Eating disorders can often wax and wane throughout a person’s life course. Most clinicians and theorists attribute this vacillation to ‘stress’ but they fail to specify the types of stress that actually trigger the disease. In the world of someone with an eating disorder, not all stress is created equal. I once asked a group of women with eating disorder if their car getting a flat tire would trigger symptoms of eating pathology to worsen. The response was a resounding ‘no’. However, earlier in the group many mentioned that ‘stress’ worsened their urges to purge and restrict. I reflected back to them that getting a flat tire is very stressful, as would be enduring a hurricane, having one’s cat die, having one’s wallet stolen, etc., yet none of these events could be imagined by the group as triggering their eating pathologies. However, when I mentioned the type of stress such as mom and dad getting in an argument and the client getting pulled into the middle, your mother telling you she is very embarrassed by you because you didn’t make the cheer squad, or being told by your husband that you are not a good mother, these ‘stressors’ were endorsed as being very triggering of eating disorder. I feel this is important, because the type of stressor that triggers symptoms speaks highly to the social and psychological origins of those symptoms. I am frustrated that most people believe that skinny models and dieting ads are ‘triggering’. Granted, a lot of people with eating pathology would endorse that these issues are triggering, but I believe this is due to a superficial understanding of what really causes eating disorders. Skinny models and dieting ads may make urges to restrict and body image concerns more salient for a short time, but it is the self-system and feedback about roles and place in the family that actually changes one’s self-worth, triggers feelings of failure, which triggers urges to self-punish and self-neglect. Most individuals are exposed to images of emaciated models and actresses, and may even experience a desire to be thinner, but eating disorders are NOT a desire to be thinner. Eating disorders are patterns of self-deprivation and self-punishment that result from a crisis of self and a severe imbalance of energy in the social system. I believe targeting the media as a cause for eating disorders is the same as believing cold weather causes the flu. Yes cold weather can worsen a flu if an individual is carrying the virus, but it is the virus itself that causes the illness of the flu, not cold weather. Yes there is an association, but I think in the field of eating disorders, we have mistaken correlation with causation.