The need for control is thought to be one of the major causes of anorexia. Individuals who develop eating disorders often have persistent feeling of being “out of control.” They address these feelings in unhealthy ways, such as focusing on body size or food intake. These feelings of lacking control can stem from childhood abuse, perfectionist expectations, or growing up in rigid systems where autonomy and independence are denied. In this sense, anorexia can be seen as a family systems problem, and therapy needs to focus on creating a home environment that is more flexible and allows members to freely express themselves.
There are certain populations more susceptible to anorexia nervosa. Individuals suffering from eating disorders are predominantly Caucasian, and it also affects teenage girls at a higher rate. Sufferers of ED often come from middle-to-upper class families who experiences difficult demands of perfection in all phases of life, including school and extracurricular activities. However, anorexia affects both sexes as well as all classes and races, but the aspects of perfectionism and lack of control are common among all cases.
People struggling with ED often feel backed into a corner, where all aspects of their existence are outside their own active control. These feelings are not necessarily experienced consciously but instead are often repressed. Sufferers tend to people-please, and set expectations for themselves that are difficult or impossible to attain. Nothing is ever good enough, and even accomplishments are usually minimized or denied.
With these factors in place, one can begin to understand the psychological relief that comes from being able to take total control over weight management; they get to decide exactly which types of food enter their body, exactly how many calories they consume, exactly how much time they spend exercising, and develop precise goals for weight loss. All aspects of food consumption become highly regimented. There is little outside intrusion at first, since working out and dieting are generally accepted and even encouraged behaviors in our culture. So individuals with eating disorders often fly under the radar and feel a sense of total control over an essential aspect of their lives that balances out feelings of helplessness.
This is why to beat anorexia one usually needs to have a safe space to learn about anxiety, the effects of abuse, and how internal and external standards of perfection contribute to the disease. Individuals in eating disorder treatment learn to set boundaries, and to separate from the selfish needs of others in your family system. In doing the work, they start to feel a real sense of control over important aspects of their development like with school work, career inclinations, interests and hobbies, and social life. Once one can achieve this, control over food consumption automatically becomes less important because it no longer provides the function of helping to blunt the painful realities of family situations.