The idea is there there can be environmental triggers for someone pre-disposed to disease. Nobody is saying that one remark by a coach sets off an irreversible trend toward anorexia, but it's important to acknowledge that pressure by an authority figure is exactly the right kind of trigger. Its a sum of factors, both genetic and environmental. Generally, EDs are understood as 'miswirings' of the reward system, the same functions responsible for addictions and other compulsive, self-destructive behaviors.
Alex P Keaton's Left Nut wrote:
Okay, it's a disease.
Would we allow individuals with severely fatal heart disease to run at a high level? That seems irresponsible.
Are there any other mental illnesses (bi-polar, schitzo-affective, etc) where the detriment is a fully aware and conscious set of decision-making (I'm not going to eat / I'm going to throw up, etc) that can be absolutely dormant but brought about by simple conversation?
Not sure what to make of the leukemia comment. how are you equating advances in treatment of a physical ailment to advances in knowledge of a mental ailment? Why not compare treatments for both or knowledge of both?
I'm not an expert but it seems that we simply don't know enough to understand what can trigger an ED or many other mental diseases. We know they individuals with the wrong genetics and in the wrong environment are far more likely to contract them though -- however our predictive power is still weak.
And absolutely it is irresponsible to let someone with an ED train exercise at a high level without dietary intervention. The goal to prevent the disease manifestation. We aren't able to change human genetics yet, but we can certainly work to avoid environmental contributions.
The leukemia comment was more tongue in cheek. It's very old school to tell someone with a mental disorder to 'stop thinking that way, can't you control your thoughts.'