We don't know what the causes are. I think we can't have primary prevention until we know. There's genetic vulnerability, the environment, a whole host of things that interact and from all my reading we don't know exactly what causes them. I know research is going on in other countries. It's called the Anorexia Nervosa Genetics Initiative, ANGI, study—Canada is not part of it—to see the genetic components so we can come up with treatments.
When I think about cause I think we need to tease out body image and eating disorders awareness from the actual mental illness of eating disorders. Because when we talk about awareness of eating disorders, we seem to focus on body image; you don't see that in children a lot. You won't see the same type of body image issues or the symptoms and behaviours of a teenage girl or a young woman that you would in a man. They may express it differently. When these people have eating disorders, these young girls and women, they're expressing how fat they are or they hate the way they look. Those are symptoms, and they're behaviours. They're not causes of eating disorders.
I think there is a lot of new neuroscientific research, and they're starting to tease out that we need to focus upstream on our research and not just look at the behaviours and the symptoms, because those aren't the causes. We need to look backwards and find out exactly what is causing them, because right now we don't know. We know there's a whole host of things at play, but in children they look different than in young adults, in young women and in young men, they all look different.
Yes, the environment does play a role, I agree, but there's so much more than just the environment.