What Causes Eating Disorders?
Breaking Down the Complex Roots Among New Yorkers
Written by Avi Klein
3 min read
Key Takeaways:
Eating disorders develop through an intersection of biological, psychological, and sociocultural factors, not a single cause or personal failing.
Depression is the most commonly co-occurring mental health diagnosis with eating disorders, with depression rates ranging from 32 to 50 percent across anorexia, bulimia, and binge eating disorder.
New York City's achievement culture, visual saturation, and competitive intensity can amplify existing risk factors for disordered eating.
Both eating disorders and depression involve a fundamental disconnection from the body, which is why somatic and trauma-informed approaches are central to lasting recovery.
Integrated treatment combining CBT, DBT, psychodynamic work, somatic therapy, and medical support addresses both conditions together rather than in isolation.
Eating disorders encompass a range of different diagnoses including anorexia, bulimia, and binge eating disorder. Each has its own patterns related to food, impacting physical, mental and emotional health. While there isn't an exact formula for the development of an eating disorder, research suggests that an intersection of biological, psychological and sociocultural factors may contribute to these conditions.
Cities like New York carry a heightened level of social, academic, and professional competition, often leading to self comparison. While city life doesn’t directly cause eating disorders, the unique pressures of urban environments can certainly amplify existing risk factors. In these densely populated areas of overarching achievement culture and constant scrutiny of personal appearance, understanding what truly causes eating disorders becomes even more crucial for early recognition and intervention.
Biological Foundation: The Role of Chemical Balance
Genetics and family history play a significant role in eating disorder development. If a parent or sibling has struggled with disordered eating, the risk increases substantially. But biology goes deeper than inherited tendencies: Essential neurotransmitters like serotonin and dopamine regulate mood, appetite, and impulse control. When these chemicals are out of balance, disordered eating habits become far more common.
Consider Sarah, a college student at NYU who began restricting her food intake during finals week. What started as a stress response quickly became a physiological trap. The malnutrition from her restriction began altering her brain chemistry, making her more prone to depression and anxiety, which in turn made her feel even less capable of nourishing herself properly. This creates a vicious cycle where the eating disorder both stems from and worsens underlying mental health conditions.
In anorexia specifically, the physiological impact of being underfed and malnourished can negatively impact brain chemistry and mood, making recovery feel nearly impossible without proper nutritional rehabilitation alongside therapeutic support.
Sociocultural Pressures: The New York City Effect
Cultural standards of beauty, social media pressure, and comparison culture create a toxic backdrop for eating disorder development. Family and community dynamics around food and body image further complicate the picture, with well-meaning comments about appearance or health often triggering disordered behaviors.
Growing up or living in New York City can intensify these pressures dramatically. With its concentration of high-achievers, booming fashion and media industries, and constant visual stimulation, New York City is an environment where appearance feels perpetually scrutinized. Walk through any neighborhood in Lower Manhattan, from Union Square to the Lower East side, and you will encounter dozens of images –from billboards to storefront displays to social media posts– that reinforce narrow beauty standards.
And let’s face it: New York City tends to draw people who are incredibly driven, which can also have its down sides. The achievement culture prevalent in Manhattan fuels perfectionist tendencies that can contribute to eating disorders. When success feels measured by external metrics, such as the perfect job, the perfect apartment, the perfect Instagram feed, it's no surprise that “the perfect body” might feel like just another box to tick.
Psychological Factors: Mind-Body Disconnection
Depression stands as the most commonly associated mental health diagnosis with eating disorders, only to be reflected by the statistics: in anorexia, 32-39% of people struggle with depression, and these individuals are 50 times more likely to commit suicide compared to the general population. In bulimia, 36-50% experience depression, while about 33% of people with binge eating disorder are also diagnosed with depression.
"Just like we don't know exactly what causes an eating disorder, there also isn't one straightforward answer to the link between eating disorders and depression," explains Maya Abouhamad LMSW, therapist at Downtown Somatic Therapy.
The relationship between depression and eating disorders is often intertwined. Depression can certainly be an underlying cause of eating disorders, as these conditions often serve as attempts to cope with or manage painful emotions and experiences. When life feels overwhelming, controlling food behaviors can offer a temporary respite and distraction, though the relief is fleeting and ultimately detrimental.
From a somatic perspective, both depression and eating disorders involve a fundamental disconnection between the mind and the body. Trauma and chronic stress responses literally live in our tissues, influencing everything from digestion to hunger cues to our ability to feel safe in our own skin. When someone has learned to disconnect from bodily sensations as a survival mechanism, it becomes nearly impossible to trust internal cues around hunger, fullness, and emotional needs.
Perfectionism, low self-esteem, and unresolved trauma also contribute significantly. Many clients describe feeling like they're living outside their bodies, going through the motions of daily life while feeling fundamentally unsafe or unwelcome in their physical form.
Honing in on Trauma: How the Body Keeps the Score
Unresolved trauma often manifests in disordered eating behaviors as the nervous system attempts to create safety and control in an unpredictable world. This is where somatic therapy models prove invaluable in eating disorder treatment.
Approaches like Somatic Experiencing, Sensorimotor Psychotherapy, and polyvagal-informed therapy help clients understand how their eating patterns may actually be adaptive responses to overwhelming experiences. When someone restricts food, they might be attempting to shrink themselves into a smaller, less noticeable target. When someone binges, they might be seeking comfort that they learned to associate with food during childhood.
At Downtown Somatic Therapy, therapists prioritize safety, helping clients with disordered eating habits process unresolved trauma that they are holding in their bodies, rather than relying on control through food. This involves gradually rebuilding the capacity to notice and trust internal sensations like hunger, fullness, emotional states, and stress responses; sensations that are typically overridden or ignored by eating disorders.
Depression and Eating Disorders: Understanding the Interplay
The relationship between eating disorders and depression creates a particularly complex clinical picture. Eating disorders are often an attempt to cope with or manage painful emotions and experiences, including those associated with depression.
When life feels overwhelming, controlling one's food behaviors can offer a temporary relief. The issue, of course, is that this form of coping and avoidant behavior ends up causing more distress and disruption.
Conversely, while eating disorders may not cause depression, there is symptomatology that may bring underlying depression to the surface. Across all eating disorders, individuals typically develop negative body image and compromised self-esteem. They feel sad and alone in their own skin, which translates and expands into other areas of life. Additionally, eating disorders are predicated on secrecy to maintain the maladaptive behaviors that characterize them, often resulting in self-isolation and withdrawal from others. As humans, we are wired for connection, and separating ourselves in these ways can lead to deepening depression.
From a somatic lens, both conditions involve a fundamental disconnection from the body's natural rhythms and signals, making integrated treatment approaches essential for lasting recovery.
Recognizing the Warning Signs
How do you know if you or someone you love might be experiencing depression alongside disordered eating?
Common symptoms include:
Feelings of sadness
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Impaired ability to think or concentrate
Loss of interest in activities that once were pleasurable
Irritability or anger
Recurrent thoughts of death or suicide
Noticing these early becomes crucial, particularly for New Yorkers as high-stress lifestyles can mask early warning signs. The constant hustle of city life might make fatigue seem normal, or the competitive environment might make irritability appear justified. However, when these symptoms appear alongside changes in eating patterns, social withdrawal, or obsessive thoughts about food and body image, professional support becomes essential.
Seeking Help
If you or someone you know is struggling with an eating disorder, seeking help as soon as possible is crucial. When eating disorders and depression coexist, both can be treated with an integrative approach that addresses the complex relationship between mind and body.
Effective treatment often combines multiple modalities:
Cognitive Behavioral Therapy (CBT) to address thought patterns and behaviors
Dialectical Behavior Therapy (DBT) to build emotional regulation skills
Psychodynamic therapy to explore underlying emotional patterns
Somatic therapy to rebuild the connection between mind and body
Medical monitoring and nutritional support to address physical health concerns
Downtown Somatic Therapy offers treatment in Lower Manhattan, accessible to clients across Manhattan and Brooklyn. Our approach recognizes that true recovery requires more than just changing eating behaviors, it involves helping clients develop a fundamentally different relationship with their bodies, emotions, and the world around them.
Using trauma-informed practices such as AEDP, EMDR, Sensorimotor Psychotherapy, and IFS, among other modalities, we slow down to address the root causes of eating disorders. We understand that eating disorders are often symptoms of deeper wounds, and through body-centered awareness, we help you access and heal at this deeper level.
Finding Your Way Forward
Understanding what causes eating disorders helps us approach treatment with compassion rather than judgment. These conditions don't develop because someone lacks willpower or wants attention, they emerge from a complex interaction of biological vulnerabilities, psychological factors, sociocultural pressures, and often unresolved trauma.
Recovery is possible, and it doesn't require you to figure it out alone. If you or someone you love is struggling with an eating disorder in Manhattan or Brooklyn, our therapists at Downtown Somatic Therapy can help. We use somatic therapy and evidence-based models to support recovery that addresses not just symptoms, but the underlying disconnection that fuels disordered eating patterns.
Your body has wisdom. Your recovery matters. And support is available right here in your community.
To learn more about eating disorder treatment options or to schedule a consultation, contact Downtown Somatic Therapy today. We're here to help you reclaim your relationship with food, your body, and yourself.
