and I certainly was eating a lot suddenly. I've always had periods with little appetite since I was little, but it never effected me the way it finally did, until I had reached late teenage. Or maybe it did, but I didn't realize it. In retrospective, with the depression and all, I wanted to make myself vanish. So back then I fit into a lot of the "traditional" aspects of anorexia. Still, you're approach has been the only one being immediately successful in my "recovery career". It's confusing me. I know, I was using my ed as a coping mechanism for all kinds of things. I used it like a tool. That was definitely psychological. But still I can tell, there is a switch in my head, that is like a point of no return and it is governed by weight, not will. Whenever I come close to that border - I can literally feel it - I am absolutely tempted. It's like an indefinitely powerful magnet. The switch is real and neither behavior nor can trauma explain the presence of this switch. Maybe extreme emotional stress causes the flight response to kick in faster? Like you're not only running to a place with food, but peace? Like stress indicates to your body that it should drop that pizza slize and run for it?

[@shantishanti5897]

Seems plausible...However I wonder why there is almost no anorexia in very poor countries or in regions with war, where so much people are in energy deficit, e.g. Jemen,South Soudan etc...Or here in Germany after World War...There should be a lot of Anorexia...but Anorexia occures primarly in rich,developped countries, where only few people come into energy defizit....

[@shantishanti5897]

@MIRIAM SANCHEZ MANZANARES you are for sure absolutely right with your point that there is little data about anorexia nervosa (AN) in very poor/war countries. But nevertheless, if it is right that genetics + energy deficit cause AN, then in these regions where so many pepole are starving (e.g 20 Mio in Yemen)..AN should occur very very very often...(assumed that AN- genetics are distributed equally in western societys and the word)...

[@Sagekittykin]

I knew some people in my country(jamaica) had EDs and self harm.

[@elevenbyfive]

i understand what you're saying, but what do you do if the eating disorder is a crutch for dealing with trauma and without it you would use worse coping methods. Shouldn't you treat the trauma to a degree that the person has enough tolerence let the eating disorder go without resorting to some other dangerous coping method?

[@Snickerdoods.x]

Eleven By Five Dialectical behavior therapy can be incredibly helpful for eating disorders. Have you heard of it/tried it? Learning distress tolerance skills and emotion regulation are key. The point is to learn healthy coping skills in place of the maladaptive ones.

[@elevenbyfive]

@@Snickerdoods.xThank you :) I am doing it at the moment actually!

[@Snickerdoods.x]

Eleven By Five Oh good, I’m glad!

[@ser2952]

I think it's a catch 22 for us honestly. We cope by using the ED, but then the prolonged energy deficit puts our brains in a place where trauma processing is difficult. So to more effectively handle trauma processing and learning coping skills, we need to be nutritionally sufficient. But trauma processing is stressful and leads to ED behaviors for coping. Gahhh it's the loop I've been in for 2 decades.

[@elevenbyfive]

@@ser2952 ugh ikr it's a shitty circle.

[@orangepulp392]

I do think if the energy deficit is during teen years it is more likely you'll get an eating disorder. Because your prefrontal cortex is less developed

[@the.walkiest]

I love you Tabitha 💚💚

[@catherineskeates8018]

A Q : Do you have to be actively losing weight to be in energy deficit or can someone who is suppressing their body weight be in energy deficit too?

[@kaylacarmical8676]

by suppressing your natural body weight you most definitely are in a energy deficit

[@angelawho9083]

Does incest impact eating disorders?