Unveiling the Complexity: A Deep Dive into the Causes of Bulimia

What causes bulimia? Eating disorders are complex because they can have several causes. The impact of eating disorders can be physical, psychological, and emotional, taking away from quality of life as well as relationships. It’s important to understand the complex and often overlapping causes of things like bulimia in order to figure out the right treatment

Multifaceted causes of bulimia

According to several epidemiological studies in the United States, the rate of bulimia ranges from between 0.14% to 0.3% of the population.

  • In sample sizes, women are significantly more likely to struggle with bulimia nervosa than men.
  • Women have a prevalence between 0.22% and 0.5%, whereas men have a prevalence between 0.05% and 0.08%.
  • In a study of people between the ages of 13 and 18, girls and boys had the same lifetime prevalence rates between 1.3% and 0.5%.
  • There is no difference in the prevalence of bulimia across US ethnic groups, but prevalence does seem to be increasing across low and middle-income countries.

So, what causes bulimia in these situations? Are there different causes of bulimia in men versus women or in different age groups?

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-Psychological Factors

The exact cause of bulimia is not known. In many cases, there are several bulimia nervosa causes that influence a single case. For example, people are more likely to develop an eating disorder like bulimia if:

  • They are a family member who has a history of eating disorders, addiction, or depression
  • They have been overly criticized about body weight, shape, or eating habits
  • They are overly concerned with having a thin body, especially if facing pressure from work or society
  • They struggle with obsessive personality, anxiety, or low self-esteem
  • They have experienced stress or trauma 

Some of the biggest psychological factors have to do with mental health. There are several mental health disorders that have a high comorbidity with eating disorders. This means that someone who struggles with one type of mental health disorder is more likely to struggle with a second or third type of mental health disorder.

People are more likely to develop bulimia if they struggle with:

  • Anxiety disorders
  • Depressive disorders
  • Any mental health disorder that has depressive symptoms
  • An obsessive personality

It’s important to note that conditions like anxiety disorders and depression have a higher prevalence among women than they do among men, which lends itself to the subsequently higher rate of bulimia among women than men.

-Sociocultural Influences on Bulimia

There are several sociocultural influences on bulimia. Individuals can be at an increased risk for developing bulimia if they struggle with the following:

  • Weight concerns
  • Depressive symptoms
  • Low self-esteem
  • Social anxiety disorder
  • Generalized anxiety disorder in childhood

For example:

Margaret was diagnosed with generalized anxiety as a child. She has always struggled with anxiety, and when she reached puberty, she gained a lot of weight. During that time, she was severely mocked by her peers. Once Margaret moved away to college, she started to experience struggles surrounding her weight, so she began the cycle of purging to try to control her weight and keep herself thin.

By comparison, Clarissa never had generalized anxiety, and though she did gain weight during puberty and was made fun of, it didn’t manifest in bulimia nervosa. Instead, Clarissa just worked out and turned to a healthy, well-balanced diet when she got to college to keep herself in shape.

One of the reasons that women experience higher levels of bulimia compared to men has to do with sociocultural influences. In many cases, women are traditionally expected to maintain thin bodies, something that manifests during critical transitions like puberty, high school, or after childbirth.

In the example above, you can see how Margaret was exposed to two potential causes of bulimia, the first being the diagnosis of a generalized anxiety disorder in childhood and the second being weight issues. Sociocultural influences about needing to stay thin, as well as anxiety symptoms, increased her risk and led to the development of bulimia, whereas Clarissa, who had none of those risk factors, managed her weight issues in a different way. 

-Biological and Genetic Factors in Bulimia

There are several biological and genetic factors that have to do with an increased risk of bulimia. Childhood obesity, for example, increases the risk of bulimia later in life. Similarly, going through puberty early increases that risk.

According to the DSM, there are potential risks of genetic vulnerability to bulimia as well as family transmission. Family transmission doesn’t necessarily mean that a family member transmits bulimia through genetics but rather through psychological factors and environmental factors.

For example:

If a mother is severely bulimic, those same traits and behaviors might be passed to her daughter, especially if it’s talked about in the home or clearly visible in the home. 

-Environmental Triggers and Stressors

There are also several environmental triggers and stressors that serve as causes of bulimia. An internalization that a thin body is an ideal body has an increased risk for weight issues. As such, someone who truly believes that a thin body is ideal might be at a higher risk for developing bulimia.

Tangentially, individuals who have experienced physical or sexual abuse in childhood are at an increased risk of developing bulimia later in life.

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The Interplay of Factors in Bulimia Development

If you have asked “what causes bulimia,” by now, you know that there is no single bulimia cause but rather several factors that can influence the risk of developing bulimia. Given how many factors there are, this interplay of bulimia nervosa causes means that treatment requires professional interventions to address things like biological, psychological, and sociocultural factors.

Someone like Margaret needs a multifaceted approach to treatment to help deal with the anxiety, the childhood issues that continue to influence her current decisions, and the eating disorder. It’s important to recognize all of the potential influences, triggers, and causes of bulimia so that you can get help in the right way and lead a healthier, happier life.

Summing Up

There are several bulimia causes, and in most cases, people don’t struggle with a single cause but rather, an interplay of several factors. That said, the most important thing to do if you or someone close to you is struggling with bulimia nervosa is to consider professional interventions and treatment plans that can help target the multifaceted nature of bulimia, working to overcome psychological, sociocultural, and biological factors.