Currently, the exact mechanism for how an inherited susceptibility to eating disorders might work is not completely understood. One possibility is that temperament, the biological aspect of an individual's personality,which is present at birth and forms the basis for adult personality, may play a factor.
Personality traits such as neuroticism (emotional stability), obsessiveness, and perfectionism play a large role in facilitating some eating disorders, particularly anorexia and bulimia. Research suggests that these traits are at least partially driven by genetics. Individuals with these personality features are predisposed to be anxious, depressed, perfectionistic and self-critical; all factors that may contribute to their difficulty managing weight and eating in a healthy manner.
Individuals with anorexia and bulimia tend to be quite competitive, and are quite driven to succeed. They tend to compare their appearance and accomplishments against unrealistic standards and typically find themselves lacking. Most of these judgments involve culturally-derived or peer-sanctioned standards rather than personal expectations. In other words, people with eating disorders are primarily concerned about what others think of them, rather than what they think of themselves. Other people with eating disorders, such as athletes, tend to judge themselves against internally derived standards, and get upset when they fail to live up to their own ideals, expectations and goals.
Regardless of what set of standards they judge themselves against, perfectionists always strive to meet the highest standard of performance possible. They easily find themselves in a self-defeating cycle of fear and dissatisfaction when they fail to meet their expectations and goals, even when such expectations are unrealistic and unhealthy. This sense of fear and dissatisfaction is exactly the fuel and motivation that perpetuates a renewed drive toward thinness, perfection, and control. Hence, the endless cycle of dysfunctional eating behavior that constitutes eating disorders.
A capacity for obsessive thinking tends to accompany perfectionism with regard to eating disorders, particularly with anorexics. Anorexic individuals become hyper-focused or obsessed with food and with the idea of controlling their eating so as to become thin. Other elements of extreme thinking may be observed as well, notably a tendency towards rigid "black and white" (for example, I am either perfect or terrible) thinking. Because of their mental inflexibility, anorexic individuals may be unwilling or unable to acknowledge that their behaviors are out of control and that there are alternative ways to become happy besides weight loss. They perceive any deviation from their self-imposed weight-loss regime as an unacceptable failure. As a result, they may have great difficulty accepting suggestions or advice from others, even from those they know to be well-meaning. People with eating disorders may experience such supportive attempts as evidence that others don't really understand them.
Psychologists and other clinicians have noted that individuals with eating disorders often lack important coping skills and that eating disordered behaviors are often used as substitutes for these skills. People may use disordered eating behaviors to provide themselves with comfort, numbness, attention, tension release, structure, identity, self-punishment, cleansing, protection, or avoidance strategies when more reasonable coping methods are not available. Disordered eating may also seem like a way to cope with developmental challenges such as stressful transitions (e.g., going to college), family conflict, and academic pressure.
Using food as a coping mechanism is especially common with binge eaters (unlike anorexics and bulimics who use their disordered behavior as a means to become thin). Many individuals who binge have difficulty managing strong emotions, such as anger, sadness, boredom, and anxiety. Approximately half of all binge eaters are depressed or have a history of depression at the time of diagnosis. Researchers are not yet clear whether depression is a side effect or a cause of binge eating. It is clear though, that bingers often turn to food when they are upset because they have not learned or are not comfortable using other coping skills to manage these feelings in a healthy way. Binging is a way to self-soothe, and to numb emotional pain.
The resulting consequence of binging, however, is a feeling of enormous guilt. The binge eater cannot deal with the resulting guilt feelings in any other way but to binge again, creating a debilitating and endless pattern of eating for the purpose of self-soothing. The relief provided by binging becomes reinforcing, and thus, they become chained to the very behavior that provides them comfort and peace.