Family Dysfunction and Anorexia: Is there a correlation?
Each year millions of people in the United States develop serious and
often fatal eating disorders. More than ninety percent of those are adolescent
and young women. The consequences of eating disorders are often severe--one
in ten end in death from either starvation, cardiac arrest, or suicide.
Due to the recent awareness of this topic, much time and money has been
attributed to eating disorders. Many measures have been taken to discover
leading causes and eventual treatment for those suffering from anorexia.
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Anorexia nervosa is a psychosociological disease which affects young
women. Anorexia is mainly a female's disease which has been evident for
centuries-however, in the past twenty years, the incidence of this disorder
has risen to horrifying proportions. It is characterized by the refusal
to maintain body wight over a minimal normal weight for age and height;
intense fear of gaining weight; a distorted body image; and, amenorrhea.
This disorder becomes a disease when the mind starts to cause problems
with one's physical well-being. A connection has been found between sociocultural
pressures to achieve, familial characteristics, and individual personality
Causes of Anorexia
Many causes are attributed to anorexia, and scientists have studied
the personalities, genetics, environments, and biochemistry of people suffering
from this disorder. Women most often share various traits--although the
more that is learned, the more complex each individual case becomes--low
self-esteem, feelings of helplessness, and a fear of becoming fat. According
to Kenneth Felker, a combination of factors influence the development of
anorexia-- perfectionism, a society that emphasizes thinness, a family
that manifests depression, and biological tendency.
A Focus on the Family
Eating disorders appear to run in families-usually affecting only the
women. One study found that mothers who are overly concerned about their
daughters' weight and physical attractiveness--along with overly critical
fathers and brothers-may put girls at increased risk of developing an eating
disorder. ( http://www.kidsource.com/kidsource/content/disorder.html#Causes
) Another study notes that, "inappropriate parental pressure was specific
for eating disorders ... and Eating Attitudes Tests (ETAT) scores correlated
significantly with hostlity toward child, sibling disability, parental
overprotection, inappropriate parental pressures, and negative changes
in family relationships." (Horesh, -Nefta) When the connection between
eating disorders and familial traits was looked into, three interpretable
factors were found by Steiger-eating concerns and symptoms, dramatic-erratic
traits, and obsessive-compulsive traits. Correlations were also found among
the subjects' factor scores--correspondences between daughters' and parents'
psychopathological traits, and between daughters' and mothers' eating concerns.
Another controlled study of 51 teenage cases including a population
sample done by Rastam found that 35 of the cases had a reasonably plausible
background factor-based on a history including heredity, early physical
and temperamental development, and the family's overall social situation--while
only 2 of the control group possessed the same characteristics. A study
documented by Telerant revealed emotional uninvolvement of fathers and
a radical change preceding the appearance of the anorexic symptomatology.
All of the parents in this study also acted in a cold and formal manner,
demonstrating verbal and nonverbal abuse and criticism. In a study noted
by Killian, enmeshment amongst family members, rigidity, lack of conflict
resolution, and overprotectiveness summed up the main familial dysfunctions
evident in cases of anorexia nervosa.
A Drive to Achieve
Anorexics tend to come from upper-middle and upper class families that
make a "good impression" according to (http://www.pgi.edu). The anorexic
females are model children and are usually known for outstanding academic
achievement-Boskind-Lodahl (1976) and Levine (1987) argue that these achievement
strivings are not true indicators of intelligence, but rather are a way
of pleasing parents and marrying well. In fact, the mothers of these females
are often highly intelligent women who gave up their own careers to have
a family. Due to the mother's eventual enmeshment with her daughter, the
daughter's "autonomous strivings are stiffed as she is socialized to be
more concerned with external parental approval than with her own internal
satisfaction." (Yager, p. 43-59). The same study found that most of these
girls strongly identified with their fathers who were generally uninvolved,
preoccupied, and hostile. White (1983) found that anorectic families have
"...certain role expectations of their members. Women in these families
are generally expected to be sensitive, devoted, and self-sacrificing"
(p. 257). These women fighting between the clashing ideals of the traditional
sex role and high achievement often become anorexic.
Is there a correlation?
There is obviously a strong correlation between family dysfunction and
anorexia-yet attempts to find whether or not a child will be genetically
predisposed to an eating disorder are still undetermined. According to
a study documented by Killian, "it is roughly eight times as common in
females first degree relatives of anorexics as in the general public."
Scientists have studied the biochemical functions of people with the disorders
and have recently focused on the neuroendocrine system-a combination of
the central nervous and hormonal systems. (hftp://www.kidsource...)
According to the same article, many of the regulatory mechanisms controlled
by this system--including such functions as physical growth and development
to appetite and digestion-are seriously disturbed in people with anorexia
nervosa. The finding that family environment is significantly associated
with the risk of developing anorexia nervosa is therefore consistent with
previous research as per Felker. Felker has also documented that Family
Environment Scores (FES) identify a perception of greater contact, greater
control, and greater achievement orientation as being associated with an
increased risk of developing anorexia nervosa. This could possibly stem
from a family vulnerability-yet how heredity and the environment interact
to produce anorexia remains unclear.
Results of the study documented by Felker indicate that select components
of family environment are associated with adolescents' risk of developing
anorexia. He states that, "while statistical significance is an important
step toward finding definitive answers within an area of interest, it is
the application of these results that may ultimately impact the health
of a population.' (p. 7 of 10) In other words, only through education can
these tremendous problems be conquered. While no one factor can be singled
out as the sole cause of anorexia nervosa, a collective group creates a
combination of factors involved in a highly complex disorder. Females who
cannot find a way to reconcile the conflicting demands may choose anorexia
as a way to control the uncontrollable.
List of Works Cited
... er.html#Causes of Eating Disorders
Boskind-Lodahl, M. (1976). Cinderella's step-sisters: A feminist
perspective on anorexia nervosa and bulimia. Signs: Journal of Women
in Culture and Society. 2.342-356.
Felker, Kenneth R., & Stivers, Cathie. (1994). The relationship
of gender and family environment to eating disorder risk in adolescents.
Adolescence. 29. 821-836.
Horesh, Netta. (1 996). Abnormal psychosocial situations and eating
disorders in adolescence. Journal of the American Academy of Child and
Adolescent Psychiatry. 35, 921-927.
Killian, Kyle D. (1994). Fearing Fat: A literature review of family
systems underscoring treatments of anorexia and bulimia. Family Relations.
Rastam, Maria. (1992). Background factors in anorexia nervosa. European
Child and Adolescent Psychiatry. 1, 54-64.
Steiger, Howard. (1996). Familial eating concerns and psychopathological
traits. International Journal of Eating Disorders. 19, 147-157.
Telerant, A. (1 992). Anorectic family dynamics. Journal of the
American Academy of -Child and Adolescent Psychiat!y. 31, 990-991.
White, M. (1 983). Anorexia, nervosa: A transgenerational perspective.
Family Process. 22, 255-273.
Yager, J. (1982). Family issues in the pathogenesis of anorexia nervosa.
Psychosomatic Medicine. 44, 43-59.