EATING DISORDERS

The impact of psychological factors on eating behavior is strikingly evident in the many people who suffer from an eating disorder.

Consider two cases:
Mary is 5'3", 15 years old who having reached 100 pounds decided that she needed to lose weight to enhance her attractiveness. After gradually reducing her food intake to a few vegetables a day and then adding a vigorous exercise program, she dropped to 80 pounds. She has been having difficulty sleeping, has at times been depressed, and no longer has regular menstrual periods. Mary is still unhappy about her weight. She is socially inactive and seldom dates, but she is very successful academically. Mary does not regard herself as ill or in need of treatment.

Alice is a 5'9", 160 pounds 17 years old who says she has always been a little chubby. For the last 5 years, her eating has been characterized by binges followed by vomiting. She will eat a quart of ice cream or an entire pie and then, to control her weight, make herself vomit in secret. Alice wants to date, but doesn't because she is ashamed of her looks. She has at times taken pills to try to lose weight.


Mary condition is diagnosed as anorexia nervosa, a disorder in which a person becomes significantly underweight (typically, 15 percent or more) yet feels fat and is fearful of becoming obese. Even when emaciated, the person continues to restrict food intake. The disorder usually develops in adolescence, and is nine times more common in females than in male.

Alice's condition, which is more common, is diagnosed as bulimia nervosa, a disorder characterized by repeated "binge-purge" episodes of overeating followed by vomiting or using a laxative. Most individuals with bulimia are women in their late teens or twenties who like those with anorexia, are preoccupied with food, fearful of becoming overweight and experiencing depression or anxiety. The feelings of depression and shame are especially keen during and following binges. About half of those with anorexia also display the binge-purge-depression symptoms of bulimia. But most bulimics fluctuated within or condition hidden.

Researchers report that the families of bulimia patients have a higher than usual incidence of alcoholisme, obesity, and depression. Anorexia patients often come from families that are high-achieving and protective. Nevertheless the origins of these disorders are for now a mystery.

There is however a cultural explanation for the fact that anorexia and bulimia occur so much more frequently in women than in men. Although ideals of beauty have varied over the centuries, women in every era have struggled to make their bodies conform to the ideal of their day. Thus the "sickness" of today's two primary eating disorders lies not just within the victims but also within our weight-obsessed culture a culture that says in countless ways "fat is bad", that motivates millions of women to be "always dieting", and that effectively encourages eating binges by pressuring women to live in a constant state of semi starvation. Anorexia nervosa always begins as a weight-loss diet, and the self induced vomiting of bulimics nearly always begins after a dieter has broken diet restrictions and gorged. An increasingly stringent cultural standard of thinness for women has been accompanied by a steadily increasing incidence of serious eating disorders in women.