An Australian study published in the International Journal of Eating Disorders in December 2007 examined the childhood experiences of girls with eating disorders and depression, finding evidence that parents’ comments, expectations, and controlling behavior could contribute to their daughter’s development of anorexia, bulimia, or depression.
The researchers gathered information on early life experiences from a total of 622 female twins, comparing the experiences of 170 girls who had anorexia, bulimia, or depression to the experiences of girls without these disorders. They also studied 226 twin pairs in which one twin had an eating disorder or depression and the other did not. Girls with eating disorders were more likely to have parents who commented on their appearance and eating habits, and they were also more likely to have received less care from their fathers. The researchers also found that girls who reported having an overprotective or controlling father were more likely to have anorexia. Family conflict also had an effect and was associated with anorexia, bulimia, and depression. In addition, high parental expectations put girls at risk for bulimia and depression, although this connection was strongest for girls with bulimia.
What was not explicitly discussed in this study, but has been reported elsewhere, is the relationship that anxiety plays in fomenting and driving disordered eating. The Australian researchers did not break out the question of anxiety from the questions of childhood experiences, so it's difficult to say whether parental behaviors were generative of anxiety or whether these parental behaviors related directly to disordered eating.
As we learn more about the factors that contribute to eating disorders and depression, physicians and therapists will be better able to tailor treatment options to fit a patient’s needs. A girl with anorexia, for example, may feel a lack of control in her life stemming from an overprotective father, while a girl with bulimia may have an incorrect perception of her parents’ expectations for her. Working together, a girl’s family and her doctor can address the specific underlying factors that may have played a role in her illness.