We really can’t be putting all the blame on “scary skinny” celebrities on the rash of eating disorders like anorexia nervosa.

A teen girl with anorexia nervosa, and more so her alarmed family, may blame the so-called scary skinny female TV and movie stars, fashion models and recording artists on the eating disorder.

“All of us are exposed to magazines that glamorize thin celebrities,  but not everyone goes on to develop an eating disorder,” says Linda Centeno, PhD, clinical psychologist, and assistant director of the Koch Center in NJ that specializes in eating disorder treatment.

“There may be dysfunctional family dynamics at play in some cases, but other factors also contribute to an eating disorder,” continues Dr. Centeno.

“Current research postulates that the development of an eating disorder is multi-factorial.

“The confluence of genetics, biology, trauma, deficiency in coping abilities, family issues, and temperament may all contribute to one developing an eating disorder.”

Why are scary skinny celebrities such an easy target for blaming as the cause of anorexia nervosa?

Well, nobody wants to blame a family member for causing a life-threatening psychiatric disorder.

A person may be part of a dysfunctional family and actually believe their family is picture perfect.

But someone has to be blamed for the eating disorder. The family may blame the patient entirely, or, they may be seeking an easy scapegoat: the latest thin glamour star to grace the cover of People Magazine.

Even people who don’t personally know an anorexic often blame Hollywood for the increased diagnoses of eating disorders.

How convenient it is to point to Angelina Jolie and declare, “That’s the cause!” Thanks to the Internet, it’s super easy to pick apart any woman’s body.

Though a teen or woman with anorexia nervosa might outright state, “I became obsessed with dieting when I decided I wanted a body like Taylor Swift’s,” this doesn’t mean that’s the cause.

“Oftentimes in clinical practice, we see that someone who is primed to develop an eating disorder is someone who may have gotten the message that it is more important to please others (vs. themselves), be as ‘perfect’ as possible, and not show (or attend to) one’s emotions,” says Dr. Centeno.

“In turn, these individuals may find coping or comfort in the ability to control their food intake.

“Oftentimes, people who have had an inability to vocalize their struggle are more apt to use food to cope because it is something they can control and they are able to hide (at least initially).

“Very often, the person is unaware of what is bothering them and these feelings become displaced onto food.

“For example, instead of being aware of being upset about something traumatic that has happened, the person may instead focus on how a type of food may ‘make them fat’ or ‘how many calories they ate for dinner.'”

This remolding of perspective then gets out of hand.

Another point to consider: Not all girls/women with anorexia nervosa ever thought, “Gee, I’d be so happy if I had a body like Nicole Richie.”

If a girl wants a body like Nicole Richie, and she begins dieting, but then develops anorexia nervosa…what happened?

Why didn’t she stop dieting when her body weight reached 100 pounds?

What happened that this girl started seeing fat legs in the mirror even though she was now at 95 pounds?

Can we really blame Nicole Richie, at around 100 pounds, for why this girl has starved herself down to 78 pounds and still thinks she’s fat?

“There IS evidence that the media contributes to body dissatisfaction in people with and without eating disorders,” says Dr. Centeno.

“For those individuals who are already at-risk for developing an eating disorder, current research says that the influence of media can make someone more vulnerable to developing a problem (and people who are vulnerable may also seek out media that reinforces certain ideals about weight and food).”

Anorexic patients, prior to the disorder’s development, were typically perfectionists–with parents who had unrealistic expectations of them.

While one girl develops a skin picking disorder as a way to feel some control in her life, her sister develops anorexia.

She becomes a master of accounting for every calorie, every crumb–what an incredible rush to know that she can do something that 90 percent of Americans can’t: stick to a strict diet long-term.

Most girls know when to halt the weight loss, but for a small percentage, matching Nicole Richie’s weight isn’t enough; they must keep losing, and losing, ultimately looking nothing like the celebrity, but rather, like a Third World child dying of starvation.

And they still think they’re “fat.” It takes more than the cover of People Magazine to lead to this.

Dr. Centeno works with adolescents and adults. In her private practice her specific clinical expertise also includes anxiety and panic disorder, depression, relationship issues and sexual abuse.