Semantically, eating disorders are highly associated with body image. Clinically, this association makes complete sense as approximately one-third of people with eating disorders also experience body dysmorphic disorder,1 and many more struggle with negative body image. However, for some people body image concerns are not the primary trigger of an eating disorder, making these challenges somewhat less relevant when we consider why these individuals develop eating disorders.

Studies have found that, in general, individuals with certain genetic variations and experiences of abuse and trauma are more likely to develop eating disorders at some point in their lives.2,3 Likewise, people with higher “baseline” levels of anxiety are more likely to develop disordered eating later in life.4,5

It’s also well-established, even at the cellular level, that chronic stress alters our brain and body in a way that increases our chances of developing an eating disorder.6 This appears to be particularly true for people who develop bulimia and binge eating disorder. In other words, when we try to understand the reason behind someone's eating disorder, we must consider far more than whether they are satisfied with their body or not.

Earlier this year, I had the opportunity to interview Jessica Grenzy, a 41-year-old female in recovery from bulimia nervosa. In 2018, she went into cardiac arrest. She survived to tell her story.

Jessica grew up in a competitive household. At age 12, she began swimming and quickly rose to a competitive level. In parallel, she excelled in school and earned a spot on the honor roll. She was a child to be proud of—but it was not necessarily pride that Jessica experienced at home.

Her father, competitive by nature, paced Jessica and her sister to excel in everything they did, applying relentless pressure to perform at the highest caliber. This home environment was a tremendous source of stress, leading Jessica to constantly wonder how she could improve both physically and mentally. Her father was shaping her into becoming a perfectionist, a mindset that is well-known to increase people’s risk of developing an eating disorder.7

Despite growing up surrounded by diet culture and the thinness ideal, Jessica did not experience disordered eating until she saw a particular movie at age 16. In the movie, two volleyball players used purging in an attempt to stay fit.

Jessica was hooked. This was her ticket to not just be but also look the best.

Her primary goal was to meet the high........

© Psychology Today