Patient’s, families and others often ask the question, “What causes an eating disorder?” While the cause of onset of an eating disorder is not the same for each person, perhaps the best way to understand an eating disorder and how it comes about is to understand what Dr. DeSarbo refers to as the “4 P’s” of an eating disorder. And while many people who suffer from an eating disorder share some common feelings, obsessive thoughts and troubling behaviors, each individual has their own combination of the “4 P’s” which makes their condition unique to them.
The 1st “P” are the Predisposing Factors. Eating disorders and other mental health conditions are thought to have underlying genetic factors that are inherited at birth much in the same way that eye and hair color are determined by genetics. Several medical and psychiatric conditions, including eating disorders, have been shown to have suspected genetic markers that MAY predispose one to developing certain conditions and certain specific gene markers have been identified by prominent eating disorder researchers.
The 2nd “P” are the Precipitating Factors. Just because one inherits the genetic properties that may make one prone to a certain illness, it does not mean they will get that illness. It is believed that many people may be genetically prone to conditions such as heart disease. Still, if they eat healthy, exercise, avoid tobacco and generally take care of themselves, they may never develop the illness. Likewise with eating disorders, there are certain types of stressors and triggering events that can “set-off” disordered eating patterns in an individual including trauma, excessive stress, emphasis on dieting and body image, media exposure, and dysfunctional relationships.
The 3rd “P” are the Perpetuating Factors. Perpetuating factors are conditions and situations that support and maintain the disordered eating patterns. Perpetuating factors may include environmental stressors such as difficult interpersonal relationships or they may be of a biological nature such as changes that occur in neurotransmitters and the brain’s anatomy that can be affected by an eating disorder. Other perpetuating factors can include denial of the condition by patient and or their support system or a lack of quality treatment.
The 4th “P” is the Prescription. The prescription for an eating disorder is the treatment plan. With many eating disorder patients the prescription includes physician-based treatment working in conjunction with other health care providers including qualified licensed therapists, nutritional consultants, group work, and family therapy at times. A medical physician experienced in eating disorders often monitors vital signs, blood and urine chemistries, cardiac and gastrointestinal functioning and, at times, prescribes medications, when indicated, for co-existing medical or psychiatric conditions. Part of the prescription also involves helping the patient with emotional states associated with the significant distress found with eating disorders and psychotherapist often utilize cognitive behavioral therapy as well as other modalities in the treatment process. Perhaps the most important part of the prescription is making sure that all involved in the treatment are very well trained and experienced with working with eating disorders.