Family Dysfunction and Anorexia: Is there a correlation?

Lauren Hanisch



Anorexia Nervosa

Causes of Anorexia

A Focus on the Family

A Drive to Achieve

Is there a correlation?


List of Works Cited 


Each year millions of people in the United States develop serious and often fatal eating disorders. More than ninety percent of those are adolescent and young women. The consequences of eating disorders are often severe--one in ten end in death from either starvation, cardiac arrest, or suicide. Due to the recent awareness of this topic, much time and money has been attributed to eating disorders. Many measures have been taken to discover leading causes and eventual treatment for those suffering from anorexia. ( of Eating Disorders) )


Anorexia nervosa is a psychosociological disease which affects young women. Anorexia is mainly a female's disease which has been evident for centuries-however, in the past twenty years, the incidence of this disorder has risen to horrifying proportions. It is characterized by the refusal to maintain body wight over a minimal normal weight for age and height; intense fear of gaining weight; a distorted body image; and, amenorrhea. ( This disorder becomes a disease when the mind starts to cause problems with one's physical well-being. A connection has been found between sociocultural pressures to achieve, familial characteristics, and individual personality traits.

Causes of Anorexia

Many causes are attributed to anorexia, and scientists have studied the personalities, genetics, environments, and biochemistry of people suffering from this disorder. Women most often share various traits--although the more that is learned, the more complex each individual case becomes--low self-esteem, feelings of helplessness, and a fear of becoming fat. According to Kenneth Felker, a combination of factors influence the development of anorexia-- perfectionism, a society that emphasizes thinness, a family that manifests depression, and biological tendency.

A Focus on the Family

Eating disorders appear to run in families-usually affecting only the women. One study found that mothers who are overly concerned about their daughters' weight and physical attractiveness--along with overly critical fathers and brothers-may put girls at increased risk of developing an eating disorder. ( ) Another study notes that, "inappropriate parental pressure was specific for eating disorders ... and Eating Attitudes Tests (ETAT) scores correlated significantly with hostlity toward child, sibling disability, parental overprotection, inappropriate parental pressures, and negative changes in family relationships." (Horesh, -Nefta) When the connection between eating disorders and familial traits was looked into, three interpretable factors were found by Steiger-eating concerns and symptoms, dramatic-erratic traits, and obsessive-compulsive traits. Correlations were also found among the subjects' factor scores--correspondences between daughters' and parents' psychopathological traits, and between daughters' and mothers' eating concerns.

Another controlled study of 51 teenage cases including a population sample done by Rastam found that 35 of the cases had a reasonably plausible background factor-based on a history including heredity, early physical and temperamental development, and the family's overall social situation--while only 2 of the control group possessed the same characteristics. A study documented by Telerant revealed emotional uninvolvement of fathers and a radical change preceding the appearance of the anorexic symptomatology. All of the parents in this study also acted in a cold and formal manner, demonstrating verbal and nonverbal abuse and criticism. In a study noted by Killian, enmeshment amongst family members, rigidity, lack of conflict resolution, and overprotectiveness summed up the main familial dysfunctions evident in cases of anorexia nervosa.

A Drive to Achieve

Anorexics tend to come from upper-middle and upper class families that make a "good impression" according to ( The anorexic females are model children and are usually known for outstanding academic achievement-Boskind-Lodahl (1976) and Levine (1987) argue that these achievement strivings are not true indicators of intelligence, but rather are a way of pleasing parents and marrying well. In fact, the mothers of these females are often highly intelligent women who gave up their own careers to have a family. Due to the mother's eventual enmeshment with her daughter, the daughter's "autonomous strivings are stiffed as she is socialized to be more concerned with external parental approval than with her own internal satisfaction." (Yager, p. 43-59). The same study found that most of these girls strongly identified with their fathers who were generally uninvolved, preoccupied, and hostile. White (1983) found that anorectic families have "...certain role expectations of their members. Women in these families are generally expected to be sensitive, devoted, and self-sacrificing" (p. 257). These women fighting between the clashing ideals of the traditional sex role and high achievement often become anorexic.

Is there a correlation?

There is obviously a strong correlation between family dysfunction and anorexia-yet attempts to find whether or not a child will be genetically predisposed to an eating disorder are still undetermined. According to a study documented by Killian, "it is roughly eight times as common in females first degree relatives of anorexics as in the general public." Scientists have studied the biochemical functions of people with the disorders and have recently focused on the neuroendocrine system-a combination of the central nervous and hormonal systems. (hftp://www.kidsource...) According to the same article, many of the regulatory mechanisms controlled by this system--including such functions as physical growth and development to appetite and digestion-are seriously disturbed in people with anorexia nervosa. The finding that family environment is significantly associated with the risk of developing anorexia nervosa is therefore consistent with previous research as per Felker. Felker has also documented that Family Environment Scores (FES) identify a perception of greater contact, greater control, and greater achievement orientation as being associated with an increased risk of developing anorexia nervosa. This could possibly stem from a family vulnerability-yet how heredity and the environment interact to produce anorexia remains unclear.


Results of the study documented by Felker indicate that select components of family environment are associated with adolescents' risk of developing anorexia. He states that, "while statistical significance is an important step toward finding definitive answers within an area of interest, it is the application of these results that may ultimately impact the health of a population.' (p. 7 of 10) In other words, only through education can these tremendous problems be conquered. While no one factor can be singled out as the sole cause of anorexia nervosa, a collective group creates a combination of factors involved in a highly complex disorder. Females who cannot find a way to reconcile the conflicting demands may choose anorexia as a way to control the uncontrollable.

List of Works Cited

Web Works

http:/ ... er.html#Causes of Eating Disorders



Boskind-Lodahl, M. (1976). Cinderella's step-sisters: A feminist perspective on anorexia nervosa and bulimia. Signs: Journal of Women in Culture and Society. 2.342-356.

Felker, Kenneth R., & Stivers, Cathie. (1994). The relationship of gender and family environment to eating disorder risk in adolescents. Adolescence. 29. 821-836.

Horesh, Netta. (1 996). Abnormal psychosocial situations and eating disorders in adolescence. Journal of the American Academy of Child and Adolescent Psychiatry. 35, 921-927.

Killian, Kyle D. (1994). Fearing Fat: A literature review of family systems underscoring treatments of anorexia and bulimia. Family Relations. 43, 137-156.

Rastam, Maria. (1992). Background factors in anorexia nervosa. European Child and Adolescent Psychiatry. 1, 54-64.

Steiger, Howard. (1996). Familial eating concerns and psychopathological traits. International Journal of Eating Disorders. 19, 147-157.

Telerant, A. (1 992). Anorectic family dynamics. Journal of the American Academy of -Child and Adolescent Psychiat!y. 31, 990-991.

White, M. (1 983). Anorexia, nervosa: A transgenerational perspective. Family Process. 22, 255-273.

Yager, J. (1982). Family issues in the pathogenesis of anorexia nervosa. Psychosomatic Medicine. 44, 43-59.



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