Eating Disorders
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CHAPTER OUTLINE
Anorexia Nervosa
What Is Anorexia Nervosa?
Medical, Psychological, and Social Effects of Anorexia Nervosa
Bulimia Nervosa
What Is Bulimia Nervosa?
Medical Effects of Bulimia Nervosa
Is Bulimia Distinct From Anorexia?
Binge Eating Disorder and “Other” Eating Disorders
What Is Binge Eating Disorder?
Disordered Eating: “Other” Eating Disorders
Understanding Eating Disorders
Neurological Factors: Setting the Stage
Psychological Factors: Thoughts of and Feelings About Food
Social Factors: The Body in Context
Feedback Loops in Understanding Eating Disorders
Treating Eating Disorders
Targeting Neurological and Biological Factors: Nourishing the Body
Targeting Psychological Factors: Cognitive-Behavior Therapy
Targeting Social Factors
Feedback Loops in Treating Eating Disorders
Follow-up on Marya Hornbacher
Bulimia nervosa An eating disorder characterized by binge eating along with vomiting or other behaviors to compensate for the large number of calories ingested.
By the time she was 9 years old, Marya Hornbacher had developed bulimia nervosa, which is an eating disorder characterized by binge eating along with vomiting or other behaviors to compensate for the large number of calories ingested. This was an unusually young age to develop an eating disorder. By the time she reached 15, she had anorexia nervosa, an eating disorder characterized by significantly low body weight along with an intense fear of gaining weight or using various methods to prevent weight gain. For the next 5 years, she careened from one eating disorder to another. By Hornbacher’s own account, she had “been hospitalized six times, institutionalized once, had endless hours of therapy, been tested and observed and diagnosed…and fed and weighed for so long that I have begun to feel like a laboratory rat” (Hornbacher, 1998. At the age of 23, Hornbacher wrote Wasted: A Memoir of Anorexia and Bulimia about her experiences with eating disorders, in which she observes that an eating disorder:
Anorexia nervosa An eating disorder characterized by significantly low body weight along with an intense fear of gaining weight or using various methods to prevent weight gain.
…is an attempt to find an identity, but ultimately it strips you of any sense of yourself, save the sorry identity of “sick.” It is a grotesque mockery of cultural standards of beauty that winds up mocking no one more than you. It is a protest against cultural stereotypes of women that in the end makes you seem the weakest, the most needy and neurotic of all women. It is the thing you believe is keeping you safe, alive, contained—and in the end, of course, you find it’s doing quite the opposite. (1998
Eating disorder A category of psychological disorders characterized by abnormal eating and a preoccupation with body image.
An eating disorder is characterized by abnormal eating and a preoccupation with body image. Approximately 90% of the people diagnosed with eating disorders are females, and so in this chapter, we will refer to a person with an eating disorder as “she” or “her”; however, the number of males with eating disorders has been slowly increasing (Hudson et al., 2007).
In this chapter, we discuss three disorders from the DSM-5 category of feeding and eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder. We examine the criteria for and the medical effects of these disorders and discuss research findings that can illuminate why eating disorders develop and the various methods used to treat them.
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