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Eating disorders

from Medical topics

Published online by Cambridge University Press:  18 December 2014

Eric Stice
Affiliation:
Oregon Research Institute
Heather Shaw
Affiliation:
Oregon Research Institute
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Eating disorders include a variety of psychiatric disturbances involving abnormalities in eating behaviours, maladaptive efforts to control shape and weight and disturbances in self-perception regarding body shape. The three eating disorder syndromes are anorexia nervosa, bulimia nervosa and binge eating disorder. This chapter will review research on the aetiology, prevention and treatment of these disorders.

Aetiology of eating disorders

Aetiological theories of anorexia nervosa have implicated numerous factors, including norepinephrine abnormalities, serotonergic abnormalities, childhood sexual abuse, low self-esteem, perfectionism, need for control, disturbed family dynamics, internalization of the thin-ideal, dietary restraint and mood disturbances (Wilson et al., 2003). However, few prospective studies investigating factors predicting onset of anorexic pathology or increases in anorexic symptoms, and no prospective tests of multivariate aetiologic models have been conducted. Prospective studies are essential to determine whether a putative risk factor is a precursor, concomitant or consequence of eating pathology. The only prospective study that tested predictors of onset of threshold or sub-threshold anorexia nervosa found that girls with the lowest relative weight and with extremely low scores on a dietary restraint scale at baseline had increased risk for future onset of threshold and subthreshold anorexic pathology; non-significant effects were observed from early puberty, perceived pressure to be thin, thin-ideal internalization, body dissatisfaction and depressive symptoms (Stice, Presnell, & Bearman, 2004). All other studies collapsed across anorexic and bulimic pathology (e.g. McKnight Investigators, 2003).

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Publisher: Cambridge University Press
Print publication year: 2007

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