The exact way in which a genetic vulnerability to eating disorders might work is not completely understood. One possibility is that temperament might play a factor. Temperament is the biological aspect of an individual's personality, which is present at birth. It forms the basis for adult personality. Personality traits, such as emotional stability, obsessiveness, and perfectionism, play a large role in the progression of some eating disorders. Research suggests that these traits are at least partially driven by genetics. Individuals with these traits are vulnerable to being anxious, depressed, perfectionistic and self-critical. These are all factors that may contribute to their difficulty managing weight and to eating in a healthy manner.
Individuals with anorexia and bulimia tend to be very competitive. They are quite driven to succeed. They tend to compare their appearance and accomplishments against unrealistic standards and typically find themselves lacking. Most of these judgments happen because of messages in their culture or standards from their peer groups, rather than from their own personal expectations. People with eating disorders are primarily concerned about what others think of them, rather than what they think of themselves. Other people with eating disorders, such as athletes, tend to judge themselves against internally set standards. They get upset when they fail to live up to their own expectations and goals.
Regardless of what set of standards they judge themselves against, perfectionists always strive to meet the highest standard of performance possible. They easily find themselves in a self-defeating cycle of fear and dissatisfaction when they fail to meet their expectations and goals. This happens even when the expectations are unrealistic and unhealthy. This sense of fear and dissatisfaction creates a renewed drive toward thinness, perfection, and control. This is the endless cycle of dysfunctional eating behavior that makes up eating disorders.
An ability for obsessive thinking tends to go along with perfectionism in eating disorders, particularly those with anorexia. People with anorexia become super focused or obsessed with food and with the idea of controlling their eating so that they will become thin. Other elements of extreme thinking may be seen as well. This includes a tendency towards rigid "black and white" thinking. An example of this is believing "I am either perfect" or "I am terrible" with no in between option being available. Because of this inflexibility, those with anorexia may be unwilling or unable to acknowledge that their behaviors are out of control and that there are others ways to become happy besides weight loss. They see any difference from their self-imposed weight-loss plan as an unacceptable failure. Because of this, they may have great difficulty accepting suggestions or advice from others, even from those people that they know really care about them. People with eating disorders may experience supportive attempts as proof that others don't really understand them.
Psychologists and other professionals have identified that individuals with eating disorders often are missing important coping skills to deal with life's situations. Eating disordered behaviors are often used as substitutes for these missing skills. When coping strategies are missing, people may use disordered eating behaviors to provide themselves with:
- tension release
Disordered eating may also seem like a way to cope with challenges such as stressful transitions (e.g., going to college), family conflict, and pressure in school.
Using food as a coping mechanism is especially common for those with binge-eating disorder. People with anorexia and bulimia use their disordered behavior to become thin. Many individuals who binge eat have difficulty managing strong emotions, such as anger, sadness, boredom, and anxiety. Approximately half of all those who binge-eat are depressed or have a history of depression at the time of their eating disorder diagnosis. Researchers are not yet clear whether depression is a side effect or a cause of binge eating. It is clear though, that those who binge often turn to food when they are upset. They do this because they have not learned or are not comfortable using other coping skills to manage these feelings in a healthy way. Binging is a way to self-soothe, and to numb emotional pain.
The resulting consequence of binging, however, is a feeling of enormous guilt. The person cannot deal with the resulting guilt feelings in any other way but to binge again. This creates a disabling and endless pattern of eating to self-soothe. The relief provided by binging becomes reinforcing, and the person remains stuck in this behavior that provides them comfort and peace.