Many parents feel responsible for every bad turn in their children's lives. But are parents truly to be blamed if their daughter develops an eating disorder? Or should we look elsewhere for explanations? 

The first point to make is that eating disorders are associated with economic development. They do not exist in subsistence societies where food is scarce and daily life involves a lot of physical exertion. In that sort of environment, people would as soon stop breathing as choose not to eat (or purge their food).

Second, eating disorders increase in frequency when more women enter the work force and compete for entry to professions. During the roaring twenties, for example, women enjoyed unprecedented economic opportunities. Weight loss was in vogue, slenderness was emphasized in flapper fashions and eating disorders reached epidemic proportions.

Third, eating disorders occur because curvaceous female figures are unfairly perceived as lacking in professional competence (see The Science of Romance, pp. 240-244) . This phenomenon is the bimbo stereotype. It is the reason that women are advised never to wear tight clothes to a job interview. Women's desire to be more slender is thus related to social pressures to succeed in education and in employment.

Men may suffer from eating disorders as well of course, but this is rarer and often tied to specific occupations (dancers, jockeys, athletes, boxers, wrestlers, etc.).

Fourth, eating disorders are more common not just in affluent countries but in high-earning segments of the population. Conversely, women at the bottom of the social ladder are more likely to suffer from obesity although these social status differences are diminishing over time. One plausible explanation is that occupational achievement is more salient among the elite than for the under class. Another is that esthetic standards differ as in the Duchess of Windsor's "You cannot be too rich or too thin."

Fifth, some eating disorders are more prevalent among people who have a high need to achieve and are perfectionist in their outlook. Ironically, most good parents spend an inordinate amount of effort in urging their children to work hard at school.

Sixth, the home lives of people suffering from eating disorders tend to be difficult and conflict-ridden. Adolescents may be highly defiant and resist parental control as to what and when they eat. Concealment of eating disorders is just one aspect of this defiance so that parents are often shocked and devastated to learn that their child suffers from a serious illness. By that time, the problem is well beyond the competence of the parents as clinical psychologists and psychiatrists are consulted. Researchers do not know whether such conflict is the cause, or the result, of an eating disorder.

Seventh, like most other psychiatric diagnoses, there is a genetic component to eating disorders.

Eighth, family therapists have tried to identify patterns in parent-child relationships of eating-disordered adolescents. The findings are all over the map. Some studies find that the parents are uninvolved or neglectful whereas others conclude that the parents are over-involved and identify too closely with the child. While both extremes might well contribute to a child's anxiety level, the evidence is too mixed to formulate a practical prevention program for families.

In summary I do not believe that parents should blame themselves for their children's eating disorders.

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