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Very often people blame society for eating disorders. Television programs and magazines are full of extremely slim models and actors. But eating disorders are nothing new. They've been around for hundreds of years.¹ These images may play a part in someone getting an eating disorder, but they're probably not the only reason.

Starving yourself may be connected to painful, difficult emotions.² It might be a way of keeping bad feelings away. It can give you a sense of control when other parts of your life are going wrong or seem too difficult to manage. Here are some of the feelings that have been linked to anorexia.

• You feel bad about yourself. You hate the way you look, don't give yourself credit for the good things you've done and feel worthless. This is called low self-esteem.^{2 3}
• You may feel shame, guilt and disgust. You might be a perfectionist. If you are, you criticize yourself for minor things like missing the top grade in an exam or for some homework, or putting on a little bit of weight.²
• You may feel you have no control over other things in your life. Anorexia might give you a sense of control when everything else seems too hard to manage. It may make you feel special or safe.^{3 4}

Doctors think that sometimes anorexia starts when someone goes on a diet.^{2 5} Some people diet to try to stay healthy. But people also diet because they are unhappy about themselves or their life. We don't know why dieting is harmless for some people and the start of anorexia for others.

Serotonin is a chemical in the brain that helps control your emotions and how hungry you feel. Some studies suggest that people with anorexia don't have the right amount of serotonin. If this chemical isn't working well in the brain, it may cause symptoms of anorexia, or make them worse.⁶

Anorexia can run in families. This may be because you and the other people in your family have some of the same genes.

If either of your parents had an eating disorder, you'll have more chance of getting anorexia than other people your age.²

Some research shows that baby girls who are born premature will have a higher risk of getting anorexia later in life than baby girls born after spending 40 weeks in the womb.⁷ This is especially true in babies who are very small when they are born.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.