Family systems theorists, such as Lundholm & Waters (1991), claim that Eating disorders, such as anorexia are a sign of a much larger family pathology. Minuchin et al (1978) claims that it is a particular type of dysfunctional family, an enmeshed family, that leads to eating disorders.

Enmeshed family members over involved with each others lives, have no clear sense of autonomy and excessive togetherness leads members to speak for each other and intrude on each other’s thoughts & feelings. Parents in enmeshed families do not see their children as individuals in their own right, but as appendages which make their lives more complete. In reality, the closeness of an enmeshed family is an illusion.

Minuchin and his colleagues (1978) explain the development of eating disorders as following a particular pattern: as the adolescent child pushes for independence, it threatens the family illusion of togetherness. The child responds by taking on a “sick role” (developing an eating disorder) which means that the family “rallies round”. This “rallying round” restores the illusion of togetherness. Minuchin also uses this explanation to account for other disorders, such as psychosomatic illnesses.

Evaluation of Family Enmeshment as a Cause of Anorexia

Arthur Crisp and his colleagues (1974) tested the idea that the families of people with eating disorders would become unstable if their child recovered. He found that when the children gained weight the parents did show a significant increase in depression and anxiety. This supports the theory because it suggests that the family is stressed by the threat of not having a crisis to bring them together. However, it is possible that the increase in anxiety and depression may be in response to the stresses of weight restoration therapy (Strober, 1992).

There is more evidence, however, that family dysfunction, is associated more with bulimia nervosa than with anorexia (Fornari et al, 1999). Moreover, although family enmeshment predicts psychological disorder in general, the following family climate variables seem to be more related to eating disorders:

• Family Body Satisfaction
• Family Social Appearance Orientation
• Family Achievement Emphasis

An issue with evidence in support of family theories is that it is very difficult to carry out research that is able to separate effects that are due to family interactions and those that are due to genetic influences. It could be that genes that lead to obsessive behaviour, for example, contribute to both anorexia and family dysfunction.