A new study of eating disorders among high school students is getting alot of press. Researchers in a study (published in the International Journal of Eating Disorders this month, April 2008) found a small “clustering effect” in female students. This means that girls who live in the same county with girls who either starve, diet, over-exercise, binge, or use diet pills are 4 percent to 10 percent more likely to engage in eating disordered behaviors than if they lived in counties where these behaviors are rare. These results are leading some to conclude that eating disorders are contagious. I worry that too much focus on “contagion” could lead to isolation and discrimination against girls with serious eating disorders.
Let’s not forget that it is well proven in a number of studies that genetics are the strongest factor in causing eating disorders. I am not the first clinician to conclude that genetics “loads the gun;” family issues and social influences can “pull the trigger.”
I suspect that this new study is picking up on girls who are experimenting with eating disordered behaviors because researchers did not look at how many girls in the study actually had clinically significant disorders. As risky as it can be to play around with eating disordered behaviors, most girls who experiment with these behaviors won’t develop an eating disorder unless they are genetically susceptible.
To test whether eating disorders are contagious, this week I asked each of my teenaged patients whether they “caught their eating disorder from someone else.” Each and everyone of them, said absolutely not! I’d like to share some of the points these girls made:
• “My eating disorder was caused by some really serious problems at home, not from peer pressure.” • “My eating disorder was too personal to be a ‘group thing.’” • “My school had strong cliques, I remember thinking that being thin would make me more popular.” • “I admired older girls in my school who had eating disorders, but they never talked about or shared what their ‘techniques’ were.” • “I got my eating disorder really young and I still struggle in college. It was really hard for me when other parents would blame me for causing their kid’s eating disorder. I remember that I wasn’t allowed to play with some girls for fear that I would “infect them.” I also remember how sad this made me feel.” The researchers of this new study argue that prevention and treatment efforts should be targeted not at individuals but at schools and other geographic communities. I urge us all to treat girls with eating disorders as individuals. Each of these girls has a personal story and their own particular pain. Each of them deserves individual attention and a treatment program tailored to their particular situation.Peace, Marcia