Similar personality traits like low self-esteem, dependency, and problems with self-direction are present to people with eating disorders. Specific personality disorders or behavioral characteristics that might put people at higher risk for one or both of the eating disorders have been determined by researchers.



The following personality disorders like avoidant personalities and dependent personalities mostly in anorexia and borderline and histrionic personalities mostly in bulimia and narcissism which can be present in anorexia and bulimia too have been reported by studies. Patients with bulimia or anorexia can present one of these personality traits. The more important factor in determining treatment choices may be the patient's specific personality disorders even if they are anorexic and bulimic.

Avoidant personalities are present to people with anorexia. The symptoms which characterize this personality disorder are: being a perfectionist, being emotionally and sexually inhibited, having less of a fantasy life than people with bulimia or without an eating disorder, not being rebellious, or usually perceived as always being "good", being terrified of being ridiculed or criticized or of feeling humiliated.

Behavioral and eating pattern can be developed by the person with both anorexia and avoidant personality disorder. So for some individuals the only way to obtain love is achieving perfection, with all that involves. Trouble-free and attaining some ideal image of thinness make part of the drive for perfection. In this case the individual is driven to demand nothing, including food. A sense of being even more imperfect and a renewed sense of striving for perfection precede the failure to achieve love. Anorexic patients have a total lack of self but generally people with eating disorders are not typically suicidal. Through process of not-eating they try to revenge on those whose love is always out of reach.

Borderline personalities can be present to people with bulimic anorexia. The following characteristics can be present to these people like: frantically fearful of being abandoned, unable to be alone, difficulty to control their anger and impulses, prone to idealize other people and unstable moods, thought patterns, behavior and self-images. Emotional weapons like temper tantrums, suicide threats, and hypochondriasis can be used by the people with borderline personalities for causing chaos around them. The difficulty in treating bulimia can be the severity of this personality disorder and it can be more important than the presence of psychological problems, such as depression.

The following personality traits like inability to soothe oneself, inability to empathize with others, need for admiration, hypersensitive to criticism or defeat can be present to people with bulimia or anorexia which are often highly narcissistic. Depression and anxiety disorders can be present to patients which have eating disorder but also can be present in families of these patients. It is unknown if emotional disorders, especially obsessive-compulsive disorder (OCD), are causes of the eating disorders.

About 69% of patients with anorexia and 33% of patients with bulimia have obsessive-compulsive disorder which is an anxiety disorder. It is believed that eating disorders are variants of OCD. In compulsive behavior, repetitive, rigid, and self-prescribed routines that are intended to prevent the manifestation of the obsession, may be present obsessions which are recurrent or persistent mental images, thoughts or ideas. Generally women with anorexia and OCD may become obsessed with exercise, dieting, and food. Compulsive rituals like weighing every bit of food, cutting it into tiny pieces, or putting it into tiny containers are often developed at these patients. Other anxiety disorders like phobias, panic disorder and post-traumatic stress disorder (PTSD) have been associated with bulimia and anorexia.

At people with eating disorders, especially anorexia, depression is present which is more severe in darker winter months. Also the patients with bulimia suffer from a specific form of bulimia which is worse in winter. May seems to be the peak month for suicide because the onset of anorexia appears to peak in this month. An eating disorder is rarely cured by treating and relieving depression. Social, psychologic or possibly biologic factors can cause a distorted view of one's body called body dysmorphic disorder which can be associated with anorexia or bulimia but can also appear without any eating disorder. In this case emotional disorders, including obsessive-compulsive disorder and depression are commonly to people with this disorder. A disorder in which people have distorted body images involving their muscles has been reported by experts and it is present to men which believe that are "puny" and results in excessive body building, preoccupation with diet and social problems.

Another factor which is present in triggering and perpetuating eating disorders is negative family influence. Children with insecure attachments are present in family with parents who fail to provide a safe and secure foundation in infancy. Mothers play an important role in their child's life. So mothers of people with bulimia are critical and detached and mothers of anorexics tend to be over-involved in their child's life. People with either eating disorder have parents with alcoholism or substance abuse. It seems that psychiatric disorders are present to parents of people with bulimia than parents of patients with anorexia. A higher incidence of sexual abuse is often present to women with bulimia. People with bulimia have an obese parent or have been overweight themselves during childhood. Parents can influence their children's eating habits and prevent weight problems and eating disorders through a healthy eating habits themselves.

Genetic factors play an important role in anorexia. From this point of view twins had a tendency to share specific eating disorders (anorexia nervosa, bulimia nervosa and obesity). A genetic propensity toward thinness caused by a faster metabolism and reinforced by cultural approval, an inherited propensity for obesity and inherited personality traits are some inherited traits that might make someone susceptible to eating disorders. Culture pressures is other factor which can lead to anorexic people.For example clothes for thin bodies, TV programs which present anorexic young models. Excessive exercise plays a major role in many cases of anorexia at athletes. Young female athletes and dancers may present the following problems:eating disorders, amenorrhea (absence or irregular menstruation) and osteoporosis.

The most common factor present in eating disorders which include chemical abnormalities in the thyroid, the reproductive regions, and areas related to stress, well-being and appetite are hormonal problems. A result of malnutrition or other aspects of eating disorders is the change of these chemicals. The limbic system is a small area of the brain where many of these abnormalities begins. Also hypothalamic-pituitary-adrenal axis (HPA) is a specific system with an important role in eating disorders. In brain is found a small structure that controls our behavior, like eating, sexual behavior and sleeping, and regulates body temperature, emotions, secretion of hormones, and movement called hypothalamus. An extension of the hypothalamus downwards called the pituitary gland controls thyroid functions, the adrenal glands, growth and sexual maturation. Major emotional activities like anxiety, depression, aggression and affection are controlled and regulated by amygdala,a small structure which lies deep in the brain.

Stress hormones called glucocorticoids are produced by the HPA system, including the primary stress hormone cortisol which is very important in marshaling systems throughout the body (including the heart, lungs, circulation, metabolism, immune systems, and skin) to deal quickly with any threat. The inhibition of neuropeptide Y (NPY), a powerful appetite stimulant that also has anti-anxiety properties is one of the specific effects. Certain neurotransmitters (chemical messengers) that regulate stress, mood and appetite and are being heavily investigated for a possible role in eating disorders are released by the HPA system. Serotonin, norepinephrine and dopamine are the three hormones that are important. So norepinephrine is a stress hormone, serotonin is involved with both well-being and appetite and dopamine is involved in reward-seeking behavior. Low levels of leptin, a hormone that appears to trigger the hypothalamus to stimulate appetite have been observed in people with anorexia and bulimia.

The reproductive hormones that are severely depleted in anorexics are produced by the hypothalamic-pituitary system. Some experts believe that these reproductive abnormalities are a result of anorexia and others have shown that menstrual disturbances occurred before severe malnutrition set in and remained a problem long after weight gain in 30% to 50% of people with anorexia.

There are many factors who contribute at development of anorexia. Unfortunately teenage females are the most affected.