Anorexia isn’t caused by wanting to look good in a bikini

A new study into anorexia makes a controversial claim. According to researchers from INSERM medical research institute, Paris Descartes University and Ste. Anne’s Hospital, what motivates sufferers is the pleasure of losing weight, rather than the fear of gaining it, as per popular belief.

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Researchers showed volunteers (some with anorexia, some without) pictures of women of different weights and asked them how good they would feel if they had the same body shape. While the healthy women preferred the images of women of a “regular” weight (whatever that may be), those with anorexia chose the images of underweight women as the most desirable. During the experiment, the extent to which they sweated (a sign of excitement) was also measured, and it was recorded that the anorexic women found the images of underweight women most stimulating.

So far, so expected. It’s another finding that forms the basis of the researchers’ claim that the main criteria for an anorexic diagnosis is incorrect. Although the anorexic women didn’t like the pictures of very overweight women, they considered them to be only slightly less desirable than the healthy volunteers.

An anorexia diagnosis is generally based on three international criteria: eating less food (which results in weight loss); a distorted perception of weight and body image; and an acute fear of gaining weight. Lead researcher Philip Gorwood believes that current treatment methods may be failing many patients because the third criterion is based on a major misunderstanding of the disorder, because professionals have failed to recognize that a defining feature of anorexia is the desire for weight loss as opposed to a fear of weight gain.

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For some anorexics, their disorder may well be motivated by a desire to lose weight. But more often, it’s way more complicated. Some professionals believe eating disorders should be mental illnesses in their own right, and there’s no denying that the line between the two is blurry. The Anxiety and Depression Association of America classes eating disorders as a “related illness” to mental illness. Many professionals and publications highlight the common co-occurrence of eating disorders with mental illness. It can be a vicious cycle: and it’s not always easy to pinpoint the starting point. Did feelings of low self-esteem, worthlessness or powerlessness trigger the eating disorder? Or did the eating disorder cause the mental illness? In the case of anorexia, where extreme weight loss and malnourishment is common, psychological changes can have a severe and negative effect on mood states.

Depression is often a factor. In a 2008 study by University of Pittsburgh Medical Center researchers, 24 percent of bipolar patients met the criteria for eating disorders. According to the National Institute of Diabetes and Digestive and Kidney Diseases, as many as half of all patients diagnosed with binge-eating disorder (the most common eating disorder in the United States) have a history of depression.

Anorexia, like all eating disorders and mental illnesses, is a complex disorders with no room for a “one size fits all” mentality. Some sufferers may desire weight loss — although whether the word “pleasure” is appropriate to use to describe the effects of anorexia should be up for debate, as it makes this desperately cruel, relentless, sometimes fatal illness sound superficial and self-indulgent. However, many others do have a real fear of weight gain.

And for some anorexics, neither may be applicable. Their disorder may stem from an overwhelming need to have control, a fear of change or compulsive behaviors. Counting calories, macronutrients, steps taken, etc. may be more important than weight. It may be a reaction to abuse or some other traumatic life event. It may stem from feelings of failure and negative feelings about oneself as a person — and not at all about weight or physical appearance.

Of course, it may be a combination of several of the above.

Studies into eating disorders are crucial. The only way to improve understanding, identify the right treatment methods and increase the recovery rate is to carry out research. The National Association of Anorexia Nervosa and Associated Disorders reports that anorexia is the most common cause of death (up to 12 times higher than any other condition) among 15- to 24-year-old women.

But it’s simply not helpful to reduce such a complicated illness to “a pleasure in losing weight.” Any sufferer will tell you that even if they can relate to this motivation, it’s only a tiny part of the picture.

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