Showing papers in "International Journal of Eating Disorders in 1988"

Body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary individuals

Abstract: The current study evaluated body image and eating disturbance in obligatory runners, obligatory weightlifters, and sedentary controls. Thirty subjects comprised each group, evenly proportioned by gender. The results indicated that weightlifters were significantly more accurate in estimating body size than runners and controls, although the latter two groups did not differ from one another. All subjects overestimated waist and hips to a greater degree than thighs; this finding was also true for their estimates of the size of a department store mannequin. Females were more dissatisfied with their body than males, with the exception that male and female weightlifters were equivalent on body dissatisfaction indices. Runners and weightlifters had greater eating disturbance than controls; females evidenced greater eating psychopathology than males. These findings indicate that type of physical activity may be related to size estimation accuracy and body satisfaction. The results are discussed with regard to the need to further refine subtypes of both obligatory runners and weightlifters for future investigations.

Binge eating increases with increasing adiposity

Abstract: Self-report and interview data were obtained from 81 obese patients to evaluate the distribution of binge eating, defined by DSM-III criteria for bulimia, across a range of adiposity. Binge eating was found to be significantly more prevalent as the degree of obesity increased.

Cigarette smoking as a dieting strategy in a university population

Abstract: The present study sought to determine the prevalence of smoking as a dieting strategy in a university population. There were 1076 people (458 males, 618 females) asked (1) the types of strategies they used to curb hunger (including smoking) and (2) whether they either began smoking or were currently smoking as a weight loss/maintenance strategy. Results indicated that 32.5% of all smokers (n = 209; 39% of females, 25% of males) reported using smoking as a weight loss strategy. A small percentage of smokers (10% of males, 5% of females) reported beginning to smoke for weight control. Overweight females were much more likely, however, to report that they started smoking for dieting reasons. Females were much more likely to report weight gain as a relapse variable than males. It is concluded that weight gain following smoking cessation, particularly among females, may be a significant relapse variable as well as a significant barrier to smoking cessation.

Bulimia in adolescents: Prevalence and psychosocial correlates

Abstract: A bulimic episode during adolescence appears to be a risk factor for chronic eating disorders, yet little is known about the prevalence or psychosocial correlates of bulimia in this age group. The prevalence of bulimia was determined in a geographically, racially, and economically diverse sample of 1,373 high school boys and girls. In addition to DSM-III criteria, a minimum binge-eating frequency of once per month was employed. For bulimia, with purging, a minimum purging frequency of once per month was employed. Bulimia was identified in 9.6% of girls (with purging, 2.2%; without purging, 7.4%) and in 1.2% of boys (with purging, 0.1%; without purging, 1.1%). The two subtypes of bulimia subjects were demographically and psychologically equivalent. Bulimia subjects (combined) did not differ from normals on race, age, or SES. Bulimics exhibited more negative body image, negative self-esteem, social anxiety, and depression than normals. In the total sample of students, general eating disorder symptomatology was predicted by measures of body image, depression, and social anxiety in girls and by body image and depression in boys.

Activity‐based anorexia: A biobehavioral perspective

Abstract: A biobehavioral model of activity-based anorexia is examined in terms of recent evidence. Strenuous exercise reduces the value of food reinforcement and results in decreased food intake. Reduction of food intake increases the motivational value of physical exercise. This produces an escalation in activity that further suppresses appetite. Cultural practices of diet and exercise initiate this anorexic cycle, and once started the process is resistant to change. These anorexias may be the result of natural selection favoring those organisms that became active in times of food scarcity. Proximate physiological mechanism(s) appear to involve the endogenous opiate system that mediates the relationshp between running and eating. It is argued that classification of human self-starvation should be based on environmental and/or biological conditions that control food regulation. Activity anorexia may be one instance of such a classification that could account for many instances of “an orexia nervosa”.

Stereotypes of obese female job applicants

Abstract: This experiment was conducted (1) to examine stereotypes about obese and nonobese female job applicants, and (2) to isolate the effects of obesity from the effects of physical attractiveness in these judgments. College students (n = 104) rated applicants for two different positions. The applicants' resumes either were accompanied by pictures of obese and nonobese targets who were matched in attractiveness or by written descriptions of obses and nonobese targets whose attractiveness was not described. A pretest confirmed that students who read these descriptions perceived nonobese targets as significantly more attractive than obese targets. Results showed that when attractiveness was controlled (i.e., the students saw pictures), students exhibited little negative stereotyping of obese applicants. In contrast, students who had to infer the target's attractiveness from a written description rated obsese applicants more negatively than nonobese applicants. These results, which occurred on one of the two resumes used, suggest that obese individuals sometimes are evaluated negatively, and that this is due to the physical unattractiveness associated with increased weight.

Multiple Aspects and Correlates of Body Figure Ratings: A Replication and Extension of Fallon and Rozin (1985)

Abstract: College females, using a set of nine figure drawings reflecting very thin to very heavy figures, rated their current figure (based on how they thought they looked versus how they felt), ideal figure, how they appeared to others, and the figure they deemed most attractive to men. A subsample of the 123 subjects also completed measures of body satisfaction, depression, eating disturbance, teasing, and noted the age of menarche. The results replicated and extended the findings of Fallon and Rozin (1985), who found that ideal figures were smaller than ratings of current size. Additionally, there was a significant difference between the two protocols for current size, indicating that subjects rated their size as larger when asked to rate based on affective instructions. Figure ratings based on cognitive/rational instructions did not differ from those based on how they conceptualized others' views of their bodies. Significant correlations were observed among figure ratings, body satisfaction, eating disturbance, depression, and teasing. The need to focus on etiological mechanisms of disturbed body image and eating behavior is addressed, and the role of teasing as a possible precipitant is examined.

Psychopathology associated with bulimia, binge eating, and obesity

Abstract: Bulimic binge-purgers, bulimic binge-eaters, nonbulimic obese presenting for treatment for obesity, obese not in treatment, and normal control subjects were compared using the Minnesota Multiphasic Personality Inventory (MMPI), Symptom Checklist-90-Revised (SCL-90-R), and Beck Depression Inventory (BDI). Results suggested a continuum of severity, with the binge-purger group showing the highest levels of psychopathology, and the binge-eaters and clinical obese showing significantly more distress than the two control groups. Analysis of the frequency of clinically elevated scores on each scale of the MMPI and SCL-90R as well as the BDI as a function of group indicated that the clinical groups evidenced significantly greater psychopathology compared with their appropriate control groups. These results clarify some of the conflicting results of previous investigations of obesity which did not differentiate obese patients and nonpatients. The implications of these findings for treatment research on obesity are that perhaps a more broadspectrum form of treatment may be required in order to address the psychological problems of the chronically obese.

Personality disorders in anorexic patients

Abstract: This study was designed to compare personality disorders in restricting and bulimic anorexics. Thirty patients fulfilled DSM-III criteria for anorexia nervosa and 38 patients fulfilled, in addition, DSM-III criteria for bulimia. Patients were given Axis I and II, DSM-III diagnoses. They were administered Gunderson's Diagnostic Interview for Borderlines, the MMPI, and the Childhood Events Questionnaire. We find from these different lines of evidence that both restricter and bulimic anorexics requiring hospital treatment equally display a major character pathology. However, there are characterological differences in that bulimics tend to discharge impulses and conflicts through action, similar to their family members.

Personality characteristics of bulimic and non‐eating‐disordered female controls: A cognitive behavioral perspective

Abstract: Although studies have examined the personality characteristics of bulimic individuals, these studies have been few and characterized by methodological shortcomings. To address these difficulties, this study compared 20 bulimic women and 20 non-eating-disordered normal weight controls on a variety of standardized psychological questionnaires. A comprehensive cognitive behavioral model of bulimia (Mizes, 1985) was evaluated by this comparison. Results showed that bulimic individuals showed significantly more pathological personality characteristics than control subjects. In specific, bulimics showed evidence of significant anxiety, depression, restrictive eating standards, low self-efficacy for dieting, distorted eating-related attitudes (i.e., weight as basis of self-esteem, striving for perfect self-control), self-control deficits, generalized irrational thinking styles (particularly helplessness and demand for approval), and body image distortion. A trend was found suggesting discomfort in social situations. Contrary to expectations, assertion deficits and concerns about sexual functioning were not found.

Attitudes toward eating and body weight in different groups of female adolescent athletes

Abstract: Although many elite athletic groups have relatively low weights, variations across sports occur. Adolescents were compared who engaged in three sports which varied on two dimensions, weight standards and energy expenditure, possibly associated with the physical characteristics of these three sports. Regional and national athletes aged 14–18 were surveyed: 25 figure skaters, 64 ballet dancers, and 72 swimmers. Adolescents who were not athletes served as a comparison group (N = 424). Height, weight, menarcheal age, sports activity, and attitudes toward eating were measured. Dancers and skaters were lighter and leaner than swimmers and nonathletes in accordance with the weight requirements expected of the former two groups. They also were more likely to have delayed menarche. Dancers and skaters also had more negative eating attitude scores than swimmers. At the same time, dancers exhibited more restraint eating than skaters, suggesting that low weights may be difficult to maintain given the fairly low energy demands required for dance.

Eating‐disorded patients remember their parents: A study using the parental‐bonding instrument

Abstract: The Parental Bonding Instrument (PBI) was used to compare the way in which a group of anorectic and a group of bulimic patients remembered their parents in childhood. The results were compared with published data. No differences were demonstrated on the “protection” score, but there were small and inconsistent differences on the “care” score. In general, the clinical subjects produced widely varied results, and the data do not support hypotheses which suggest that eating disordered patients have had a childhood characterized by any particular pattern of parental relationship.

Relevance of a standard measurement of undernutrition to the diagnosis of anorexia nervosa: Use of Quetelet's Body Mass Index (BMI)

Abstract: Quetelet's Index provides a measure of nutritional status which is both objective and easy to calculate. A review of the normative data published in the literature indicates that a BMI value of 16 provides a convenient criterion for the recognition of significant undernutrition. This value was applied successfully to a group of 150 anorexia nervosa patients. On the other hand, a BMI of over 18 appeared appropriate in the case of a small group of 22 bulimia nervosa subjects.

Psychosocial components of the stress process in bulimia

Abstract: Increasingly, investigators have sought to relate stress to the etiology and maintenance of bulimia. The current research literature on stress in general now views stress as a process that includes not only stimulus and response but mediators such as appraisal, control, coping, and social support that may predispose one to experience stress or to be more reactive to potential stressors. We suggest that viewing the stress process comprehensively may have heuristic value in the study of bulimia. Such an approach provides a clearly articulated, testable model and facilitates organization of a currently confusing literature. We review current research on stress and bulimia in this context and try to identify what knowledge exists, where the gaps are, and what kinds of questions must be asked in future research.

The adjustable light beam method for the assessment of size estimation accuracy: Description, psychometric, and normative data

Abstract: Description, psychometrics, and normative data for an ajustable light beam apparatus for the assessment of size estimation accuracy are presented. Alpha coefficient and test-retest reliability indices are within desirable limits. Comparison of size estimation scores with affective measures of body satisfaction indicates strong discriminant validity. Normative data on 159 females indicates that subjects overestimate the size of their waist, hips and thighs; average overestimation is 21%. The need for further research is discussed.

Overeaters anonymous: Impact on bulimia

Abstract: Patterns of utilization and effects of participation in Overeaters Anonymous (OA) in 40 individuals meeting DSM-III criteria for bulimia are described. All were abstinent from compulsive overeating for a mean of 3 years, with 21 (52.5%) initiating sustained abstinence within the first month of membership. Most attended meetings 5 times per week and called their sponsors daily, and 25 (62.5%) were in psychotherapy concurrently. The authors describe the nature and philosophy of OA and discuss factors which might explain the symptomatic control achieved by this group.

Perceived weight, actual weight, and depressive symptoms in a general adolescent sample

Abstract: To examine the relationship between perceived weight, actual weight, and depressive symptoms in a general adolescent sample, 344 junior and senior high school students were administered the Beck Depression Inventory and the Health Behaviors Questionnaire. Chi-square analyses revealed that perceptions of weight varied by sex but not by age. An analysis of variance using depression scores as the dependent variable revealed a main effect for age, with 11-13 year olds less depressed than 14-16 or 17-18 year olds; a main effect for weight perception, with those who perceived themselves to be of normal weight less depressed than those who thought they were underweight or overweight; and a significant interaction of actual weight and sex, with females tending to be less depressed if actually underweight and males tending to be less depressed if actually overweight.

Eating disorders in old age

Abstract: There are 5 women over the age of 55 with an eating disorder described. In view of a possible increase in the eating disorders among the elderly, the correct diagnosis and treatment of these disorders were emphasized.

Emotional eating and how it relates to dietary restraint, disinhibition, and perceived hunger

Abstract: During the past decade much research on eating disorders has been devoted to instrument development. Herman and Polivy's 10-item Restraint Scale has been the most widely used instrument, but it has both conceptual and psychometric limitations (Ruderman, 1986). To improve the measurement of restraint, and to combine it with the concept of latent obesity, Stunkard and Messick (1982, 1985) used itemselection and factor-analytic techniques to develop their Eating Inventory (EI). The current paper reports a factor analysis of this instrument on a large sample (N = 442) of relatively unselected, adult women (age 25–40). The results confirm the EI's Dietary Restraint and Perceived Hunger factors. However, the Disinhibition factor split to form two new factors: Weight Lability and Emotional Eating. The Emotional Eating factor may be particularly important because of the growing body of evidence that emotions–perhaps even more than cognitions–affect the eating of obese individuals. The Weight Lability factor was able to differentiate between two obese subgroups, suggesting that it may be useful in research on obesity.

A comparison of purging and nonpurging normal weight bulimics

Abstract: Bulimia can be separated into two major subtypes according to whether the individual does or does not couple binge eating with purging via vomiting or laxative abuse after eating. Twenty normal-weight purging bulimic women were compared with 20 normal-weight nonpurging bulimic women and 20 normal-weight controls. Compared with the nonpurging bulimics, the purging bulimics showed greater anxiety about eating, disturbance on standardized measures of eating attitudes and disorders, body size distortion and desire to be thin, and disturbance on behavioral trait scales of the Eating Disorders Inventory. The nonpurging bulimics were never significantly more maladjusted than the purging bulimics on any measure although by comparison to normal controls, they exhibited more anxiety about eating, disturbance on eating disorder questionnaires, and depressive symptoms and lower self-esteem. These results suggest that bulimia with purging is associated with a greater amount of psychopathology than bulimia without purging in normal-weight women.

Prevalence of pathogenic weight-control behaviors among native American women and girls

Abstract: Results of a survey administered to 85 Native American girls and women, aged 12–55, revealed that 74% were trying to lose weight and that 75% of those who were dieting to lose weight were employing potentially hazardous techniques. The results also showed that 24% of the dieters used one or more purging behaviors. The mean age of those using pathogenic weight-control methods was 28.8 years. Subjects with higher body mass indexes were more likely to use dangerous weightcontrol methods. These findings suggest that Native American women should be included among the groups at risk for eating disorders and that older and heavier women in this population also should receive attention.

Mood changes and affective disorder in the bulimic binge—Purge cycle

Abstract: Mood changes over the bulimic binge–purge cycle were studied in retrospective questionnaire reports of patients, 16 with and 34 without concurrent affective disorder. Moods clearly differed over phases. Mood reports depicted the period between the binge and purge as most unpleasant, with low energy/excitement and security/relief and high panic/helplessness and guilt/disgust/anger. Feelings after the purge were relatively calm and pleasurable, with low panic/helplessness and excitement/energy and high security/relief. Patients with affective disorder did not differ from those without affective disorder in their mood changes during the cycle.

Parental caring versus overprotection in bulimia

Abstract: Since issues of empathy and control seem important in both the etiology and management of eating disorders, we investigated the relationship of parental caring and controlling to bulimia by administering Parker's Parent Bonding Inventory (PBI) to 56 patients with bulimia and 30 normal controls. Depressive symptomatology, a potentially confounding variable, was assessed with the Beck Depression Inventory (BDI). Parenting style was perceived as being different by bulimics as compared with controls. Bulimics perceived their mothers as significantly less caring, and this difference approached significance for fathers. An analysis of covariance showed no significant effect from depression. These findings support the concept that bulimic patients experience different kinds of parenting experience than normals and this may have etiological and treatment implications.

Lay beliefs about disordered eating

Abstract: Although “disordered eating,” as a set of psychiatric conditions, implicitly evaluates components of a social phenomenon, little attention has been paid to the boundaries between socially accepted and abnormal eating. Lay knowledge and evaluations of the formal criteria for a diagnosis of anorexia nervosa or bulimia were therefore examined. The results show that although males and females know more about anorexia nervosa than bulimia, the DSM-III criteria for anorexia nervosa, which involve the determined pursuit of slimness and a body image disturbance, were judged by very few people to be both uncommon and abnormal. Bulimia, however, seems to be much closer to what is commonly judged to involve unusual behavior.

Body image assessment in patients with bulimia nervosa and normal controls

Abstract: A video image distortion technique was used to assess differences in the perceived (actual) and ideal body size and shape among female patients with bulimia nervosa (n = 12) and two groups of nondepressed, non-eating-disordered women classified as restrained (n = 12) or unrestrained (n = 12) eaters. On the majority of measures of body image the bulimic patients and restrained eaters differed from the unrestrained eaters but did not differ significantly from each other. The results do not show that body image disturbance, at least as it was assessed in this study, discriminates bulimics from appropriate nonclinical controls. In absolute terms the bulimics were more accurate than the controls in estimating their current body size. The latter underestimated their body size. However, the bulimics' estimates were higher in relation to the controls. The discrepancy between perceived body size and ideal body size also differentiated the groups, with the bulimic and restrained subjects exhibiting significantly more discrepancy between perceived and ideal than the unrestrained subjects. Significant correlations between body size estimation and self-report of body satisfaction suggests that evaluation and perception of body are closely associated.

Dissimilarities in eating attitudes, body image distortion, depression, and self-esteem between high-intensity male runners and women with bulimia nervosa

Abstract: It has been suggested that high-intensity exercise regimens in males bear a resemblance to the features of eating disorders and that male runners may resemble women with anorexia nervosa and bulimia nervosa with regard to eating and weight attitudes, negative body image, and negative psychological adjustment. Twenty high-intensity male runners were compared with 20 sedentary-moderate exercising male controls and 20 women with bulimia nervosa. Compared with the bulimia nervosa subjects, the male runners were not anxious about eating, overly preoccupied with food, excessive in binge-eating or purging behavior, negatively preoccupied with their weight, intent on losing weight, high on personality traits presumed to underlie eating disorders, nor depressed or low in self-esteem. The male groups of high-intensity runners and controls were not significantly different on any measure. These results suggest that high-intensity exercising in males is not analogous to anorexia nervosa and bulimia nervosa.

Eating disorders and the mother—Daughter relationship

Abstract: Eating disorders, notably anorexia nervosa and bulimia, are prime examples of gender-specific psychopathology. The author's thesis, based on current research on female development and on extensive clinical experience, is that women's vulner-ability to these disorders derives at least in part from the nature of early female psychosexual development. The early process of separation-individuation from the all-powerful pre-Oedipal mother is enormously more difficult for girls than for boys, since girls must simultaneously individuate from and identify with a primary caretaker of the same sex. Hostile-dependent conflicts and ambivalent struggles for autonomy from the mother may persist life-long in women and are all too easily acted out via abnormal control of food intake and body shape. The paper indicates some of the ways in which these struggles are reenacted in treatment with the therapist, whose efforts to help the patient modify eating patterns are inevitably experienced as maternal intrusions. It also describes some corresponding countertransference reactions evoked in the therapist.

Critical variables associated with bingeing and bulimia in a university population: a factor analytic study

Abstract: Psychometric data and intercorrelations among 24 variables associated with bingeeating and bulimia were reported for a sample of 158 female university students. A factor analysis was performed which extracted five factors: binge-restraint dynamics, psychopathology, social dysfunction, weight and body shape, and achievement. Variables loading on each of these factors were discussed in terms of the theoretical conception of the eating disorders in the literature. It was concluded that the orthogonality of the dimensions suggests that many of the problems that have been associated with severe binge-eating and bulimia may be common problems associated with this type of population and not unique to the disorders.