These myths influence the way women view and value themselves. The anorexic fashion models, presented as the prototype for sexual desirability, are testaments to the cultural ideal of physical attractiveness. Additionally, there is a cultural legacy of women's appearance being prized above all else. Those highest at risk for eating disorders are those whose self-esteem is based on physical appearance and external approval. However, few women are immune to these sociocultural influences.
Psychological conflicts lead to mounting anxiety as well as anger, sadness, hurt, and fear.
These emotions may become overwhelming and may be temporarily avoided by preoccupation with food, dieting, or exercising. Additionally, internal awareness of hunger and satiety seem to be diminished for individuals who struggle with eating disorders and thus control of their diet becomes critical. Biological and family factors contribute to eating disorders. Research suggests that eating disorders may develop in response to inherited predisposition to mood problems. Parents of eating disordered women have an increased incidence of depression and alcoholism.