A period of undernourishment may trigger AN because our hormones etc need a certain balance to keep them in check. Without the correct balance of micronutrients, vitamins and minerals, which must come from food, some people set off the trigger for AN. The AN then takes its own cue from that imbalance. It becomes like an unbalanced see saw (teeter-totter?). Ever seen it with just one child on it? It goes swinging quickly after a very slight momentary period of slow motion down. The closer it gets to the bottom, the faster it goes. Same with the imbalance in the body of the right foods. I feel some people, likely AN sufferers, have a small limit of balance, unlike those who have a massive limit of balance, and therefore cannot become anorexic. It takes me just a few pound off my ideal weight to not get periods, and a a few more for the AN to take hold and swing off on its own.

I hope that gives you an idea of why some people, I beliece correctly, state that AN requires a predisposition. I am not sure if it is AN pese, but more a predisposition for a smaller imbalance of nutrients of which AN is a symptom of.

My two cents given! (I’m Aussie)

Kate

I completely agree that media images of thin women are triggering for patients with AN, and may contribute to body dissatisfaction for most women. My point, however, is that, in a different era/culture which did not embrace the thin ideal, the incidence of AN (meaning how prevalent it is in the general population) would be the same. It is my belief that patients who are triggered by the thin ideal today would have been equally triggered by religious dictates to fast, or cultural pressures to be hardworking and self-sacrificing and not give oneself enough rest, or the “high” they get from restricting, or a medical illness that causes inadvertent weight loss, or extreme stress from any source, or the hormonal changes of puberty, or any number of other things.

My point is that the “thin ideal” is not central to the etiology of AN; it is merely what many AN patients latch onto as the focus of their obsessions and compulsions. Just as OCD patients latch onto our modern obsession with hand sanitizer and cleaning products – these products are not central to the etiology of AN; people with this same brain predisposition, in another area, would have had symptoms with another focus.

Right now I’m supposed to be gaining weight and I so don’t want to. I gained a few pounds and absolutely hate it and want to say “screw it all” and go back to restricting more and working out more. I hate it. If I’m with people and I eat something that I wouldn’t normally eat I hear “Ooh, I can’t believe you’re eating that.” Translation – “You shouldn’t be eating that.”

My ED started out as a diet and then turned into this. I agree, not everyone who diets has the genes to develop an ED, but I think a lot of times a simple diet turns into an ED.

As for BMI, I don’t know why anyone professionals give that a second thought. It’s a bunch of BS, which I’m sure you know since you’re a smart woman!

I still love this magazine and think it was more my daughter’s tendency than what was written. But, maybe it’s a lesson that even when you try to do the right thing, it can backfire inadvertently.

I do wonder what research has been found that relates exposure to the idea of EDs to the rate of diagnosis. When I reflect on my journey, I remember reading many books about it and my unhealthy fascination at a really young age. I don’t believe I could’ve thought up bulimia without being exposed to the idea to use it as a diet method or coping mechanism. It was as if, I already had body image issues without learning it–but methods to “cure” my unhappiness was exposed to me.

To answer your question, yes, the thin ideal may be considered one of many triggers which sets off a domino effect. That being said, I don’t think it is necessarily as much of a “trigger” as people think.

In the 1400′s, religion was one of many triggers (along with scarcity of food, rampant disease and lack of medical care, the necessity of expending a great deal of energy on activities of daily living) which sets of a domino effect. Religion was ubiquitous at that time and pervaded every aspect of a person’s life (kind of like the thin ideal today). People passed judgment on sinners (much like they pass judgment on overweight people today). People were striving to be more devout, more Godly, to feel closer to God by fasting. That fasting led to energy imbalance which triggered AN in those who were genetically susceptible.

Sometimes I wonder if, back in the medieval times, well-meaning but misguided prevention efforts would have been aimed at changing the “holy ideal,” or encouraging people to become athiests, in attempt to prevent people from developing AN.

I believe that AN will manifest in one way or another, and will express itself in the context of the culture in which it emerges. For example, many people with OCD have obsessions and compulsions surrounding germs, in part due to our society’s focus on cleaning products, hand washing, hand sanitizing, etc.

Twin studies have shown that the risk of developing AN is between 50-80% genetic. A 2010 study demonstrated that single-nucleotide polymorphisms (SNPs) in the gene OPRD1 and near the gene HTR1D confer risk for developing AN. So, to answer your question, there is no single “anorexia gene,” but rather various genes that predispose a person to developing AN in the presence of certain environmental conditions, the most obvious of which is an energy imbalance. So people with AN are genetically wired to respond to low nutrition in a certain way.

The fact that an illness is genetically inherited does NOT mean that psychotherapy doesn’t work, and does NOT mean that a person cannot recover. The pathway into an illness is not necessarily the same as the pathway out of the illness. We are not yet able to alter our genes, but we can alter our behaviors and environments in ways that are conducive to optimal health, given our unique genetic makeup. For example, alcoholism is largely genetic. However, a person who is aware of his family history of alcoholism can avoid having the disease manifest by avoiding alcohol and other addictive substances, and getting psychological treatment for depression, anxiety, etc. so that he is less susceptible to using alcohol to self-medicate. A person who already suffers from alcoholism can recover with the help of psychotherapy, 12-step programs, perhaps a stay in rehab if needed, building a support network of friends who do not drink, etc.