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No One Chooses to Have an Eating Disorder

Eating disorders (EDs) are a complex group of severe mental and physical illnesses that often have life-threatening consequences.
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Eating disorders are not a choice; they are serious, complex mental illnesses influenced by genetics, brain chemistry, psychological trauma, and cultural pressures. No one chooses to struggle with intrusive thoughts about food, eating, or body image; no one chooses to suffer the physical, emotional, and relationship consequences eating disorders can bring. Yet, stigma and misinformation surrounding these dangerous illnesses continue to reinforce harmful stereotypes that eating disorders are a lifestyle choice, a passing phase, or (perhaps most damaging) a sign of self-discipline or taking pride in one’s appearance. 

Like other mental health conditions, eating disorders require compassionate, evidence-based treatment, not blame or judgment. Recovery is possible, but it starts with the understanding that these disorders are not a reflection of willpower or vanity—they’re signs of deep distress that require specialized care.

An Illness, Not a Choice

Research shows eating disorders are driven by a complex range of factors: genetic vulnerability, brain chemistry, psychological traits (like perfectionism or anxiety), societal factors, and environmental stressors. 

Studies using brain imaging reveal disruptions in neural circuits related to reward processing, impulse control, and body perception, especially in individuals with anorexia and bulimia¹. These changes are not voluntary or chosen; they reflect underlying neurological dysfunction that can make a person more vulnerable to developing an eating disorder.

Trauma, emotional dysregulation, and societal influences also contribute to the onset and maintenance of disordered eating behaviors. 

Trauma + eating disorders

Research shows that individuals who experience trauma, such as abuse or neglect, often develop challenges in regulating emotions². Trauma can overwhelm the brain’s stress-response systems, disrupting how emotions are processed and regulated. Studies have shown that trauma, particularly in childhood, alters the amygdala and prefrontal cortex—key areas for emotional control.

A study in Biological Psychiatry found that trauma exposure leads to dendritic atrophy in the prefrontal cortex and dendritic extension in the amygdala. This means that areas of the brain that help with thinking and self-control are weakened and areas that react to fear and stress are strengthened3. This dysregulation can result in difficulties coping, increased risk of mental illness, and harmful behaviors like self-injury or disordered eating.

Societal pressures + eating disorders

Societal pressure to look a certain way or conform to particular body type can deeply impact how people feel about their bodies, weight, and eating habits.

Numerous studies have shown that unrealistic beauty standards (like the thin ideal that is constantly glorified in media, fashion and social media) significantly increases body dissatisfaction — a strong risk factor for developing an eating disorder. 

According to a review in the Journal of Eating Disorders, exposure to idealized body images can lead to disordered eating behaviors, especially in teens and young adults4. Social media also plays a powerful role; a 2021 study in Body Image found that frequent comparison to other people online was linked to higher rates of body shame and unhealthy eating habits5.

By themselves, these pressures don’t cause eating disorders. But they can trigger them or make them worse them in people who are already vulnerable. It’s important to remember that no one chooses to feel this way; eating disorders are illnesses that require evidence-based treatment and ongoing support.

The consequences of eating disorders

Eating disorders are considered serious mental and physical illnesses. They are officially recognized in medical and psychiatric manuals like the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and supported by decades of scientific research. Eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder involve more than just food or eating habits; they affect how a person thinks, feels, and functions. 

These disorders involve changes in the brain, genetics, and body systems, much like other diseases like depression or diabetes. If left untreated, a person with an eating disorder may develop serious medical issues, emotional problems, and psychological distress. Most importantly, eating disorders — particularly anorexia nervosa — have the highest mortality rates of any mental health disorder6.

Fighting Myths About Eating Disorders

It’s important for all people, especially parents, to be educated about eating disorders. A deeper understanding of these illnesses can better equip individuals to spot early warning signs of disordered eating, provide appropriate support, and facilitate life-saving treatment. 

Eating disorders are not choices or phases; they are serious, biologically influenced mental illnesses. They are associated with severe symptoms including self-harm and dangerous purging behaviors like self-induced vomiting, severe calorie restriction, and abuse of dietary aids and laxatives. The psychological toll of eating disorders, coupled with the physical effects of malnutrition and purging, make them not only dangerous but life-threatening. Without proper knowledge, warning signs can be missed, harmful myths can spread, and stigma can silence those who need help.

So how can we fight the stigma and myths surrounding eating disorders? We can start by making simple changes in the way we talk about and evaluate our own bodies and the bodies of other people.

1. Avoid making comments about weight, food, or appearance, even if you mean well, as these can reinforce harmful beliefs. Instead, focus on values like kindness, resilience, and health beyond body size.

2. Speak openly and compassionately about mental health, and challenge harmful stereotypes—such as the idea that only young, thin, white females struggle with disordered thoughts or behaviors about their bodies or food. Eating disorders affect people of all sizes, genders, and demographics. Ignoring the signs of disordered eating because the person exhibiting them doesn’t fit a preconceived stereotype only furthers the damaging effects of these illnesses.

3. Support media and messages that promote body diversity and realistic beauty standards. If someone is struggling, listen without judgment and encourage them to seek help. Your empathy and understanding can make a powerful difference.

Magnolia Creek is dually licensed to treat eating disorders and a multitude of co-occurring disorders. We tailor our treatment plans to individual needs and goals while empowering every client in our care to embrace recovery with resilience and independence.

Sources

  1. Kaye, W. H., et al. (2013). Neural mechanisms of anorexia nervosa: A focus on reward and motivation. Nature Reviews Neuroscience, 14(9), 589–600.
  2. Racine, S. E. (2017). Trauma and eating disorders: A systematic review. Journal of Clinical Psychology, 73(5), 425–440.
  3. Arnsten, A. F. T., Raskind, M. A., Taylor, F. B., & Connor, D. F. (2015). The effects of stress exposure on prefrontal cortex. Neurobiological Stress, 1, 89–99.
  4. Morris & Katzman (2003). The impact of the media on eating disorders in children and adolescents, J. Eat. Disord., 1, 10. (PMCID: PMC2792687)
  5. Fardouly et al. (2021). Social media and disordered eating in teens, Body Image, 36, 192–200.
  6. Arcelus, J., Mitchell, A. J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68(7), 724–731.

Magnolia Creek is dually licensed to treat eating disorders and a multitude of co-occurring disorders in adults women and adolescent girls, ages 12+. We tailor our treatment plans to individual needs and goals while empowering every client in our care to embrace recovery with resilience and independence.

More Resources

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Yes. Learn how Magnolia Creek’s specialized program supports clients with an established vegan lifestyle.