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Eating disorders can be triggered by lack of support following traumatic events such as bereavement, relationship problems, abuse and sexual assault, according to research published in the May issue of the Journal of Clinical Nursing.

Researchers from the University of Minnesota, USA, spoke to 26 women and one man aged from 17 to 64 receiving treatment from a specialist outpatient clinic. They had suffered from eating disorders for an average of 20 years.

"The aim of our study was to find out if there was any link between transitional events in family life and the onset of eating disorders," said lead author Dr Jerica M Berge, Assistant Professor at Minnesota."Eating disorders are an important public health issue and knowing what causes them can help us to develop more effective treatment and support."

Six key themes covered the transitional events that preceded eating disorders:school transition, relationship changes, death of a family member, home and job transition, illness/hospitalization and abuse/sexual assault/incest.

In the theme of relationship changes, breaking up with a partner affected some participants and others talked about their parents splitting up and moving on.

When her father got a new girlfriend when she was seven, one woman lost the close relationship they had enjoyed. "Overnight she became the most important thing in his life…his girlfriend would be really mean to me and my dad wouldn't defend me." Another woman described how her dad left for "the perfect Barbie", adding "I was so mad at my dad for choosing her over us…I think that is when my eating disorder really began."

In the theme of abuse/sexual assault/incest, some talked about abusive events and how they felt let down or deserted by the very friends and family they needed to support them. Two said they ate more to become unattractive or bigger and intimidating.

Being sexually abused by her brother triggered one woman's eating disorder. "I think in a way I developed the eating disorder just to get away from it…Just to kill the pain because I couldn't tell anyone." 

Berge said the study confirms that eating disorders can be triggered by a number of life changes and that lack of support was a common theme.

"We hope that our findings will be of interest to parents as well as health professionals as they underline the need for greater awareness and support at times of change and stress," he concluded.