Social Learning Theory Anorexia

Social Factors Influencing Eating Habits

Social factors can have a major impact on a person's eating habits. It's hard to deny that many of us care about what other people think about us, especially if they are our family, friends, or peers. So it should come as no surprise that our eating habits can be greatly influenced by social factors such as peer pressure, family dieting, teasing or bullying, and cultural ideas of thinness, fitness, and muscularity.

This article will describe and evaluate the social learning theory of anorexia nervosa. People with anorexia often think they are overweight, even though this is not the case.

Albert Bandura proposed the social learning theory (SLT) in 1977. The theory assumes environmental and cognitive factors working together cause behaviour.

The SLT explains anorexia as follows:

• During childhood, children encode the behaviour of their role models (e.g., celebrities or parents), imitating it.

• They do not imitate all behaviour, but if it is reinforced or is the generally accepted opinion of society, they are likely to replicate it.

• Society and the media perceive 'skinnier' women and 'muscular' men as more attractive.

As a result, a person can develop a distorted image of themselves and model the behaviour they observed, causing the onset of anorexia nervosa.

Fig. 1 People with anorexia nervosa often have unrealistic expectations.

Social Learning Theory: Anorexia Theories

There are several anorexia theories related to the social learning theory. Let's explore behavioural and cognitive explanations for anorexia.

Behavioural Explanations for Anorexia

As previously stated, the social learning theory considers aspects of the behavioural approach for explaining anorexia nervosa. According to the social learning theory, people can learn anorexia nervosa via associations (principles of classical conditioning). They can then maintain this maladaptive behaviour via reinforcement (principles of operant conditioning).

An example of how classical conditioning explains anorexia in terms of the development of a fear of food is an individual forming an association between eating and psychological distress, causing avoidant behaviour and leading to anorexia. Here are some examples of how operant conditioning may explain anorexia:

Keel and Klump (2003) found that the role of media influences and culture affects the rate of anorexia nervosa. The research found anorexia nervosa in all countries, but the more Westernised countries had higher rates of anorexia. However, other factors exist, so we can only say that the Western media plays a role and is not the only determining factor.

Cognitive Explanations for Anorexia

Bandura would also often refer to his theory as the social cognitive approach. The cognitive aspect of the SLT theory explains behaviour in terms of observational learning, a form of cognitive learning.

One mental process that is vitally important for us to engage in cognitive learning is attention. Without us actively paying attention to a particular behaviour, we would not be able to imitate it later, let alone recall the behaviour we observed.

We are also more motivated to pay attention to the behaviour of those that we look up to or respect. This could explain why a person may be more likely to imitate anorexic behaviours if they also observed a parent or caregiver engaging in them.

Evaluation of Social Learning Theory of Anorexia

The strengths of the social learning theory to anorexia are:

Grabe et al. (2008) found that women exposed to media images about the thin-ideal body had body image concerns. SLT approach is more holistic because it takes a multifactorial approach (uses more than one approach to explain phenomena) to explain anorexia, i.e., it does not try to over-simplify complex human behaviours.

However, the weaknesses of the social learning theory to anorexia are:

This model ignores the importance of biological factors leading to the onset of anorexia. For example, Kaye et al. (2015) found that patients with anorexia had high levels of dopamine receptors in the basal ganglia (the brain region involved in reward processing). Therefore, dysfunctional eating behaviour may result from dopamine irregularities in the basal ganglia.

One problem with this model is that not everyone who has such role models (role models that cause or encourage unhealthy eating behaviours, such as promoting the dieting culture the SLT explains as a possible cause of anorexia) develops anorexia. This idea suggests that the diathesis-stress model may provide a better explanation for anorexia.

Risks Factors Associated With Anorexia Nervosa

The social learning theory can only explain part of why a person may develop anorexia nervosa. There are several other risk factors associated with anorexia nervosa. For one, studies have found a genetic component to this eating disorder. Twin studies reveal that anorexia has a heritability of 50 to 60% (Yilmaz et al., 2015).

Another risk factor associated with anorexia is if someone has a perfectionist temperament.

People diagnosed with anorexia nervosa may set standards for themselves that are impossible or unrealistic for them to achieve, causing them to ruminate when they fall short of their or others' expectations.

Fig. 2 People with anorexia nervosa may equate body image with the number on a scale.

Other possible risk factors of anorexia nervosa are:

• Sex, e.g. females are at higher risk.

• Early onset of menarche.

• Experiencing transitional stages associated with significant social and physical changes (i.e. adolescence or pregnancy).

• Dieting.

• Stress.

• Obsessive-compulsive traits.

• Low self-esteem.

• Past trauma, neglect, or abuse.

Social Learning Theory Anorexia in Psychotherapy

It's important to keep in mind the social learning theory when treating anorexia in psychotherapy. One of the most common and effective types of psychotherapy used to treat anorexia is cognitive-behavioural therapy (CBT). CBT can effectively dismantle the harmful thinking that a person may have learned due to the social learning theory.

A therapist using cognitive-behavioural therapy to treat anorexia nervosa will focus on breaking down anorexic thinking that causes distorted beliefs about weight loss, body, and food.