Circumstances, Motivations, Trigger and Symptoms
The following frequently asked questions infer preconceptions about AN which are widely believed but wrong.
- Doesn’t it have a lot to do with academic pressure?
- Isn’t it for attention?
- Is it about low self-esteem?
- Do they just want to look like models?
- Is it their way to control their life?
Challenges and influences from society (such as stress, death in the family, bullying etc.) are all alleged causes of AN. However; these are issues that all people have to deal with and overcome, they are life circumstances. Genetic makeup are inherent circumstances which when coupled with life circumstances and their resulting motivations can lead to someone triggering AN.
Aims (such as those refered to in the above questions) including desire to look good, academic excellence, religious piety and social acceptance are motivations. Motivations are what drive people to (often unknowingly) intiate the triggering of AN through weight loss. People’s motivations can vary widely, but the outcome of weight loss is a common element of all AN cases.
Not everyone becomes anorexic as a result of life/inherent circumstances, nor personal motivations alone. A combination of genetic predisposition (inherent circumstance) and triggering of weight loss (driven by motivation or by accident) is necessary for a person to initiate AN and begin exhibiting symptoms.
Life circumstances aren’t enough to explain why AN happens
AN has been documented as a condition for at least 200 years, it has not arisen from modern, ‘size zero’, culture. It exists in Curacao, a Carribean island off the coast of Venezuela where fat is considered beautiful¹. In India/Hongkong, AN is induced by religious fasting and eccentric nutritional ideas².
A variety of motivations leads to the same outcome
Prof. Kaye noted, “Anorexia is a very homogeneous disorder. People who have it have the same symptoms. They also tend to say the same things, act the same way. When you see that kind of pattern, it says ‘biological.'”³
Symptoms require conviction and persistence to reverse
Once AN is triggered and a low BMI sustained, the effects of starvation combined with a debilitating psychobiological reaction associated with AN make it extremely difficult for an otherwise intelligent and functioning person to reverse the process. This is the time when such a person needs the most help and support.
Recognizing this new information, isn’t time to support persons with AN by treating them with compassion and encouragement rather than detachment and passivity?
¹ Interview with Dr. Hans Hoek from The Hague Psychiatric Institute on Living on Air, BBC Documentary.
² Miller and Pumariega, 2001. Culture and eating disorders: A historical and cross culture review. Psychiatry 64. 2, 93-110
³ Walter Kaye, a psychiatrist and professor at the University of Pittsburgh quoted on Into Thin Air article from Seed, November 2003.