Showing papers in "International Journal of Eating Disorders in 1986"
TL;DR: The Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described in this article, which indicates a high degree of stability of dimensions on the eating behavior scales.
Abstract: The development of the Dutch Eating Behaviour Questionnaire (DEBQ) with scales for restrained, emotional, and external eating is described. Factor analyses have shown that all items on restrained and external eating each have high loadings on one factor, but items on emotional eating have two dimensions, one dealing with eating in response to diffuse emotions, and the other with eating in response to clearly labelled emotions. The pattern of corrected item-total correlation coefficients and of the factors was very similar for various subsamples, which indicates a high degree of stability of dimensions on the eating behavior scales. The norms and Cronbach's alpha coefficients of the scales and also the Pearson's correlation coefficients to assess interrelationships between scales indicate that the scales have a high internal consistency and factorial validity. However, their external validity has yet to be investigated.
2,840 citations
TL;DR: In this article, the predictive validity of the 10-item Dutch Restrained Eating Scale has been evaluated and it was found that about 20% of the variance of scores on the Restrained eating Scale could be explained from these measures of food intake.
Abstract: The present study aims to determine the predictive validity of the 10-item Dutch Restrained Eating Scale. The ultimate criterion of restrained eating is the degree to which an individual eats less than he or she actually would like to eat. Since a study on both actual food consumption and restriction of food intake is very complicated, if not impossible, the difference between actual and desired intake of energy was studied indirectly, that is, from estimates of deviations from the required energy intake. The relationships were studied between restrained eating scores and the magnitude of the deviation from energy requirement, and between restrained eating scores and intake of fat and sugar, because restriction in intake of these may also reflect dietary restraint. About 20% of the variance of scores on the Restrained Eating Scale could be explained from these measures of food intake, which suggests that the Dutch Restrained Eating Scale has moderate to good predictive validity.
375 citations
TL;DR: In this article, the authors assessed the relationship between observed child mealtime behavior, physical activity, selected parent behaviors, and child relative weight, and found that parental encouragements to eat correlated both with the percent of time the child ate and with child's relative weight.
Abstract: The current investigation assessed the relationship between observed child mealtime behavior, physical activity, selected parent behaviors, and child relative weight. Subjects were 30 (15 male, 15 female) preschool children varying in age from 22 to 46 months (mean = 30.5 months). Each subject and parents were observed during the dinnertime meal with an observational instrument designed to measure children's mealtime behaviors and parental influences on child eating. Further, children's activity levels were assessed for one hour and parental influences on child activity were observed. Results indicated that parental encouragements to eat correlated both with the percent of time the child ate and with child relative weight. Similarly, parental encouragements to be active correlated to extreme levels of child motor activity and negatively to relative weight. Implications of the current study are discussed and the present findings are compared and contrasted with previous research.
193 citations
185 citations
182 citations
TL;DR: In this paper, historical analyses were used to test the hypothesis that the recent outbreak of eating disorders among women may be due, in part, to the slim standard of bodily attractiveness for women that has become fashionable.
Abstract: Historical analyses were used to test the hypothesis that the recent outbreak of eating disorders among women may be due, in part, to the slim standard of bodily attractiveness for women that has become fashionable. Historical changes in the standard were estimated by means of a measurement of the curvaceousnes of women depicted in photographs appearing in Vogue and Ladies Home Journal since 1901. When variation in the standard is measured across time, adherence to a slim standard is associated with low body weight among college women, with preoccupation with obesity in popular magazines and with various symptoms of eating disorders reported by experts cited in the mass media.
167 citations
TL;DR: A self-report questionnaire designed to elicit the DSM-III inclusion criteria for bulimia was completed by 1389 students (95.9% of those surveyed) from the same geographic area surveyed 3 years previously as discussed by the authors.
Abstract: A self-report questionnaire designed to elicit the DSM-III inclusion criteria for bulimia was completed by 1389 students (95.9% of those surveyed) from the same geographic area surveyed 3 years previously. Approximately 8% of the female students endorsed the criteria for bulimia in each survey. Even with the more stringent criteria used in the current survey, the percentage of female students who reported all the operationalized criteria for bulimia and in addition engaged in weekly binge-purging behavior increased from 1% in 1980 to 3.2% in 1983. The female college students reporting bulimia in the current survey more closely resembled the bulimic patients coming for treatment than those in the previous survey, particularly in the reported frequency of daily binge eating, self-induced vomiting for weight control, and the endorsement of DSM-III Criterion B behaviors. Validation studies indicated that self-report questionnaires may not correctly identify binge eating, fear of loss of control over eating behaviors, or self-deprecatory thoughts after binge eating, when compared with professional assessment by interview.
155 citations
TL;DR: Overall absolute clinical efficacy was limited, as only four treated subjects showed a full remission of binge episodes, and longer treatment with more specifically tailored cognitive- behavioral techniques may be warranted in the search for more efficacious results for bulimia.
Abstract: The efficacy of 6 weeks of twice-weekly, cognitive-behavioral group therapy (n = 15) was compared with a waiting list control (n = 15) in 30 women with bulimia by DSM-III. Relaxation techniques and group discussions to alter dysfunctional attitudes regarding eating and appearance was used. A significant decrease in both binge and purge frequency was found in the treated compared with the wait-listed group. Treated subjects who decreased their binging and purging maintained improvement 4 months after treatment termination. However, overall absolute clinical efficacy was limited, as only four treated subjects showed a full remission of binge episodes. Longer treatment with more specifically tailored cognitive- behavioral techniques may be warranted in the search for more efficacious results for bulimia.
145 citations
TL;DR: Anorexia Nervosa was diagnosed in a group of seven black and his- panic female adolescents, constituting 5% of the patients treated for this condition during a 12 year period at Children's Hospital National Medical Center (CHNMC).
Abstract: Anorexia Nervosa (A.N.) was diagnosed in a group of seven black and his- panic female adolescents, constituting 5% of the patients treated for this con- dition during a 12 year period at Children's Hospital National Medical Center (CHNMC). Although A.N. had existed for an average of one year, the correct diagnosis had been establishedprior to coming to CHNMC in only half of the patients. The characteristics of these patients as well as the course of their ill- ness are described and a hypothesis is developed relating to the emergence of A. N. among minorities. Young female members of the Black and Hispanic middle class may develop A.N.: the prevailing stereotype of the white upper middle class victim may conspire against early recognition.
143 citations
TL;DR: The interpretation of research into the eating disorder bulimia nervosa is complicated by the use of two different sets of diagnostic criteria as mentioned in this paper, which embrace different, but over-lapping, populations.
Abstract: The interpretation of research into the eating disorder bulimia nervosa is complicated by the use of two different sets of diagnostic criteria. In North America the DSM III criteria are usually employed (American Psychiatric Association, 1980), whereas in Britain Russell's criteria (Russell, 1979) are preferred. While the two sets of criteria appear to be designed to identify people with essentially the same disorder, they embrace different, but over-lapping, populations. Discrepancies between the findings of various investigations may therefore be attributed in part to the fact that different patient groups have been studied. In this paper both these sets of diagnostic criteria and the proposed DSM III R criteria (American Psychiatric Association, 1985) are reviewed in the light of current knowledge. In addition, the relationship between bulimia nervosa and anorexia nervosa is examined. Certain revisions to the diagnostic criteria for both disorders are suggested reflecting the view that extreme concerns about shape and weight are a central psychopathological feature uniting anorexia nervosa and bulimia nervosa.
142 citations
TL;DR: In this article, the authors assess body size distortion and the relationship between self-esteem and distortion in normal weight, asymptomatic individuals, and find that females had significantly higher body distortion scores than males, but significantly lower selfesteem scores.
Abstract: The purpose of this study was to assess body size distortion and the relationship between self-esteem and distortion in normal weight, asymptomatic individuals. There were 30 male and 30 female subjects selected from a general college population. Criteria for acceptance included a weight range within 10% of ideal and no history of eating disorder behaviors. Subjects completed Rosenberg's self-esteem questionnaire and estimated the size of four body sites using an adjustable light beam technique. Estimations were compared with actual sizes assessed with body calipers. On the average, all subjects overestimated their body sizes. Females had significantly higher body distortion scores than males, but significantly lower self-esteem scores. There was a significant positive correlation between self-esteem and distortion level for the males' waist and a significant negative correlation for the females' thighs. In addition, there was a significant negative correlation between overall distortion level and self-esteem for females. The results were discussed with regard to the greater incidence of eating disorders in females and the importance of correlates of body distortion in asymptomatic populations.
TL;DR: The eating attitudes and behavior, psychological functioning, and family dynamics of 25 women with bulimia (binge-purge syndrome) were examined by comparing their responses on self-report measures to those of a normal control group.
Abstract: The eating attitudes and behavior, psychological functioning, and family dynamics of 25 women with bulimia (binge-purge syndrome) were examined by comparing their responses on self-report measures to those of a normal control group. As expected, the bulimic clients displayed many more problems in their eating attitudes and behavior and a disturbingly high level of behavioral-emotion distress. Responses to the family assessment measures suggested possible familial factors that may contribute to the syndrome. The implications of the results for current treatment approaches and conceptualizations of bulimia are discussed.
TL;DR: In this paper, the authors examined 50 female patients with bulimia at normal body weight to determine factors associated with the onset and maintenance of their disorder, including sexual conflicts, major changes in life circumstances, and loss acting upon the above underlying factors.
Abstract: Fifty female patients with bulimia at normal body weight were examined in a prospective study to determine factors associated with the onset and maintenance of their disorder. Factors given by patients and interpretations drawn by the psychiatrist for the underlying, precipitating, and maintenance factors of bulimia were recorded. Bulimic patients describe a remarkably similar and consistent series of underlying factors, particularly centered on doubts concerning femininity but also including a poor relationship with parents, academic striving, parental marital conflict, and poor peer group relationships. All patients described at least one and usually two or three major groups of life events: sexual conflicts, major changes in life circumstances, and “loss” acting upon the above underlying factors which together with carbohydrate-abstinent dieting precipitated the onset of the condition. Maintenance factors included carbohydrate craving, binge eating for its sedative qualities or, alternatively, as a stimulant to replace loneliness or boredom.
TL;DR: The development and preliminary validation of a new Self-report questionnaire for screening individuals at risk of developing an eating disorder (SCANS) is described, and normal individuals identified as being theoretically at high risk of an eating Disorder were found to score significantly higher than controls on all measures derived from the Eating Attitudes Test (EAT).
Abstract: The development and preliminary validation of a new Self-report questionnaire for screening individuals at risk of developing an eating disorder (SCANS) is described. This instrument was derived from the functional-analytic model of anorexia nervosa, previously outlined by the first author (Slade, 1982). Forty items were created to measure five hypothesized, antecedent conditions, and this questionnaire was then administered to 722 control subjects and 40 eating disorder patients. Two principal component analyses were carried out on successive samples of control subjects (368 validation and 354 cross-validation), which yielded virtually identical solutions. Using scales empirically derived from the first component analysis, the eating disorder groups, anorexia nervosa and bulimia nervosa patients, differed significantly on all five scales from controls. Moreover, normal individuals identified as being theoretically at high risk of an eating disorder were found to score significantly higher than controls on all measures derived from the Eating Attitudes Test (EAT). Further studies and reports are planned.
TL;DR: In this paper, the authors compared patterns of family relations in 16 bulimic-anorexic and 24 nondistressed family triads and found that families of bulimics are less involved and supportive, and more isolated, conflictual, understructured, and detached than were the nonproblem controls.
Abstract: The present study compared patterns of family relations in 16 bulimic-anorexic and 24 nondistressed family triads. Father, mother, and teenage daughter completed the Family Environment Scale (FES) and the Family Adaptibility and Cohesion Evaluation Scale (FACES), independently. Both scales were factor analyzed and found to consist of 8 orthogonal factors. Findings from fathers, mothers, and daughters converged, and revealed that families of bulimic-anorexics were less involved and supportive, and more isolated, conflictual, understructured, and detached than were the nonproblem controls. These results were discussed as consistent with clinical observations and prior research on the potential contribution of family disturbance to eating disorders.
TL;DR: It is concluded that a history of anorexia is frequent among women (but not men) with obsessive-compulsive disorder but not agoraphobia.
Abstract: The case notes of 280 patients with obsessive-compulsive disorder were examined retrospectively; 16 of the 151 females had a past history of anorexia nervosa. Not one male obsessive-compulsive had such a history, nor did any of 100 agoraphobics (83% female) studied as a contrasting anxiety disorder. Compared to nonanorexic cases of obsessive-compulsive disorder, the anorexics' were younger, their obsessive-compulsive problems began earlier, and they were more often single. No significant phenomenological differences were detected compared to nonanorexic obsessive-compulsive women. In conclusion, a history of anorexia is frequent among women (but not men) with obsessive-compulsive disorder but not agoraphobia.
TL;DR: This paper found that during periods when the intelligence and professional competence of women are stressed, the standard of women becomes non-curvaceous, and that women who are concerned about how intelligent they appear to be to others will adhere to a slim standard of bodily attractiveness for themselves.
Abstract: Based upon studies that have demonstrated that curvaceous women are rated as less competent and less intelligent than noncurvaceous women, it was hypothesized that during periods when the intelligence and professional competence of women are stressed, the standard of bodily attractiveness for women becomes noncurvaceous, and that women who are concerned about how intelligent they appear to be to others will adhere to a slim standard of bodily attractiveness for themselves. Using measures of variation in the standard of bodily attractiveness across time and across individuals, it was found that over the course of the twentieth century, when the proportion of American women working as professionals or graduating from college has increased, the standard of bodily attractiveness for women has become less curvaceous and that college women who report that their fathers did not believe them to be very intelligent tend to want to be slim.
TL;DR: In this paper, the authors examined the effectiveness of an empirically based, psycho-educational, group treatment program for bulimia, which focused primarily on decreasing depression, enhancing self-esteem, increasing assertion and improving body image.
Abstract: The present study examined the effectiveness of an empirically based, psychoeducational, group treatment program for bulimia. The seven-week program focused primarily on decreasing depression, enhancing self-esteem, increasing assertion and improving body image. In addition, women monitored their own bingeing and purging. Relative to no treatment controls (N = 7), women who received treatment (N = 11) showed significant improvements in their number of binges per month, self-esteem, and depression. Also, the number of purges per month tended to decrease. Women in both groups showed significant improvements in body image. The treatment gains were maintained at a ten-week follow-up. These results suggest that a short-term group treatment approach that focuses on personality and behavioral deficits as well as the maladaptive eating pattern is an effective treatment strategy for bulimia.
TL;DR: In this paper, a causal model of bulimia using linear structural relations analysis (LISREL) was proposed, based on three components: sources of stress, mediators of stress and manifestations of stress.
Abstract: Two studies conducted to develop and cross validate a causal model of bulimia are reported. It was hypothesized that a stress process, comprised of three components, the sources of stress, the mediators of stress, and the manifestations of stress would provide the basis of a causal model of bulimia, using linear structural relations analysis (LISREL). In Study 1, 144 female introductory psychology students were assessed for bulimia as well as 10 other variables representative of the stress process. The proposed model was comprised of two sources of stress: Environmental stressors (life events and daily hassles), and Depression (depression and risk for depression). The model indicated that coping skills are an important mediator of stress, and that having a high frequency of environmental stressors and/or the presence of depression or risk for depression, may lead an individual to resort to ineffective coping mechanisms, which, in turn, results in the expression of bulimic behavior. The model was cross-validated in Study 2, in which 150 female introductory psychology students were assessed on the same variables. Treatment implications are discussed.
TL;DR: Preliminary data suggest that adolescents' scores on the EAT and the EDI are similar to young adult women's scores, and also that further refinement of a discriminant equation might lead to the development of an effective screening device for eating disorders in adolescents.
Abstract: The prevalence of eating disorders has increased in teenage and young adult women. Since early treatment of eating disorders is thought to lead to improved outcomes, the development of an effective self-report screening device for eating disorders in adolescents could help reduce morbidity from these illnesses. In order to examine the feasibility of developing such an instrument, eating attitudes and behaviors were studied in a sample of 72 female adolescents, using the Eating Attitudes Test (EAT), the Eating Disorder Inventory (EDI), and blinded structured clinical interviews focused on eating disorders. Scores on the EAT and EDI were similar to scores of older normal female comparison groups in other studies. Based upon interview information, 54 subjects were classified as normal, 9 as dieters, 8 as suspected bulimics, and 1 as bulimic. Subjects, on average, accurately reported their actual weight and height. The results of the interviews indicated that 25% of the 72 subjects were currently dieting, 60% regularly skipped meals, 35% said they were overweight or very overweight, 22% were binge eaters, 8% vomited after eating, and 4% used drugs to lose weight.
Linear discriminant analysis was used to compare the results of the questionnaires with that of the interviews in order to identify a composite set of questionnaire items to be used as a screening device for individuals with clinical eating disorders and for those at high risk of developing such disorders.
A preliminary equation was obtained that correctly classified 86% of subjects into categories of normal, dieter, or suspected bulimic that were determined from the interviews.
These preliminary data suggest that adolescents' scores on the EAT and the EDI are similar to young adult women's scores, and also that further refinement of a discriminant equation might lead to the development of an effective screening device for eating disorders in adolescents.
TL;DR: The frequent cooccurrence of these two phenomena in female therapy clients may be sufficiently explained by their high base rates in this population but may have led clinicians to perceive a relationship where none exists.
Abstract: Undocumented clinical reports have suggested that, among women in psychotherapy, women who have been sexually abused manifest an increased prevalence of eating disorders. The relationship between these two phenomena was investigated in a sample of women (N = 87) who were receiving group psychotherapy. Individual interviews were used to document the presence of a sexual abuse history. Diagnoses of anorexia nervosa and bulimia were based on DSM-III criteria. Rates of abnormal eating patterns in the absence of a fully diagnosable syndrome were also assessed. The following rates of eating disturbance were found in the total sample: 21% bulimic, 1% anorexic, and 82% with at least moderately abnormal eating patterns. Comparisons of women with and without histories of sexual abuse suggested no association between the occurrence of eating disturbance and a history of sexual abuse. The frequent cooccurrence of these two phenomena in female therapy clients may be sufficiently explained by their high base rates in this population but may have led clinicians to perceive a relationship where none exists.
TL;DR: The phenomenology of chronic anorexia nervosa is compared with that of addictive states, and a model is proposed in which brain opioids mediate the elation, neuroendocrine changes, and down-regulation of metabolism that occur in adaptation to dieting.
Abstract: The phenomenology of chronic anorexia nervosa is compared with that of addictive states. A model is proposed in which brain opioids mediate the elation, neuroendocrine changes, and down-regulation of metabolism that occur in adaptation to dieting. The physiology of opioids is reviewed, and clinical and animal data are marshalled to support an auto-addictive model. Opiate blockade together with therapeutic approaches used in the addictions may prove helpful in this stubborn disorder.
TL;DR: This article found that the EAT-26 is a reliable and economical substitute for the 40-item Eating Attitudes Jest, the 26-item eating attitudes test, the Restrained Eating Inventory (El), and the Eating Disorders Inventory (EDI).
Abstract: The 40-item Eating Attitudes Jest, the 26-item Eating Attitudes Test, the Restrained Eating Inventory (El), and the Eating Disorders Inventory (EDI) were given to 81 women who were participating in an eating disorders study. The EAT-26 totals and the scores of the three factors were intercorrelated. The scores of the EAT-26 were also correlated with the scores of the EAT-40, and El, and the EDI. The EAT-26 correlated significantly with all three of its factors as well as with the EAT-40. These results suggest that the EAT-26 is a reliable and economical substitute for the EAT-40. The EAT-26 correlates highly with the eight subscales of the EDI and with the El, suggesting concurrent validity.
TL;DR: In this article, the application of the Eating Disorders Inventory (EDI) to 399 black, white, and mixed race schoolgirls attending private schools in Zimbabwe was described, and the results indicated concern with eating and weight amongst the black and mixed-race groups when compared with previous studies of indigenous subjects in de- veloping countries.
Abstract: This paper describes the application of Garner's Eating Disorders Inventory (EDI) to 399 black, white, and mixed race schoolgirls attending private schools in Zimbabwe. To the authors' knowledge the instrument has not been applied previously on the African continent. The results obtained indicate concern with eating and weight amongst the black and mixed race groups when compared with previous studies of indigenous subjects in de- veloping countries (Buhrich, 198 1). High scorers are isolated on the basis of obtaining scores on or above the 90th percentile (normative sample com- prised of North American female college students N = 770)on the “drive for thinness” subscale of the ED/. There are 80 high scorers of which 12.5% are black and 17.5% of mixed race, the remainder are white. There is a bulimic tendency amongst the high-Scoring black and mixed race groups. The results of the high scores are further evaluated on the remaining dimensions of the EDI, namely, body dissatisfaction, ineffectiveness, interpersonal distrust, per- fectionism, interoceptive awareness and maturity fears. Finally, a small sample of black, white, and mixed race are engaged in a semistructured interview—-EAT. (The EAT was constructed by Dr. C. Szmukler, Maudsley Hospital, London). This semistructured interview assesses attitudes towards (inter alia) increased interest in certain foods and avoidance of others, de- tailed calorie counting, bingeing, dieting, fear of loss of control over eating, overactivity, etc. The results are reviewed against a background of traditional and evolving cultural values which are juxtaposed within this developing so- ciety.
TL;DR: Concerns about eating seemed to increase between the ages of 12 and 13 and remain high thereafter and many of the students who scored high on the EAT were overweight, suggesting that these attitudes or concerns are not specific to anorexia nervosa and/or bulimia.
Abstract: Although cases of anorexia nervosa and bulimia are being seen increasingly by health care professionals, little data is available on the prevalence of these disorders in the general population of school age children. Using a validated eating attitude test (EAT), a total of 5150 students, aged 12–20, from public schools and one university in the Province of Manitoba were surveyed. Overall, 5% of males and 22% of females scored 30 or above on the scale, suggesting significant concerns and attitudes regarding eating. These concerns were somewhat higher in urban versus rural settings and seemed to increase between the ages of 12 and 13 and remain high thereafter. Many of the students who scored high on the EAT were overweight, suggesting that these attitudes or concerns are not specific to anorexia nervosa and/or bulimia.
TL;DR: The relationship between two pathological eating syndromes, the night eat- ing syndrome (NES) and bulimia, was examined in a sample of 74 morbidly obese adults and both were positively related to measures of psychoneu- roticism.
Abstract: The relationship between two pathological eating syndromes, the night eat- ing syndrome (NES)and bulimia, was examined in a sample of 1 74 morbidly obese adults. The prevalence of NES (15%) and bulimia (2%) was greater among the morbidly obese compared to the normal weight sample (under 1 % for both syndromes). The scales measuring NES and bulimia were posi- tively correlated and both were positively related to measures of psychoneu- roticism.
TL;DR: Although the restrained eating pattern and bulimia were highly correlated, neither was correlated with NES or with attributes associated with NES.
Abstract: Prevalence of eating behaviors and components of three patterns—bulimia, restrained eating, night eating syndrome (NESI—are described in 232 normal weight adults. Some components of eating patterns occurred frequently fe.g., guilt about eating), but items suggesting pathology were rare (e.g., self-in- duced vomiting). The prevalence of bulimia and NES is under 1 %, whereas 14% manifested the restrained eating pattern. More women than men man- ifest bulimic and restrained eating patterns; sexes were comparable on NES. Although the restrained eating pattern and bulimia were highly correlated, neither was correlated with NES or with attributes associated with NES.
TL;DR: In this paper, the food preferences of 80 stress-eating and non-stress-eating adults and examined the relationships of them with current stress, sex, age, and weight.
Abstract: Psychological stress has been shown to produce feeding behavior in both humans and animals. In our animal studies, it appears that the texture of the food may determine how well a food alleviates stress. We studied the food preferences of 80 stress-eating and nonstress-eating adults and examined the relationships of them with current stress, sex, age, and weight. Preference for high caloric density foods is predicted by being a stress-eater and lower current stress and is associated with a concern over feeding behavior and normal weight. Preference for low caloric density foods is predicted by high stress and stress-eating, as well as obesity, being older and not smoking. Food preference was associated also with food texture. A preference for salty foods (as opposed to sweets) was associated with being younger, stressed, nonobese, and eating less when stressed.
TL;DR: This article investigated general knowledge of the symptoms, causes, and treatment of bulimia and anorexia nervosa, as well as attitudes toward anorexics and bulimics.
Abstract: The current study investigated general knowledge of the symptoms, causes, and treatment of bulimia and anorexia nervosa, as well as attitudes toward anorexics and bulimics. High school and college students, 15 to 25 years of age, were administered an anonymous questionnaire. Adequate definitions of bulimia and anorexia were provided by 44% and 71% of the subjects, respectively. Females demonstrated more knowledge than did males. Emotional problems were seen as the most likely cause of both disorders, and psychotherapy was considered the most effective treatment. The subjects were more rejecting of an anorexic female, an obese female, and an average weight vomiter than an average weight binger. Over 4 7 % of the males were rejecting of an anorexic, obese, or purger female as a dating partner.