Causes of Eating Disorders: Is It Parenting?

"And" vs. "But" Important in Discussing Causes of Eating Disorders

Conversations about what causes eating disorders involve a lot of "and, and, and" and "but, but, but."

I think we'd all do better if we make a distinction when it comes to causes of eating disorders.

"But some parents are abusive"

When I say "parents don't cause eating disorders," I hear a lot of "buts."

"But, SOME parents are abusive."

"But, MY father told me I was fat."

"But, parents are so important to their children's development and self-image."

"But, every case is different."

"But, we can't let parents off the hook!"

Here's an experiment: try using "and" in the place of "but." It works.

I recently had an argument about this. This person was willing to concede that not all eating disorders are caused by parents. But because I wasn't willing to concede that at least SOME parents cause eating disorders, I was seen as extreme in my views. He cited a child custody case where the abusive father cited a statement absolving parents for causing eating disorders as a reason he should not lose custody.

I asked him to re-frame this. If the dad was abusive, then that is what bears on the custody issue. Whether the abuse could or could not cause an eating disorder was irrelevant, right? The presence of the illness might bear on her additional need for care but, again, no need to attribute cause.

"But if we let these parents off the hook..."

I asked this doctor to use the word "and." This young woman had an eating disorder AND she was abused by her father. This is doubly tragic. If the patient had been abused and not developed an eating disorder would the father be a more suitable custodial parent?

More to the point, because there is no evidence that abuse causes eating disorders, the real problem with the reflexive "but" in these situations is the pall of suspicion it puts on the great majority of parents who have not abused their children. Abuse is never acceptable, but also no less deserving of our condemnation if the victim remains well.

Some people have eating disorders AND dysfunctional homes. Some people get eating disorders AND suffered abuse. Do these conditions cause eating disorders? No. Do they make eating disorders worse or keep the patient from recovering? I would assume so. Do these families need to deal with the abuse? Good gracious: of course.

Let's separate the issues and help patients as individuals and their families as we find them - but start with an assumption of innocence. Hold poor parenting accountable without accusing the rest.