Only a few days ago I asked a colleague who works with eating disorders, “What do you know about the families of patients with anorexia nervosa?” Without thinking, she replied, “The mothers of the girls I’ve treated are usually controlling and intrusive. The fathers are disengaged. The girls don’t grow up with autonomy and independence.”
Misconceptions about anorexia abound. One of these is that anorexia happens almost exclusively to women and girls. Another is that families – and mothers in particular – are primarily responsible for their children developing the disorder. In fact, the situation is far more complicated.
Traditional theories claim that “family problems” are part of what causes anorexia in both males and females. And it’s true that most families of individuals with anorexia share certain commonalities. Our first exposure to the social aspects of eating is in the family, so it’s not surprising that certain factors in the family are tied to the development of anorexia. Unfortunately, research has focused on the families of adolescent girls, and the mother daughter relationship in particular, to the exclusion of the families of men and boys.
Existing research on the families of men and boys is limited and inconclusive. Boys with anorexia may exhibit less independence and autonomy. In some cases, caretakers are overly controlling and protective. Because boys with overly protective caretakers fail to develop the confidence needed for independent and autonomous behavior, they struggle with the demands of adolescence and may develop anorexia as a result. In other cases, excessive parental expectations may play a role. In one study, several boys with anorexia said their fathers pressured them to excel in sports or to have a muscular physique.
However, it’s essential to remember that each person is unique. While family dynamics may substantially contribute to the development of anorexia in some men and boys, in other cases different factors are more prominent. In all cases, there are many factors to consider.
Furthermore, family-based treatments for anorexia have demonstrated that families can be an immense resource in their children’s recovery. For example, a family-based treatment pioneered at the Maudsley Hospital in London casts parents in an active and positive role in helping their children to regain normal levels of weight, develop autonomous and healthy eating habits, and get back on track in their adolescent development. It’s essential, then, that we recognize that most families want the best for their children and, with the assistance of trained professionals, can be instrumental to their recovery.
Felker, K. R. & Stivers, C. (1994). The relationship of gender and family environment to eating disorder risk in adolescents. Adolescence, 29(116), 821-834.
Romero, F. (1994). Adolescent boys and anorexia nervosa. Adolescence, 29(115), 643-647.