Eating Disorders
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Other Eating Disorder Maintaining Factors

Bridget Engel, Psy.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.

Peer pressure

Adolescents and young women experience a great amount of pressure from their peers to be thin and stay thin. One source of this peer pressure are "thinspiration" websites and discussion groups that have been created on the Internet by people who support and promote eating disorders. Thinspiration sites offer tips and tricks on how to lose weight, induce vomiting, what foods purge the easiest, and how to avoid detection, as well as inspiring photos, quotes and message boards. The anonymity of these websites provides support, friendship, and justification for disturbed thinking or behavior in private. Treatment professionals and other experts are concerned that these pro-ED (pro eating disorder) websites generate pervasive subcultures that potentially help spread dangerous and unhealthy eating behavior.

Other Maintaining Factors

Biological factors that cause eating disorders often continue to perpetuate them as well. As mentioned previously, researchers suspect that physiological mechanisms can help to maintain destructive behaviors. Malnutrition and unhealthy eating patterns change the level of neurotransmitters (chemicals that transmit nerve impulses) in the brain, including serotonin. Some anorexics have abnormally high levels of serotonin in parts of the brain involved in creating and maintaining anxiety and obsessiveness (repeated unwanted thoughts). For these individuals, not eating decreases levels of serotonin, which in turn decreases anxiety. Because these people now feel less anxious, their eating restriction behavior is reinforced.

In contrast, bulimics often show increased serotonin levels in the brain for short periods of time when they binge, which seems to decrease symptoms of depression that are caused by inadequate levels of neurotransmitters. Binging, therefore, temporarily decreases depressive symptoms. However, when serotonin overloads the brain after a large carbohydrate binge, the resulting increased anxiety, irritability, and agitation become precursors to purging behaviors.

Electrolytes (naturally occurring chemicals in the blood that conduct electricity) also play a key role in perpetuating disordered behaviors. Starvation of the body and improper vitamin and mineral intake causes abnormalities in electrolyte levels, resulting in confusion and unclear thinking. Researchers believe that unhealthy electrolyte levels and the resulting confusion maintain disordered behavior because individuals make poorly judged decisions about eating and their bodies.