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).