New evidence suggests eating disorders may be sparked by stress.
Such disorders are often blamed on body image issues and a flawed relationship with food. Less often, they are seen as a tangible way for women (and men) to manage emotion.
After all, when chaos looms, control kicks in. And what is a more tangible thing to control than the body?
A researcher at Pennsylvania's Bucknell University has looked at the emotional drivers of eating disorders, uncovering a link between thought suppression and stress.
Lauren Feldman, undergraduate psychologist, hypothesised that stressed subjects would respond differently to food-related words such as "pizza" or "restaurant".
She found that stressed subjects were significantly slower than non-stressed subjects at recognising such words.
"It's as if, when stressed, eating-disordered individuals suppressed thoughts of food," Feldman said. "This makes sense, because blocking out such thoughts would facilitate eating-disordered behaviours like dieting and restricting.
"Much of the research on eating disorders looks at weight, food and body shape as motivators," she said. "But there's also a theory that eating disorders serve emotional functions rather than physical ones."
While the findings hardly offer the final word on diet disorders, they confirm the school of thought that says eating disorders are not so much about achieving a particular body weight as they are about trying to manage emotion.
Drazenka Floyd, clinical director of the Butterfly Foundation, which helps people with eating disorders, said such disorders might start off being about weight but were fundamentally about a lack of coping skills.
"We've known that for a while," she said. "It stops being about [weight] and starts being about underlying emotions, perfectionism and black and white thinking."
The organisation suggests that disordered eating is emerging as a norm in Australian society from a young age.
Ninety per cent of 12 to 17-year-old girls and 68 per cent of 12 to 17-year-old boys have been on a diet of some type. One in 10 Australian women will suffer from an eating disorder.
"We know eating disorders are impacted by emotions, stress and anxiety ... If someone is depressed or experiencing negative emotions, they are less likely to eat. Or with bulimia, it has the opposite effect."
For this reason, a significant part of the recovery process is tackling emotions and "teaching ways to sit with negative emotions".
For instance, deep breathing through the nose calms physiological responses, while meditation techniques help to calm anxiety and stress, Floyd said.
"We also explore core negative beliefs and low self-esteem - [teaching a patient] that they're worthy."
Findings such as those from the Bucknell experiment, which will be presented in March at Bucknell's Kalman Undergraduate Research Symposium, highlight the importance of a holistic approach to treating eating disorders by building a patient's emotional and coping skills.
"We're just finding out more and more," Floyd said.
"Genetics, environment, who we are [all have an impact]. It's a multi-faceted, complex illness. Treatments are getting better, but it's a tough one."
For more information, see the Butterfly Foundation website.
Correction: An earler version of this article incorrectly stated that Feldman was a co-experimentor and a professor.
