I have recently been reading an excellent book by Johan Hari called, “Lost Connections”. A book that I highly recommend if you have not read it.
The book is predominantly about depression and the journey that the author, Johan Hari took to try to find an explanation for the causes of depression, beyond the explanation that it is a ‘chemical imbalance in the brain’. Hari’s extensive research, which took him around the world, led him to find several factors that might be the causes of depression, particularly in our modern society where more of us now live lives that are more disconnected from other people than ever have been.
The book takes away from the old fashioned view that depression is solely attributed to brain chemicals and points to research demonstrating that when someone with depression is actually recognised as a whole person, the causes of depression are nearly always arising from factors around how they live, what their life experiences are, what support they have, past trauma or life purpose.
The reason though that I am telling you this in a blog on eating disorders, is that in the book Hari also identifies that some people seem to get very attached to one particular idea of the cause of their depression and are resistant to consider any other possible contributing factor. A reason he attributed to this was the (perceived) stigma attached to the possible causation that people might experience. He even found researchers who discovered that if other people thought another person’s depression was caused by brain chemistry over traumatic life events, they were likely to treat that person less kindly than those they thought were depressed due to some kind of trauma in their life.
This got me thinking about eating disorders and all the people I have known over the years, with eating disorders, who have their story for why they are convinced they developed the illness and they become very attached to their version of the cause… sometimes even aggressively so.
And I know that I have done this too. I have had my understanding that I could make peace with in my mind for what caused me to develop an eating disorder and I would protect that version if it was challenged. Maybe this is because when something makes so little sense (as let’s face it an eating disorder does), we need a way to make some sort of peace with it internally to be able to keep going.
But I also think it is due to stigma, or perceived stigma around the eating disorder and what we think others might think of us depending on what they understand caused the illness.
We have all developed our understanding of the why we developed an eating disorder from various sources or experiences. Some have learnt from research science, influencers, health professionals, therapists and others do have trauma in their past and attribute their cause to that.
This post is not to challenge your story or your why – because your story matters and I believe the causes of eating disorders like so many other illnesses can never be attributed to a single simple explanation and so there is truth to your story, no matter what it is.
But while reading Hari’s book, I did really realise as I reflected on my story that I did have fears over stigma or being thought of as weak when I cling tightly to my explanations of why I developed this illness. For me, understanding my cause as a genetic predisposition to a period of energy deficit in my body was a cause that in my internal world held less stigma or dare I say it, embarrassment, than if I understood my cause to be ‘feeling out of control’ or ‘stressful life events’….
Yet I know many others who do describe the illness as their need for control or being caused by a traumatic life experience and that the illness subsequently became their go to and for them, this explanation evidently holds the most comfort and least perceived stigma.
Of course there are many other explanations too, which might include diet culture, dieting gone too far, pressure from industries such as ballet or body building, family pressures or parenting, body dysmorphia or extreme perfectionism and other personality traits.
But the reality is, whichever cause we are clinging to, our story is only a small part of the bigger picture for why we developed this illness.
Just like any illness, the causes are so multi-faceted and complicated and still so poorly understood that yes – whatever you are telling yourself about your cause is right but so are a huge number of other factors.
We know genetics now play a part but that not everyone who has the right combination of genetics for an eating disorder will go on to develop one because genes have to be switched on by environmental factors (such as energy deficit or maybe stressful life events). Energy deficit is also a key part – be that through dieting and society or diet culture’s influences or some other cause (physical illness or a stressful experience causing a person to stop eating for a period of time perhaps). Other environmental factors are also going to impact, such as how supported we are, our connection to others, sense of life purpose, how much sleep we get, how much stimulation we get mentally and physically. These are just a few of the factors that might contribute to why you and not the person next to you developed an eating disorder and the ingredients present for each person who develops this illness will never be the exact same mix as another person but that is ok and that does not make one illness more valid than another.
The cause of any illness is complex. Every possible thing we experience or do with or to our body can impact on what level of stress our body is under, what chemical processes are occurring, our brain health, our genetic health… and all of this will affect what illnesses we might develop or not. We cannot micro manage that and we cannot predict in advance to any specific degree, so all we can do is keep living in ways that we do know humans have evolved to live and be healthiest in: with good food, plenty of rest and time to allow stress levels to come down each day, lots of sleep (ideally at night time), good social connections, love and support and a sense of life purpose.
In recovery too, the way each person recovers will differ widely and what works for one will be different to another, but all these basic factors (listed above) in terms of what will help us long term to be the best version of ourselves we can be will all help make recovery that bit more possible.
At the end of the day, the causes of an eating disorder are complex and it is a cocktail! Clinging to one story though in fear of stigma or shame is something too many of us do and it is time that we acknowledge that this illness is caused by a huge number of genetic, environmental, societal and biological factors which are still poorly understood due to how complicated they are…
We don’t have to justify why we developed this illness through a story to protect ourselves from shame. We need to educate people that just as any illness, the causes are not simple, the symptoms are not simple and nor is the treatment.
If you are interested in reading Lost Connections then here is a link to the book:
And an incredible TED talk by Johan Hari that summarises a little of his findings: