Yesterday's article on Ozempic in The Wall Street Journal ("A 12-Year-Old's Journey Into the World of Ozempic. A mother found success with a weight-loss drug after a lifelong battle. Noticing her daughter start down the same path...") aroused several thoughts.
The baby's first source of food is their mother and they later learn eating habits from their family. Children with eating disturbances tend to develop in families where food serves other purposes beside nourishment.
Anorexia (which has the highest death rate of all mental health disorders) and Bulimia develop in children where eating becomes entwined with their healthy desire for autonomy, which is resisted by their mother. Thus, control over eating for the child serves their emotional need of exhibiting their independence and, once created, is difficult to treat as it entwines with fanciful notions about beauty, nutrition, and exercise. Obsessive-compulsive exercising has its own motivation since, as reflecting an ego defense against anxiety, it serves to reduce the continuing anxiety of the anorexic/bulimic child.
Sadly, many doctors ignore the family underpinnings of these behavioral disturbances.