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What Are the Risk Factors of Having Bulimia?

Editorial Staff
Editorial Staff
The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.
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What are the few types of risk factors in having bulimia?

Risk Factors of Having Bulimia Include:

  • A history of dieting
  • Exposure to fashion magazines
  • Co-occurring anxiety disorders
  • Poor communication skills
  • Genetic vulnerabilities
  • Family history of bulimia or dieting

The eating disorder bulimia is characterized by a lack of control.

People with bulimia simply cannot control how much they eat. Once they start eating, they feel compelled to keep on eating until they physically cannot eat any more. To them, there is no real way to stop a binge in progress.

They may not have control over whether or not they binge. When the urge appears, they feel compelled to act upon it. The only way to mitigate the damage, to them, is to purge with vomiting, laxatives, or exercise. Since they cannot stop the binge, they must deal with the aftermath.

To someone with bulimia, the disease can seem a little baffling. It may not be clear how the issue developed, and it may not be at all clear how it should be controlled. While the disorder might seem mysterious, researchers know that it comes about due to risk factors that are clear, crisp, and easy to understand. These are just a few of those triggers.


Body Image

body imagePeople’s body image involves their perception of their physical self. This is a term that encompasses how people feel when they look in the mirror and see their bodies staring back. Often, people are not happy about what they see. In a study of the issue, highlighted in the journal Pediatrics and Child Health, researchers found that about half of teenagers ages 12-18 were unhappy about their weight. When these teens looked in the mirror, they only saw fat and flab.

A person like this might be tempted to go on a restrictive diet, substituting real meals for things like:

  • Apples
  • Grapefruit
  • Lemonade
  • Cabbage soup

At the end of a day filled with this extreme diet, people might be so desperately hungry that they begin to snack. When they start snacking, they feel so upset about the loss of control that they keep on eating, and that binge is followed by a purge. The binge might seem sudden, but it is an issue that starts with a body image concern.

This problem typically impacts women, as the National Eating Disorders Association suggests that about 80 percent of people with bulimia nervosa are female.

In Western cultures, women are typically expected to be long, lean, and lithe. In order to be truly beautiful in this model, women need to have no curves or fat pads at all, even if those pockets of fat come about due to the work of the hormones coursing through a woman’s body. If she wants to match the cultural expectation of her gender, she will lose weight in order to make her body conform to a beauty ideal.

The media may play a role in this cycle, as it is not at all uncommon for fashion magazines and television shows to highlight women who are intensely thin. Women who look at these media outlets might walk away with the impression that they must be much thinner in order to be considered even remotely beautiful. But, as Mayo Clinic points out, it is not at all clear if the media causes this reaction, or if it simply reflects preferences of the community as a whole.

In other words, it isn’t clear if the media makes people feel the need to be skinny, or if people feel the need to be skinny and the media reflects that need. It is a complex relationship, and quick conclusions are hard to come by.

It is clear that many people feel as though they should be much thinner in order to gain any kind of success in the world. That body image issue is a huge risk factor for bulimia.


Distress Control

Every single person in the world deals with some type of disappointment or distress from time to time. Things do not always go as planned, and when they do not, it is common to feel downhearted and low. Some people feel upset and even hostile when things take a turn for the worse. Some people are able to cope with these feelings when they arise, but some people are not, due to an underlying mental health issue.

In a study in Archives of General Psychiatry of 467 female twins, researchers found close ties between bulimia and anxiety disorders. This seems to suggest, researchers said, that there is a genetic connection between bulimia and anxiety issues, but bulimia might also be an expression of anxiety.

When people feel anxious and unable to handle that anxiety, they might turn to bingeing as a form of release. They want the terrible feelings to go away, or at the very least, they want some other activity to focus upon. A bulimia binge provides that outlet, and it could seem like a good solution for someone with anxiety.

Having a stressful life, in and of itself, might also be considered a trigger for bulimia. For example, in a study by the American Psychological Association, researchers found that 71 percent of parents said they had “just enough” or not enough money to pay for needs within a month. These financially strapped people might always feel as though they’re just a step or two away from disaster, and if they do not have good outlets for that stress, they might turn to eating disorders in time.
Someone who has protective factors against bulimia might use techniques like mediation or exercise to handle a stressful event. They might know all about how stress works and what it can do, and they might be very prepared to handle the consequences of stress in a reasonable way, so they do not feel compelled to binge. But someone who does not know how to deal with distress, and who leads a stressful life, might be at risk for bulimia.


Communication Styles

In addition to learning how to handle distress and stress, most people need to learn how to communicate their inner concerns to the outer world. Every word a person speaks can have an impact on how that person feels. Some people do not share their thoughts and feelings.

People with poor or nonexistent communication skills simply do not share their thoughts with others. They keep their feelings hidden deep inside, far below the surface. They may have an outer face that they show to the world that is completely at odds with how they feel inside. In time, people like this can feel as though they might burst with all the things they might like to say. They may feel isolated, as no one really knows what they are like on the inside.

This cycle of swallowing feelings and sensing isolation can result in a deep sense of loss and frustration, and that can trigger an eating disorder binge. By working on the ability to articulate feelings and emotions, these people could get a great deal of help from the people they love. But if they do not start the talk, they may never get that help.

Genetic Factors and Vulnerabilities

While there are numerous risk factors that involve the way people go about their day-to-day lives, there are some issues that spark bulimia that have nothing to do with a person’s habits. These are issues of genetics.

Genes do all sorts of things within the human body. Some genes, according to the National Eating Disorders Collaboration, could stand behind bulimia. Those genes control:

  • Food intake
  • Appetite
  • Pleasurable feelings
  • Mood
  • Metabolism

Genes are not destiny, so having just one of these genes does not necessarily dictate whether or not a person has bulimia, but having these genes paired with environmental triggers could push a person to bulimia.

It’s hard to know just how powerful genes really are in an individual, but researchers have attempted to answer this question. In one such study, highlighted by Psych Central, researchers found that about 38-53 percent of a person’s risk for bulimia could be explained by genes. That is a relatively high number, and it demonstrates just how big a factor genes could be.

Issues of Upbringing

While genes play a role, the place in which a person grows up might also have something to do with the development of bulimia. For example, in a study published by the Science of Eating Disorders, researchers found that people living in a big city were five times more likely to develop bulimia when compared to people living in rural districts.

It’s unclear why this connection exists, but it could be due to the stress and crowding that comes with city life. People who live in the city might always be fighting for space or recognition, and that could lead to eating difficulty. Living in the city might also mean being exposed to people of different body shapes and/or size, and that could help to spark body image dissatisfaction issues.

Parental psychiatric illness could also play a role, according to research in Addictive Behaviors, as people who grew up with parents who had some sort of mental illness were more likely to have bulimia when compared to those who did not have such parents. It could be that caring for a parent with mental illness caused stress, or it could be that living with a parent like this caused social isolation. It’s not clear, but the connection seems strong.

Living with a parent who has an eating disorder can also spark bulimia. Parents with their own body image issues can project those issues onto their children, leading those children to feel badly about their own bodies and their own chances for success. These children might feel picked on at the dinner table, unable to eat without supervision, and they might resort to bingeing. Or their parents might suggest bingeing as a reward for a job well done or a task completed. That learned treat could turn into a private treat and then a binge.


Handling Risk Factors

Clearly, there are many different risk factors that could play a role in the development of bulimia. Some are under a person’s direct control, while others come about due to factors that people simply cannot change. Despite the origin of the behavior, there is help available.

With supervised treatment programs, people with bulimia can dig deep into the roots of their urges. They can develop a deeper understanding of why they feel compelled to binge, and they can pick up the skills they need in order to deal with that craving without giving in. Treatment does work, and there are options available, no matter how bulimia developed.

Disclaimer: Facilities in the American Addiction Centers family do not treat bulimia directly.

Last Updated on February 3, 2020
Editorial Staff
Editorial Staff
The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.
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