Anorexia nervosa, commonly referred to as anorexia, is a complex and potentially life-threatening eating disorder characterized by self-imposed starvation, an intense fear of gaining weight, and a distorted body image. It disproportionately affects women, particularly adolescent and young adult females. According to research, women are up to ten times more likely than men to develop anorexia. While societal pressures and beauty ideals often come to mind first, the causes of anorexia in women are multifaceted and include psychological, sociocultural, biological, and environmental factors. This essay explores these underlying causes in depth, aiming to provide a comprehensive understanding of what drives this serious mental health condition.
1. Psychological Factors
A. Low Self-Esteem and Perfectionism
One of the most common psychological traits seen in women with anorexia is low self-esteem. Many women with anorexia feel inadequate, flawed, or unworthy, and controlling their weight becomes a way to establish a sense of worth or achievement. Perfectionism also plays a significant role. Anorexic individuals often set unrealistically high standards for themselves and are highly self-critical. This perfectionism can manifest in various areas of life—academics, relationships, appearance—but body image and weight often become the focal point.
B. Control Issues
For many women, anorexia serves as a means of exerting control in their lives, particularly when other aspects feel chaotic or unmanageable. Restricting food intake gives a sense of mastery and autonomy. This is especially true for individuals who feel powerless in other domains—such as family, school, or social relationships. The rigid rules they set around food and weight can offer a perceived stability.
C. Co-occurring Mental Disorders
Many women with anorexia also struggle with other mental health disorders, such as anxiety, depression, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). These conditions may either predispose someone to anorexia or exacerbate its development. For instance, obsessive thoughts and compulsive behaviors are closely tied to the restrictive eating patterns and rituals commonly seen in anorexia.
2. Sociocultural Influences
A. Media and Beauty Ideals
Perhaps the most widely discussed cause of anorexia in women is societal pressure and media influence. From a young age, girls are bombarded with images that idealize thinness as the standard of beauty. Magazines, television, movies, and now social media frequently portray extremely thin women as successful, desirable, and happy. As a result, many women internalize these standards, leading to body dissatisfaction and the belief that thinness equates to self-worth.
B. Social Media and Comparison Culture
In the digital age, social media platforms like Instagram, TikTok, and Pinterest have amplified appearance-related pressures. Women often compare themselves to filtered, photoshopped, or curated images of influencers and peers, leading to unrealistic body expectations. This “comparison culture” can fuel feelings of inadequacy and trigger or worsen disordered eating behaviors.
C. Cultural Norms and Gender Roles
In many cultures, there is a heavy emphasis on women’s appearance, reinforcing the notion that being thin is a feminine ideal. Traditional gender roles may also pressure women to prioritize attractiveness, compliance, and social acceptance over authenticity and health. These cultural scripts can deeply influence how women perceive their bodies and their value in society.
3. Biological and Genetic Factors
A. Genetic Predisposition
Studies show that anorexia has a genetic component. Individuals with a first-degree relative (parent or sibling) who has had an eating disorder are significantly more likely to develop one themselves. Twin studies have demonstrated heritability estimates of anorexia to be between 50% and 80%, suggesting a strong genetic influence.
B. Neurobiological Abnormalities
Neuroimaging and biochemical studies reveal that anorexia may be linked to abnormalities in brain function, particularly in areas related to reward, emotion regulation, and appetite control. The hypothalamus, which helps regulate hunger and satiety, may not function properly in individuals with anorexia. Additionally, neurotransmitters such as serotonin and dopamine, which influence mood and anxiety, are often dysregulated. This can contribute to the obsessive behaviors and mood disturbances seen in anorexia.
C. Hormonal Factors
Hormonal imbalances, particularly during puberty, may also play a role in the onset of anorexia. The hormonal shifts that occur during adolescence can affect mood, body perception, and behavior. For some women, puberty marks the beginning of body dissatisfaction, especially if they gain weight or experience changes they perceive as undesirable.
4. Family and Environmental Influences
A. Family Dynamics
Certain family environments may contribute to the development of anorexia. These include families that are overprotective, rigid, controlling, or enmeshed (where boundaries between family members are blurred). In such settings, a woman might feel that her autonomy is stifled, leading her to assert control through food and body image. Families that emphasize appearance, weight, or success can also unintentionally pressure daughters into unhealthy behaviors.
B. History of Trauma or Abuse
A history of emotional, physical, or sexual abuse significantly increases the risk of anorexia. Trauma can lead to dissociation, loss of control, and feelings of shame or self-loathing—all of which can manifest through disordered eating. For some women, anorexia becomes a coping mechanism or a way to “disappear” from unwanted attention or trauma-related emotions.
C. Peer Pressure and Bullying
Women, particularly during adolescence, may face peer pressure to conform to certain beauty ideals. Teasing or bullying about body size, shape, or weight can be a powerful trigger for anorexia. Even casual comments from friends or family—such as praising weight loss or critiquing weight gain—can have lasting psychological impacts and lead to restrictive eating behaviors.
5. Life Transitions and Stressors
A. Adolescence and Puberty
Adolescence is a particularly vulnerable period for the development of anorexia. The physical, emotional, and social changes that occur during puberty can be overwhelming. For some girls, developing a more adult body (with curves, fat distribution, and menstruation) may feel distressing. If they are not emotionally equipped to handle these changes, they may attempt to halt or reverse them through starvation.
B. Major Life Changes
Transitions, such as going to college, starting a new job, entering a relationship, or experiencing a loss (e.g., a death, divorce, or breakup), can also trigger anorexia in susceptible individuals. These events often come with heightened stress, uncertainty, and the need for adaptation. Anorexia may develop as a misguided way to regain a sense of predictability or control.
C. Academic and Career Pressure
High-achieving women in competitive academic or professional environments may turn to anorexia as a way to manage stress, anxiety, or feelings of inadequacy. The same perfectionistic traits that drive academic success can contribute to obsessive control over diet and body image.
6. Cognitive and Personality Traits
A. Black-and-White Thinking
Women with anorexia often engage in cognitive distortions, such as all-or-nothing thinking. For example, they may believe that eating one “bad” food makes them a failure, or that they must be either thin or fat—with no middle ground. This rigid thinking can fuel the extreme dieting behaviors characteristic of anorexia.
B. Harm Avoidance and Sensitivity
Some personality traits commonly associated with anorexia include harm avoidance, sensitivity to criticism, and high levels of conscientiousness. These traits can lead to excessive worrying about making mistakes or disappointing others, reinforcing the desire to maintain tight control over weight and behavior.
C. Need for Approval
A deep-seated need for validation and approval, particularly from parents, peers, or authority figures, can also play a role. Women may believe that being thin will make them more loved or accepted, perpetuating harmful behaviors to maintain a certain appearance.
Conclusion
Anorexia nervosa is a deeply complex disorder with no singular cause. In women, its roots often lie in a combination of psychological vulnerabilities, cultural pressures, biological predispositions, and environmental triggers. It is not merely a desire to be thin, but a multifaceted struggle that reflects deeper emotional, cognitive, and relational issues.
Understanding the causes of anorexia in women is crucial for prevention, early intervention, and treatment. Effective care requires a comprehensive, multidisciplinary approach that addresses the biological, psychological, and social dimensions of the disorder. By fostering supportive environments, challenging harmful cultural ideals, and promoting mental health awareness, society can take meaningful steps toward reducing the incidence of anorexia and supporting those affected by it.