Why do eating disorders start and continue?

Why do eating disorders start and continue?


There are several different models which explain why eating disorders commence and continue. One straightforward model with supporting evidence is the Dual Pathway Model[1][2]. This model proposes that two factors lead to body dissatisfaction:

  1. Internalising the ‘thin-ideal’, that is, learning that being skinny or unrealistically thin is the ideal body type.
  2. Pressure to be thin, such as from your peers (including bullying about weight), the media (such as showcasing thin models or a focus on diets), your family, or other environments (for example, dance, gymnastics, bodybuilding competitions, and modelling cultures all focus on a thin body type).

Either of these factors, or both, leads to people being unhappy with their current body size and shape (body dissatisfaction). In turn, body dissatisfaction creates two pathways leading to disordered eating: negative feelings, and dieting. Dieting is a known risk factor for disordered eating such as bingeing and purging. However, once disordered eating emerges, this then creates further negative feelings (such as guilt and shame), and also encourages further dieting as people try to compensate for binge-eating. In turn, dieting and negative feelings also make body dissatisfaction stronger, which in turn reinforces the negative feelings, dieting, and disordered eating: you get stuck in a cycle which maintains and strengthens itself. This is why it is so hard to stop on your own.


Therapy can help you reclaim your life from disordered eating, and there are a number of evidence-based interventions available. It is well worth finding out what your treatment options are: it is never too late to start on the process of change.



[1] Stice, E. (1994). Review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review, 14, 633-661. doi: https://doi.org/10.1016/0272-7358(94)90002-7

[2] Stice, E. (2001). A prospective test of the dual-pathway model of bulimic pathology: Mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110, 124-135. doi: 10.1037/0021-843X.110.1.124


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