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Ohio State University Extension


Eating Disorders Awareness: Emotional Issues Involved With Eating Disorders

Family and Consumer Sciences
Jenny Nickol Even, Educator, Family and Consumer Sciences, Miami Valley EERA, Ohio State University Extension
Gail Kaye, Program Director, Human Nutrition and Elizabeth Snyder, Special Projects Assistant, Ohio State University Extension

Eating disorders are devastating mental illnesses brought on by a combination of factors. These factors may include emotional and personality disorders, family pressures, a genetic or biologic susceptibility, physical or sexual abuse, and a culture in which there is an overabundance of food and an obsession with thinness. Eating disorders are generally categorized as anorexia nervosa, bulimia nervosa, binge eating disorders, or not otherwise specified (NOS).

Anorexia nervosa is a mental illness characterized by an intense fear of gaining weight and an unwillingness to maintain a healthy or normal body weight. Persons with anorexia severely restrict their food intake; some attempt to lose weight by vomiting and/or the use of diuretics and laxatives. Bulimia nervosa describes a style of binging and purging. It usually begins in early adolescence when young women attempt restrictive diets. When these diets fail, the adolescent reacts by binge eating and purging through vomiting or taking laxatives, diet pills, drugs to reduce fluids, and excessive exercising. A third category called "not otherwise specified" was established to define eating disorders not specifically defined as anorexia, bulimia, or binge eating disorder. This category includes binge eating without purging, and other behaviors or anorexia and bulimia accompanied by normal weight or vomiting after eating small amounts of food.

Females are more than two times as likely as boys to have an eating disorder (anorexia nervosa, bulimia nervosa and/or binge eating disorder). The estimated prevalence of eating disorders among 13 to 18-year-olds is 3.8% for females and 1.5% for males.

This fact sheet will focus on individual and family emotional problems that contribute to eating disorders.

Personality Characteristics of Individuals With Eating Disorders

People with Anorexia Nervosa:

  • Perfectionists
  • Conflict avoidant
  • Emotionally and sexually inhibited
  • Compliant
  • Approval seeking
  • Excessively dependent
  • Socially anxious
  • Fear of spontaneity
  • Reluctant to take risks
  • Practice food rituals

People with Bulimia:

  • Unstable moods, thought patterns, behavior, and self-images
  • Cannot stand to be alone
  • Demand constant attention
  • Difficulty controlling impulsive behavior
  • Secretive behavior

Bulimia, Anorexia Nervosa, and Binge Eating Disorders:

  • Inability to soothe oneself or to empathize with others
  • Need for admiration
  • Hypersensitivity to criticism or defeat
  • Frequently experience depression
  • Depression common in families
  • Low amounts of neurotransmitters

Anxiety disorders are more common in anorexia and its variations. Obsessive-compulsive disorder (OCD) usually precedes the onset of anorexia nervosa.

Family Factors

Families of People with Anorexia Nervosa:

  • Enmeshed, overprotective, conflict-avoiding
  • Unresponsive to patient's self-expressions
  • Independence is discouraged
  • Patient overly dependent on parents
  • Parents may urge young daughters to lose weight

Families of People with Bulimia:

  • Parents are critical and detached
  • Characterized by hostile enmeshment
  • Non-nurturing
  • Emotionally unresponsive
  • May have an obese parent, a parent with an eating disorder, or who may have been overweight themselves during childhood

People with eating disorders are more likely to have parents with alcoholism or substance abuse than the general population, and women with eating disorders have a higher incidence of being sexually abused. In addition, anorexia is eight times more common in people having relatives with the disorder, but experts do not know precisely what the inherited factor might be.

Family Intervention and Therapy

In order to help a person with an eating disorder, the following issues must be addressed:

  • Feelings of intense guilt and anxiety.
  • Families must understand the danger of the disorder.
  • Families must acknowledge their collaboration in the patient's illness.
  • Appropriate interpersonal boundaries need to be established.
  • Needs and feelings of patient must be recognized, accepted, and articulated.
  • Sense of self should be separate from parents, especially that of mother-daughter.


Gluck, Samantha. 2022. "Eating Disorders Not Otherwise Specified (EDNOS)." Healthy Place.

Johnson, Craig L., Randy A. Sansone, and Mary Chewning. 1992. "Good Reasons Why Young Women Would Develop Anorexia Nervosa: The Adaptive Context." Pediatric Annals, Volume 21, Issue 11: 731–737.

Mehler, Philip. 1994. "Eating Disorders: Anorexia Nervosa." Hospital Practice, 109–117.

Meyer, Dinah F., and Richard K. Russell. 2011. "Caretaking, Separation From Parents and the Development of Eating Disorders." Journal of Counseling and Development, Volume 76, Issue 2: 166–173.

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Eating disorders: Anorexia and Bulimia Nervosa. 

Reviewed and edited by Gail Kaye, Program Director, Human Nutrition and Elizabeth Snyder, Extension Special Projects Assistant.

Originally posted May 5, 2011.