To paraphrase the poet John Donne, no human is an island. We are all connected.
Our most basic connection is to family. Family ties link us to a genetic, as well as a cultural, past. Through marriage, work, and play, one family interacts with others, forming the network of society. Each thread in this fabric affects, and is in turn affected by, the others.
How, exactly, do families contribute to eating disorders? Researchers use different criteria. Some look at how members communicate. Do they use facts or emotions? Do they express emotions openly or in a disguised way? What about problem-solving: Does the family take a creative approach, or is it stuck with rigid, unworkable solutions? And leadership: Who’s in charge?
Is an eating disorder hereditary? Studies of identical twins, who share the same genetic traits, found that when one of a pair of twins has anorexia, her sister has a better than 50 percent chance of developing the disorder. The correlation is pretty high, but is it proof? Not really – remember that both twins are reared in the same family environment and experience the same social and psychological pressures. What we need are studies of identical twins who have been brought up in different homes. If both twins develop a disorder, then the evidence for a genetic predisposition would be strong.
Michael Strober, a psychologist at UCLA, recently found that anorexia nervosa was eight times as common among close relatives of anorexic patients as in the general population. He writes: “At least some cases of the illness arise from a familiarly transmitted liability, although the manner in which genetic and environmental factors combine to produce illness remains uncertain.”
The stereotype holds that eating-disordered people are white and come from upper-middle-class backgrounds, but patients actually come from many different races and all levels of society. The parents of eating-disordered children tend to be older, but the same holds true of many psychiatric illnesses. Nor is birth order significant—being born first, second, or twelfth doesn’t make any difference. And proportionally, as many eating-disordered individuals come from broken homes as they do from intact ones.
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