Surfacing After Silence

Life. After.

Nurture vs Nature

I recently received a comment in my Questions and Topics page about the biological basis of eating disorders: “As someone that has truly been there, who has struggled with an eating disorder for some time and then made it to recovery, what do you believe?  Where do you fall on the nature vs nuture?  What do you think the important components for treatment with the goal of full recovery are?”

This is a rather loaded question, and it’s had me thinking a lot during the day.  There have been studies about the biological nature of eating disorders, if certain people are, indeed, genetically predisposed to developing an eating disorder (article and article).  I do think that there may be a biological link to all of this, but I don’t think that it’s as easy as saying, “There’s a gene that causes anorexia” (they have not found such a gene).  A lot of people have a genetic predisposition for heart disease yet never develop heart disease because of their lifestyle.  Some people get exposed to germs and never get sick; some people get exposed to those very same germs and do get sick.  A certain medication works for some people yet doesn’t work for others.  Our bodies are amazingly complex and each individual body has unique characteristics and this challenges and frustrates medical doctors, let alone psychiatric doctors.

If an eating disorder were solely the result of faulty genetics, then restoring weight or stopping behaviors would mean the individual is cured.  However, that doesn’t seem to be the case for anyone I’ve met, talked to, read about, or heard about.  Nature alone cannot be blamed nor relied upon for a cure.  Nurture–the environment–must be accounted for.

Quite honestly, I think that once a person has been diagnosed with an eating disorder, the nature part is almost irrelevant and focusing on that alone would do more harm than good.  Each person needs to address the environmental triggers that contributed to his or her eating disorder.  Each individual needs to learn an entirely new way of living free of eating disorder symptoms.  Each individual must tackle the cognitive distortions that come along with an eating disorder.  All of this takes time–usually much longer than restoration of weight or cessation of outward symptoms.

So I suppose I fall on the nurture side of the debate.  I’m not denying that there may be a genetic predisposition for some people, but I think in the treatment of the eating disorder, in the treatment of the individual, environmental factors such as family, history of abuse, peers, personality traits, cognitive distortions, and one’s lifestyle hold more sway and, therefore, need more attention.  Successful recovery requires that you address not one small fraction of a person but the whole, complex individual.


June 17, 2011 - Posted by | Eating Disorders, recovery, therapy | , , , , , , , , , , , , , , , , ,


  1. Also, in practical terms – there is not much you can do about the nature piece. With some diseases, when a person has a genetic predisposition, they can do extra or early testing, take medication, be vigilant about lifestyle, etc. I don’t know that that kind of prevention is possible with an eating disorder, beyond what I think all parents should be doing. Our culture creates such a susceptibility to ed’s, that whatever we can do to raise awareness and prevention, we should, in any case.

    Comment by a | June 17, 2011 | Reply

  2. Thank you so much for responding to my question. I think your viewpoint is spot on. 🙂

    Comment by T | June 18, 2011 | Reply

  3. Research has shown that there is genetic predisposition toward eating disorders. Eating disorders often run in families. As a daughter of an anorexic mother, a recovered anorexic myself, and a mother of two children, I know that I need to keep a close eye on my kids. I also need to be very careful to model healthy eating habits. I also am very careful to not make body image based comments.

    Comment by alex | June 26, 2011 | Reply

    • Good for you for being careful! And for your hard work yourself.
      The fact that eating disorders run in families does not necessarily mean there’s a genetic component. There would have to be twin studies or some kind of genetic finding to really “prove” that. But learned behavior and all the messages we internalize are powerful. I grew up in a family with lots of issues around food, and that definitely played a huge part in my own fight with an eating disorder.

      Comment by abw | June 29, 2011 | Reply

  4. Something that really helped me on the road to recovery was some information that I came upon regarding Restricted Eating. This in essence, addresses the biological response to the eating disorder. It explains why anorexia so often leads into bingeing and purging as a further step in the disease progression. It gave me something practical to hang onto and a way to move forward. I haven’t been able to resolve all of my nurture-based issues (maybe I never will), I still have my personality type, I still struggle with cognitive distortions…but I hold on each day to my practical approach. That is, I WON’T starve my poor body anymore. It’s a struggle every single day. I have had this for nearly 30 years. That many years of wanting to disappear into a zero measurement…zero on my soul, zero on my body.
    My other motivation? Being a better role model for my children who despair at my thinness. Not wanting this to consume the second half of my life. With an eating disorder, there is no room in your life for much else. What a waste! I am still in recovery…I still have a long way to go. I am re-programming. Just the very feeling of having food in my stomach is so difficult, but I am pushing through this. I am learning to love and nurture my body rather than to fight it and it’s needs. I will fight to stay with my body and not try to be rid of it….

    Comment by Leeanne | June 30, 2011 | Reply

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