Family Factors:

  • Perfectionism, highly critical parents
  • Over involved parenting, enmeshment
  • Under involved parenting, little affection or emotions expressed in family.
  • Chaotic family functioning
  • Disengaged family function
  • Family history of eating disorders
  • Family history of obesity
  • Family history of mood disorders
  • Family history of substance abuse
  • Ethnicity – white, middle-upper class for anorexia

Personal Factors:

  • Perfectionism
  • Difficulty expressing feelings and emotions
  • Low self-esteem
  • Body image dissatisfaction
  • Age (13-18 years)
  • Gender (female)
  • Weight (obesity)
  • Lack of coping skills, difficulty handling stressors
  • Frequenting dieting behaviors
  • Unhealthy weight control measures/behaviors (i.e. laxatives, diet pills)
  • Early maturation/puberty
  • Early dating
  • History of depression
  • History of anxiety
  • History of substance abuse
  • History of physical abuse
  • History of sexual abuse

Cultural Factors:

  • Media (i.e. models, magazines) and Hollywood, as models and actresses get thinner the rates of anorexia and bulimia increase.
  • Narrow definition of beauty
  • Western society’s focus on body image and appearance
  • Stigmatization of obesity (i.e lazy, lack of will power and self-control)
  • Birth after 1960 (continued focus on thinness as ideal, increased dieting pressure)

Peer Factors:

  • Attitudes about weight
  • Teasing Behaviors

Factors Related to Activity:

  • Modeling
  • Performers/Actors
  • Gymnastics
  • Dancers
  • Runners
  • Wrestling
  • Weight lifting

Fat Caliper Testing: Potential Risk Factor

Here at Healthy Within we have had a number of patients whose anorexia started after the skinfold fat caliper testing dine at their school. The fat caliper/skin fold test was actually developed for use with triathletes, 25 years of age or older . The problem is that for many years, this measurement has been used by school districts around the country to measure children in high schools, junior highs and even grade schools. The result is that youngsters, for whom should be provided adequate nutrition for their growing bodies and minds, are instead going on diets because they think they are fat!

An ANAD (National Association of Anorexia Nervosa and Associated Disorders) resource person and concerned mother, noticed significant dieting behavior in her 9 year old daughter after this test was administered at her school. The mother was able to gather data regarding the dangers of fat caliper testing and a resolution was passed pledging to work toward the elimination of fat caliper testing throughout the state (Illinois State PTA). This mother along with ANAD are seeking to implement this resolution in schools in all 50 states.

How you can help: If you have information that fat calipers/skin-fold test or other fat testing is being used in your school, please obtain documentation as to what testing is being done and its repercussions on the students in your district. Specify grade levels or student age and type of fat testing done. If your school district has eliminated fat testing please send documentation on why this was done. To get additional information on this issue, contact ANAD-FT at:

ANAD Box 7
Highland Park IL 60035
Phone: 847-831-3438

*Also for San Diego residents please click here to send your statements directly to Dr. Divya Kakaiya.


Adapted from Taylor, CB, Alman, TM. Psychopharm Bulletin, 1997; 33:413 and Fairburn, et al. Archives General Psychiatry 1997; 54:509

Winning the War Within: Nutrition Therapy for Clients with Anorexia or Bulimia, Stellefson, E. (Chapter 1, 1-4, 1998) Helm Publishing, 1999.