Eating disorders are complex mental illnesses with physical manifestations. A number of factors can contribute to the development of an eating disorder, including genetics and mental health as well as cultural factors. This is called the biopsychosocial model.
While eating disorders are serious and can have life-threatening complications, they are also treatable illnesses.
Many factors can influence the development of an eating disorder. These factors can be biological (genetic and biochemical), psychological (personality and mental health), and social (including cultural norms about food and appearance). Individuals who are struggling with their identity and self-image can be at risk, as can those who have experienced trauma. Because eating disorders and mental illness are still stigmatized, some people who have disordered eating may be secretive or ashamed and go to great lengths to hide their disorder.
If the way you eat and think about food interferes with your life and keeps you from enjoying life and moving forward, you may be experiencing disordered eating. Take it seriously and talk to someone who can help. You don’t need to wait for a diagnosis by a doctor.
The experience of living with an eating disorder can be different for each affected individual. Some people feel shame stemming from their symptoms or the way they eat, and so are secretive about food and eating. Some people experience other mental illnesses, such as anxiety, depression, obsessive-compulsive disorder, or post-traumatic stress disorder together with their eating disorder.
Eating disorders are as diverse as the people they affect.
According to a 2002 survey, 1.5% of Canadian women aged 15–24 years had an eating disorder.
Government of Canada. (2006). The Human Face of Mental Health and Mental Illness in Canada 2006.
The prevalence of anorexia and bulimia is estimated to be 0.3% and 1.0% among adolescent and young women respectively. Prevalence rates of anorexia and bulimia appear to increase during the transition from adolescence to young adulthood.
Hoek, H. W. (2007). Incidence, prevalence and mortality of anorexia and other eating disorders. Current Opinion in Psychiatry, 19(4), 389-394.
Lifetime prevalence rates for AN, BN, and BED tend to be higher among women than in men.
- Lifetime prevalence of AN = 0.9% in women and 0.3% in men
- Lifetime prevalence of BN = 1.5% in women and 0.5% in men
- Lifetime prevalence of BED found to be 3.5% in women and 2.0% in men
The average lifetime duration of BN is found to be approximately 8.3 years.
Hudson, J. I., Hiripi, E., Pope, H. G. & Kessler, R. C. (2007). The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61(3), 348-358.
AN has the highest mortality rate of any psychiatric illness – it is estimated that 10% of individuals with AN will die within 10 years of the onset of the disorder.
Sullivan, P. (2002). Course and outcome of anorexia nervosa and bulimia nervosa. In Fairburn, C. G. & Brownell, K. D. (Eds.). Eating Disorders and Obesity (pp. 226-232). New York, New York: Guilford.
Children learn (unhealthy) mainstream attitudes towards food and weight at a very young age. In a study of five-year-old girls, a significant proportion of girls associated a diet with food restriction, weight-loss and thinness.
Abramovitz, B. A. & Birch, L. L. (2000). Five-year-old girls’ ideas about dieting are predicted by their mothers’ dieting. Journal of the American Dietetic Association, 100 (10), 1157-1163.
According to a 2002 survey, 28% of girls in grade nine and 29% in grade ten engaged in weight-loss behaviours.
Boyce, W. F. (2004). Young people in Canada: their health and well-being. Ottawa, Ontario: Health Canada
Thirty-seven percent of girls in grade nine and 40% in grade ten perceived themselves as too fat. Even among students of normal-weight (based on BMI), 19% believed that they were too fat, and 12% of students reported attempting to lose weight.
Boyce, W. F., King, M. A. & Roche, J. (2008). Healthy Living and Healthy Weight. In Healthy Settings for Young People in Canada. Retrieved from http://www.phac-aspc.gc.ca/dca-dea/yjc/pdf/youth-jeunes-eng.pdf.
In a survey of adolescents in grades 7–12, 30% of girls and 25% of boys reported teasing by peers about their weight. Such teasing has been found to persist in the home as well – 29% of girls and 16% of boys reported having been teased by a family member about their weight.
Eisenberg, M. E. & Neumark-Sztainer, D. (2003). Associations of Weight-Based Teasing and Emotional Well-Being Among Adolescents. Archives of Pediatrics & Adolescent Medicine, 157(6), 733-738.
Body-based teasing can have a serious impact on girls’ attitudes and behaviours. According to one study, girls who reported teasing by family members were 1.5 times more likely to engage in binge-eating and extreme weight control behaviours five years later.
Neumark-Sztainer, D. R., Wall, M. M., Haines, J. I., Story, M. T., Sherwood, N. E., van den Berg, P. A. (2007). Shared Risk and Protective Factors for Overweight and Disordered Eating in Adolescents. American Journal of Preventative Medicine, 33(5), 359-369.
Overweight and obese children are more likely to be bullied than their normal-weight peers. For example:
- In a survey of 11–16 year-olds, 10% of normal-weight children reported being bullied, compared to 15% of overweight and 23% of obese children
- Obese girls were 2.7 times more likely than normal weight girls to be verbally bullied on a regular basis and 3.4 times more likely to be excluded from group activities
Janssen, I., Craig, W. M., Boyce, W. F. & Pickett, W. (2004). Associations Between Overweight and Obesity With Bullying Behaviours in School-Age Children. Pediatrics, 113(5), 1187-1194.
In a study of 14–15 year old adolescents, girls who engaged in strict dieting practices:
- Were 18 times more likely to develop an ED within six months than non-dieters
- Had almost a 20% chance of developing an ED within one year
Girls who dieted moderately were five times more likely to develop an ED within 6 months than non-dieters.
Patton, G. C., Selzer, R., Coffey, C., Carlin, J. B. & Wolfe, R. (1999). Onset of adolescent eating disorders: population based cohort study over 3 years. British Medical Journal, 318, 765-768.
In childhood (5–12 years), the ratio of girls to boys diagnosed with AN or BN is 5:1, whereas in adolescents and adults, the ratio is much larger – 10 females to every male.
Public Health Agency of Canada. Canadian Paediatric Surveillance Program, 2003 Results.
Retrieved from http://www.phac-aspc.gc.ca/publicat/cpsp-pcsp03/page6-eng.php.
Four percent of boys in grades nine and ten reported anabolic steroid use in a 2002 study, showing that body preoccupation and attempts to alter one’s body are issues affecting both men and women.
Boyce, W. F. (2004). Young people in Canada: their health and well-being. Ottawa, Ontario: Health Canada.
The fashion industry has long dictated that female models be tall and waif-like; however, male models are now facing increasing pressure to slim down and appear more androgynous, in order to book top fashion jobs.
Trebay, G. (2008, February 7). The Vanishing Point. The New York Times. Retrieved from http://www.nytimes.com/2008/02/07/fashion/shows/07DIARY.html?pagewanted=1.
According to a Norwegian study, elite athletes demonstrate significantly higher rates of EDs compared to population controls. In one study, 20% of elite female athletes met the criteria for having an ED, compared to 9% of female controls. In men, 8% of elite male athletes met the criteria for having an ED, compared to 0.5% of male controls.
Female athletes competing in aesthetic sports (e.g. dance, gymnastics and figure skating) were found to be at the highest risk for EDs. Athletes competing in weight-class and endurance sports were also at elevated risk for EDs.
Sungot-Borgen, J. & Torstveit, M.K. (2004). Prevalence of Eating Disorders in Elite Athletes is Higher Than in the General Population. Clinical Journal of Sport Medicine, 14(1), 25-32.
There are many different kinds of food and weight preoccupations, including eating disorders. This section aims at de-mystifying issues relating to dieting, food, weight concerns, shape concerns, self-esteem and body image. To do so, we will be looking at those influences that most contribute to how we feel about our selves and our bodies, and that ultimately can help us make healthier choices for more enjoyable lives.