Recent studies have indicated that as many as 10% of the girls and women in the US have eating disorders. Of those, an estimated 50,000 will die as a result of their disease. Most of us, whether we realize it or not, know a girl, or several teenage girls, who struggles with an eating disorder. What used to be the subject of an After School Special is now the subject of conversation after gym class, in on-line journals, or Instant Message chats.

How does it happen? How does a vibrant, seemingly happy young woman become so obsessed and dissatisfied with her body that she begins to willingly jeopardize her health and even her life in order to “look better”?

Scientists are only beginning to understand how a myriad of factors interact to cause eating disorders. Family and twin studies coupled with recent advances in genetic research indicate that heredity is responsible for about 50% of the risk of developing Anorexia Nervosa with the environment responsible for the other half. Genetic links have also been seen between Anorexia Nervosa and Bulimia Nervosa, Anorexia and Obsessive Compulsive Disorder, and eating disorders and mood disorders.

At most, genetics is only half the story: there are a number of factors that occur in a person’s life that puts them at greater risk to develop an eating disorder. A history of feeding problems as an infant, childhood obesity or excessive thinness, and fad dieting all may contribute. Severe life stress involving family members or close friends frequently occur in the year before a person develops an eating disorder. Childhood trauma and preoccupation by family members on the importance of weight and appearance may also contribute. If mom, dad, or a sibling is constantly dieting and obsessing about her or his weight, it can cause a young girl to begin obsessing about her own weight. If talk in the house is continually focused around eating and weight, it stands to reason that a young girl will begin to continually think about eating and weight.

Cultural factors that emphasize thinness as part of the ideal appearance of women, an image reinforced by advertising and mass media, create a pervasive dissatisfaction in women about their bodies. On the one hand, magazines and televisions are filled with advertisements for fast food and junk food. On the other hand, those same magazines and televisions inundate us with images of the “super-thin” super model, movie star, television star, or rock star. Consequently, girls often have an unhealthy or inaccurate opinion about their bodies. Feeling pressure to be thin increases the likelihood of binge eating and bulimic symptoms. Certain personality traits have been considered as risk factors for developing an eating disorder. Perfectionism is the one most often linked to “a relentless pursuit of the thin ideal”.

Regardless of which among these factors may be most responsible, once an eating disorder takes hold, the individual is likely to report low self esteem and an overwhelming need for control. Weight loss and thinness define their sense of self worth. And while it’s sad to think that so many girls are feeling so badly about themselves, the good news is that it gives us a place to start. It gives us, and them, something specific to focus on so that the healing process can begin.