Eating Disorders - Risk Factors

Borderline Personalities. Studies indicate that almost 40% of people who are diagnosed with bulimic anorexia (losing weight by bingeing and purging) may have borderline personalities. People with borderline personalities have been described as causing chaos around them by using emotional weapons, such as temper tantrums, suicide threats, and hypochondriasis. Such people tend to:

Have unstable moods, thought patterns, behavior, and self-images
Be frantically fearful of being abandoned
Be unable to be alone
Have difficulty controlling their anger and impulses --in fact, betweenone-quarter and one-third of people with bulimia have impulsive symptoms
Be prone to idealize other people (frequentlyfollowed by rejection and by disappointment)

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Some research has suggested that the severity of this personality disorder predicts difficulty in treating bulimia, and it might be more important than the presence of psychological problems, such as depression.

Narcissism. Studies have also found that people with bulimia or anorexia are often highly narcissistic and tend to:

Have an inability to soothe oneself
Have an inability to empathize with others
Have a need for admiration
Be hypersensitive to criticism or defeat

Accompanying Emotional Disorders

Between 40 -96% of all eating-disordered patients experience depression and anxiety disorders. Depression, anxiety, or both is also common in families of patients with eating disorders. It is not clear if emotional disorders, particularly obsessive-compulsive disorder (OCD), cause the eating disorders, increase susceptibility to them, or share common biologic cause.

Obsessive-Compulsive Disorder (OCD). Obsessive-compulsive disorder is an anxiety disorder that occurs in up to 69% of patients with anorexia and up to 33% of patients with bulimia. In fact, some experts believe that eating disorders are just variants of OCD. Obsessions are recurrent or persistent mental images, thoughts, or ideas, which may result in compulsive behaviors (repetitive, rigid, and self-prescribed routines) that are intended to prevent the manifestation of the obsession. Women with anorexia and OCD may become obsessed with exercise, dieting, and food. They often develop compulsive rituals (e.g., weighing every bit of food, cutting it into tiny pieces, or putting it into tiny containers). The presence of OCD with either anorexia or bulimia does not, however, appear to have any influence on whether a patient improves or not.

Obsessive-compulsive disorder is an anxiety disorder characterized by an inability to resist or stop continuous, abnormal thoughts or fears combined with ritualistic, repetitive, and involuntary defense behavior.