Life Transitions Can Trigger
Even small changes, coupled with lack
of support, can provoke eating disorders.
Traumatic life events, such as relationship changes, the loss of a loved one, or a sexual assault, can trigger eating disorders, according to the results of a small study of 26 women and 1 man ranging in age from 17 to 64 years (median age: 27 years). As Dr. Jerica M. Berge and colleagues at the University of Minnesota recently reported (J Clin Nurs 2012; 21:1355), even a small change, such as moving to a new home or enrolling in a new school, may trigger anorexia nervosa (AN) or bulimia nervosa (BN).
The patients in the retrospective study had been receiving treatment for an eating disorder for from 10 months to 18 years. Nine had AN, 1 had a combination of BN and AN, 3 had BN, and the other 14 participants had eating disorders that did not meet the diagnostic criteria for a single, specific eating disorder. The participants were studied with semistructured interviews.
Six transitional events
Notably, since this study involved a small number of subjects and used a retrospective design, its findings should be verified with prospective research and larger samples of subjects. Nevertheless, the authors' findings are of interest. Six themes were identified as family life transitional events that preceded the onset of an eating disorder: (1) school transitions, (2) death of a family member, (3) relationship changes, (4) home and job situations, (5) illness/hospitalization, and (6) sexual abuse or incest.
The researchers found that transitional events in the family life cycle, followed by a lack of needed support during the transitions, could precipitate the onset of an eating disorder. This lack of support at times of stress was particularly important in the evolution of the eating disorder, and the authors suggest that future research might lead to interventions to help the family and patient reduce the stress from these transitional periods. Helping parents become aware of stressors and more supportive might be even more important than trying to solve or fix the individual problem, according to Dr. Berge and colleagues.