What Causes Anorexia?

The instinct for survival and the desire to nourish oneself are so basic to the human condition, and yet, anorexics defy this instinct. It’s a puzzling disorder. The explanations generally given involve psychological disposition (anorexics tend to be overachievers, perfectionists, and so on) and social pressures (young women are bombarded with impossible images of perfect beauty). While this certainly plays a part, it never seemed to me like the complete story. If not, what does make a person want to starve himself - or more usually - herself, even to the point of death?

What causes anorexia?
Dr. Natasha Campbell McBride offers what sounds to me like a more complete hypothesis. She describes a series of interconnected events that occur something like this:




è  A common scenario starts with the decision to become a vegetarian. The teenager (usually it’s a teenager) is still eating eggs and dairy, so things are still ok.
è  The young person may then decide to eat a very low-fat diet, become vegan – or worst of all, become a low-fat vegan. On a vegan diet, the growing body starts to become deficient in protein and fat.
è  Protein malnutrition affects the production of hormones, enzymes, neurotransmitters and more.
è  The person becomes deficient in zinc, (which we usually get from red meat). Zinc is involved in about 200 enzymatic reactions in the body.
è  The low-fat diet causes a deficiency in fat-soluble vitamins: A, D, E, and K, which in turn affects many functions, but especially the immune system.
è  With a compromised immune system, the person gets sick often, and so is treated repeatedly with antibiotics that compromise the gut flora.
è  Damage to the gut flora further impairs the immune system – a vicious cycle of antibiotics and damage to gut flora occurs.
è  The abnormal flora eventually produce toxins that leak through the gut wall and affect various aspects of cognitive function including sensory perception.
This last point is the missing link that makes sense of this most puzzling of disorders.
malnutrition   è  brain toxicity   è   distorted sensory perception   è  
inability to eat   è more malnutrition






To further complicate matters, it isn’t only that the anorexic person sees a fat person in the mirror. As the gut deteriorates, it stops producing digestive juices and enzymes. The person cannot digest and absorb food properly and suffers from discomfort from eating. No wonder he or she doesn’t want to eat.  
I have given a brief summary of the explanation provided in the book. Dr. Campbell McBride explains how the GAPS diet can break this cycle. What I found interesting is that the key to breaking the vicious cycle involves getting to what she calls a “bingo day”. Stage one of recovery starts with a special broth with added nutrients to heal the gut and start to reverse the malnutrition. Being low in calories, broth is a food that anorexics are more likely to agree to ingest than most other things. She writes,
“As the most severe deficiencies start melting away, the “Bingo Day” will come: your patient will wake up one morning, look in the mirror and suddenly realize just how emaciated she or he looks.”
I would suggest that anyone with a family member suffering from malnutrition have a look at Gaps and Psychological Syndrome. While only one chapter deals with eating disorders, I think it’s a very compelling hypothesis.


Photo credit Aimee Heart
This post was shared with the Healthy Home Economist, Kelly the Kitchen Kop Gnowfglins , The Nourishing Gourmet.and Real Food Forager.

18 comments:

farmer_liz said...

wow that makes so much sense, I hope this will start to help all the people suffering from this disorder. Its hard to believe how conventional medicine can get things so wrong sometimes in its search for drugs to solve every problem, when nutrition seems to me to be the answer to nearly everything!

Sarah said...

I went through this same thing! It started as an emotional issue (not being vegetarian), but I got to the point that I stayed so sick that I just couldn't eat. I lost so much weight. Luckily, I had a good doctor who put me on probiotics, then I read "The Maker's Diet". I've come so far, and now I'm healthier than most of the people I know!

The Voogts said...

Love this post. I follow GAPS and loved Dr. CMB's chapter on eating disorders. It's like she was writing my story. I have come a long way, but still have a ways to go. Not so much with the distorted self image but with the ability to eat now. My gut is so messed up still. I have a hard time with meat and fat. Very frustrating when that's what I should eat and want to eat. Good for you for posting this to make more people aware of the real issue and what to do about it.

Amy said...

Mmm...as someone who struggles through an eating disorder for years, this is not how it happened with me at all. I was never vegetarian, I ate butter. I had a really tough childhood and had a lot of issues becoming independent for the first time, and my eating disorder developed out of that. Then I started eating very little fat, but it was a result, not a trigger. When you look at eating disorder patients, the common theme is family issues and low self-esteem. Real food was a key part of my recovery, but working with a therapist was a bigger part.

Amy said...

*struggled (I've recovered now)

Anonymous said...

I'd also like to add in a mention for "The Mood Cure" by Julia Ross. I first read about her on cheeseslave's blog, and it is an incredibly interesting book which deals with all kinds of mood issues, including eating disorders like anorexia and bulemia. She mainly pinpoints amino acid deficiencies as the culprits, which actually fits right in with the information above presented for GAPS, as serotonin is the main amino responsible for "feeling good" in general, and deficiencies in serotonin have been linked to OCD, eating disorders, etc. And, of course, we get serotonin production from tryptophan (i.e. meat/protein).

I personally have not had an eating disorder but I HAVE been dealing with OCD, and they are VERY similar in nature (in fact, I really believe eating disorders are just another form of OCD, as the thought processes are almost identical). There are lots of reasons we can be low in serotin (caffeine and stress both deplete serotonin levels for example, babies fed formula and not breastfed will start life lower in serotonin, etc.), so it is vitally important to eat lots of protein. However, if we are really deficient, food alone may not be enough and we need to supplement. I would highly recommend reading the book, as she goes into all of this in detail (also try www.moodcure.com).

Anonymous said...

Also, I'd really like to emphasize that I have been researching this topic like crazy lately, trying to get a grip on my OCD. My issue mostly revolves around needing things to be really clean, and while I know that therapy can be very useful (I have been thru some myself), I have lately become convinced that it really doesn't get to the root of the problem. Although I can look back and say that I definitely had tendencies towards perfectionism as a child, I didn't really develop the OCD until recently (the last 5-6 years), and I can't tell you how many times I've found myself thinking that it just feels like my brain isn't functioning properly.

After doing some online research on nutritional approaches to this, I did find one site that seemed to hit the nail on the head-she said that it absolutely is a physical issue, that most people have a signal in their brain that goes off once they've completed a task, to be able to just let it go, but with OCD, that pathway is broken, which is why you find yourself going over and over and over stuff in your head (like checking that doorknobs are locked or that the oven is off), because you can't quite convince yourself that you did it.

I realize all of this seems off topic, but when I started therapy for my OCD, my therapist actually told me that she wished I could talk to some of her anorexic patients, as there were very similar issues going on. Not long after, I was talking to one of my childhood friends about what I was dealing with, and she responded almost immediately that she knew exactly what I was feeling, because of her past issues dealing with eating disorders (she was mildly anorexic all thru high school/college). Again, thought processes are very similar.

I'm still very much trying to get it all figured out, but reading the Mood Cure I feel has helped start me on the right track towards really evaluating physical issues that may be causing/contributing to it. What is really scary is how many of my friends that I've talked to since are actually dealing with similar issues, to one degree or another. My theory so far is that I really believe that as each generation has progressed, moving towards more processed foods all the time, moving away from real, healthy fats (we grew up eating margarine and Wesson oil), that all of the mental disorders we are seeing are a direct result, it's finally catching up to us. What form it takes varies from person to person, for me it became the cleaning, while for my friend it was the anorexia, but I do believe ultimately they all have the same cause.

Sorry this was so long and rambling :-).

Ruth Almon said...

Thanks for sharing your story, Amy. Not everyone's story is alike.

Anonymous, your comment was very interesting. I've heard of The Mood Cure, but I haven't read it yet. I'd definitely like to.

vanessa said...

I second Amy's comment. I, too, have struggled with anorexia, but I firmly believe that the disease (along with other psychological illnesses - hence the "psychological" part) have their roots in emotional factors. Yes, people with eating disorders usually exhibit unhealthy eating habits which do not serve their overall well-being, but this is most often a result - not a direct cause - of the illness. A healthier diet which included more fat and protein definitely helped nurse my body back to health, but I never would have even attempted to eat better had I not done the psychological work in the first place.

Betsy said...

I think poor nutrition might exacerbate the underlying issues, but let's not forget that it's the underlying emotional/psychological issues that trigger all of this in the first place. Most of the people I knew who struggled with eating disorders, especially anorexia, had suffered some kind of childhood abuse - emotional, physical, sexual, or a combination of it all.

One friend of mine who had been sexually abused told me she felt it was her fault she had been abused because she was a girl, and that if she stopped trying to look like a woman, then it wouldn't happen to her again. Her womanly body shape - curves, breasts - was only a reminder to her of what happened so she fought to stay as stick thin (thereby resembling a boy) as possible. Another friend who had been abused said that she had no control over what others did to her, but the one thing she did have control over was what she ate so her denying her hunger was her way of mastering control over the only thing in her life she felt she could control. To give in to the hunger meant she was weak, and worthless.

Saying it's a simple lack of nutrition is dangerous, and dismisses the often traumatic psychological damage that triggered it in the first place. It's also dangerous to imply that it's as simple as girls being bombarded with skinny images. It is so, so, so much more than that.

Ruth Almon said...

Thanks for your comment Vanessa. I'm definitely not trying to say that the psychological aspect doesn't exist. But I think that is well established. I'm just saying that it might not be the whole story - and the nutritional aspect is overlooked.
If nutrition plays a key role, then that has to be taken into consideration as part of the cure.

I didn't go into it here, but the doctor has a step by step treatment method that takes into consideration the fact that the patient won't want to eat better.

Clara said...

This is so interesting. I've been reading about brain function and how important fats are to brain health. Amazing what happens when we don't eat as we should.

Lori @ Laurel of Leaves said...

What in interesting article! (and one that makes a whole lot of sense!) Thanks so much for sharing this, Ruth. I have the GAPS book on my wish list and I'm looking forward to learning even more about it.

Anonymous said...

It was interesting to read the posts. I too dealt with anorexia and bulimia for years. I came from a very loving family and never wanted much although we didn't have much. I still think about, but have no answer, as to why I did what I did. I remember reading an article about how bad it was to be bulimic and oh by the way...here's how you do it. I pray my children never read those stupid teen rags. I do know my gut issues come from years of abuse. But I eat better now and know so much more. Hopefully my children benefit from all the knowledge I've gained.

Veronica said...

This article can, at its best, be called quackery. There is no sound scientific evidence to support these ludicrus claims which are not only damaging but potentially dangerous when put in the hands of individuals who do not critically analyze what they read or hear.
I am currently getting my Masters degree in Human Biology in its application to Health and Disease at the University of Toronto. I graduated with a double major in human biology and nutritional sciences in the life science department 2 years ago and have been a vegan since I was 16 years old.
I find this article not only offensive, but grossly mislead. the author mistakenly assumes that vegan-ism in some way causes anorexia. The logic is as follows: vegan = undernourished = anorexic. This is fallacious on many grounds, most perversely in the assumption that vegan-ism leads to anorexia. The logical equivalent of this statement is that all vegan are anorexic. This is far from the reality of events, myself as a great example: I have been vegan for almost 9 years (and will be for the rest of my long life) and not only show no signs of deficiencies but no signs of anorexia or other eating disorders; on the contrary, I confidently state that I am in the best health of my life. Interesting, as this was part of her thesis, yet I and the vast majority of vegans are not anorexic! We are normal people with normal eating habits (granted, more morally and socially responsible) and more importantly, normal body images with above average health.
Campbell assumes young people become anorexics because of a vegan diet, ignoring the omnivorous anorexics that make up more people that those vegan anorexics. The switch to a vegan lifestyle, though it has been documented to be beneficial to the health in many respects, including lowered cancer and cardiovascular risks and significantly lower obesity rates, as well as a longer average lifespan (7 years!). Many anorexics use the word vegetarian or vegan as an excuse not to eat in social settings or to severely restrict what passed by their lips - not from feeling of moral obligation, but as a result of their disorder. She treats it as a cause and not the potential symptom that it is.
The way to treat anorexia and other eating disorders is to simply treat the disorder. Anorexia is a product of biological and environmental factors, often obsessive personalities and those with low self esteem are afflicted and these disorders are triggered by stressful events. The proper course of treatment is behavioral and cognitive therapy coupled with counseling to prevent remission.
I find this offensive and grossly mislead and urge everyone reading this comment and article to critically evaluate what you may believe - research it and make educated decisions based on sound science and reasoning.

Ruth Almon said...

Hi Veronica,
Thanks for writing.

" vegan-ism leads to anorexia. The logical equivalent of this statement is that all vegan are anorexic"

By the same token, does that mean that smoking doesn't cause cancer because not every smoker gets cancer?

Just because every vegan isn't anorexic and every anorexic isn't a vegan or former vegan, doesn't mean that veganism doesn't contribute to anorexia.

I have no way to know for sure if the theory I presented here is valid, but I found it very compelling. Thanks for sharing your thoughts.

Anonymous said...

I suffered from anorexia. Prior to onset, I was a healthy teen who had no body image issues. What started me down the path of anorexia was my mom going on Weight Watchers and serving us up "healthy food". I started to lose weight, get compliments and before I knew it, I kept losing weight. I was definitely NOT a vegetarian. I would eat an entire chicken for dinner, BUT would not have any fats nor carbs. My onset was 17, same age as my 26 year old daughter started with anorexia. Hers began with stress in senior year trying to get into college of her choice. I think that anorexia is primarily genetic, with personality traits such as perfectionism and social anxiety etc being common. I was definitely not a vegetarian nor was my daughter.

Ruth @ Ruth's Real Food said...

Thanks for sharing your story, anonymous. Dr. McBride doesn't claim that all anorexics start out as vegetarians, it's just a common scenario. I think her more important point is that a person's diet can lead to deficiencies which change a person's thinking, which then perpetuate themselves as anorexia.

The idea of it having a genetic component isn't necessarily a contradition. We know that certain people can eat a bad diet and handle it better than most. Maybe in anorexia, a person has a genetic disposition to fall into the vicious circle of anorexia when diet is just a little bad.

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