While a mother's behavior is very likely one component in the development of anorexia, says TIME medical contributor Dr. Ian Smith, it's far from the only influence. "Girls and women at risk for anorexia have a distorted self-image and that image can be affected by wide variety of factors," he says. "The media pitches in to create an unrealistic, perfect image, and so do peer pressure and various parental issues." Anorexia, Dr. Smith points out, has a wide range of causes, and the breaking point varies from person to person. A nervous or particularly invested mother could play into an anorexic's neuroses and serve to highlight preexisting, unreasonable expectations of perfection. "Anorexics tend to be very successful, but they can't see that they are successful," says Dr. Smith. "These women have a very poor view of themselves physically and emotionally." The key to treatment and prevention, experts agree, is isolating the triggers in each anorexic, addressing those problems and, eventually, simply hoping the patient is strong enough to survive.
On the surface, the psychology of anorexia is tantalizingly simple: The disease convinces its victims they are fat, and sufferers slowly give in to the idea that nothing could ever be quite so important as getting rid of that "fat." Beneath their single-minded dedication to starvation techniques and their denial, however, anorexics are generally dealing with an array of psychological, social and physical conflicts. Tuesday, a group of British psychiatrists added another page to the reams of possible causes of the disorder, which affects more than 1 in 250 girls and young women in the U.S. alone. The doctors' study, which compared the infancy and early childhood of 40 anorexic girls and 40 healthy girls, suggests that the behavior of overprotective, anxious mothers can contribute to their daughters' eventual anorexia. These anxiety-ridden mothers may share the fear of losing their daughters; 25 percent of the anorexic girls' mothers had experienced a miscarriage or stillbirth before their daughters were born, as opposed to only 7.5 percent of the healthy girls' mothers.