As we continue to discuss the numerous risk factor considerations involved in both disordered eating and eating disorders, psychological risk comes next. This category of risk has a logic and rationale behind it that some of the other risk factor categories do not. As eating disorders are psychological illnesses related to body image thoughts, feelings, and emotions, and most often coexist with other psychological conditions, underlying risk for them that is psychological in nature, is both rational and reasonable.
Often eating disorders are accompanied by psychological issues surrounding anxiety, depression, obsessive compulsive disorder, personality disorders, panic disorders, substance abuse, and low self-esteem. Rarely, if ever, will an eating disorder be diagnosed without any comorbid condition of some type, as often those affected by them are suffering with low self-esteem as well as weight and shape related issues. Further, any negative early childhood psychological or physical experiences can have a strong effect on the development of eating disorders and risk for them. Any type of abuse, whether physical, emotional, or even spiritual can negatively impact a child, thereby increasing risk. Negative body comments, weight related teasing or mocking of any type, as well as body-related bullying or discrimination greatly increase risk. This is true whether the source is a peer, a teacher, a religious figure, a relative, or one’s own parent.
Inversely, the same is true of too much positive attention surrounding weight loss. If someone is dieting and losing weight, when people around him or her heap on extra praise and attention about it, the likelihood of this weight loss leading to something clinical is also increased, as this praise reinforces feelings of validation and attention directly attributed to their weight loss. This can be especially dangerous and damaging for individuals who have a natural tendency to feel less noticed, are not used to receiving extra attention, and/or who are younger adolescents.
Risk is also increased for those who are shy or naturally inhibited. For those who feel a general sense of powerlessness over their life or overall feelings of the inability to control or effect change in their life, anxiety is increased as is their internalization of the thin ideal, both of which have been found to be more damaging to their self-esteem. Additionally, anyone who is unable to positively and constructively manage their emotions is also at increased risk for feelings of low self-worth and increased emphasis on body image and shape concerns.
Psychological risk factors are complicated and there is not consensus as to whether the risk factor is the cause or the result of the disordered eating and/or eating disorder. This further obfuscates an already confusing and complex issue.