Psychology2016

568 CHAPTER 14

female, are obsessed with their appearance, diet excessively, and believe themselves

to be fat even when they are quite obviously not fat. But individuals with bulimia are

typically a little older than individuals with anorexia at the onset of the disorder—

early 20s rather than early puberty. Individuals with bulimia often maintain a normal

weight, making the disorder difficult to detect. The most obvious difference between

the two conditions is that the individual with bulimia will eat, and eat to excess, bing-

ing on huge amounts of food—an average of 3,500 calories in a single binge and as

much as 50,000 calories in one day (Humphries, 1987; Mitchell et al., 1981; Oster, 1987).

A typical binge may include a gallon of ice cream, a package of cookies, and a gallon of

milk—all consumed as quickly as possible.

But wait a minute—if individuals with bulimia are so concerned

about gaining weight, why do they binge at all?

The binge itself may be prompted by an anxious or depressed mood, social stress-

ors, feelings about body weight or image, or intense hunger after attempts to diet. The

binge continues due to a lack of or impairment in self-control once the binge begins.

The individual is unable to control when to stop eating or how much to eat. Eating one

cookie while trying to control weight can lead to a binge—after all, since the diet is com-

pletely blown, why not go all out? This kind of thought process is another example of the

cognitive distortion of all-or-nothing thinking.

One might think that bulimia is not as damaging to the health as anorexia. After

all, the individual with bulimia is in no danger of starving to death. But bulimia comes

with many serious health consequences: severe tooth decay and erosion of the lining of

the esophagus from the acidity of the vomiting, enlarged salivary glands, potassium,

calcium, and sodium imbalances that can be very dangerous, damage to the intestinal

tract from overuse of laxatives, heart problems, fatigue, and seizures (Berg, 1999).

BINGE-EATING DISORDER Binge-eating disorder also involves uncontrolled binge eat-

ing but differs from bulimia primarily in that individuals with binge-eating disorder

do not purge or use other inappropriate methods for avoiding weight gain (American

Psychiatric Association, 2013).

CAUSES OF EATING DISORDERS The causes of anorexia, bulimia, and binge-eating

disorder are not yet fully understood, but the greatest risk factor appears to be someone

being an adolescent or young adult female (Keel & Forney, 2013). Increased sensitivity

to food and its reward value may play a role in bulimia and binge-eating disorder,

while fear and anxiety may become associated with food in anorexia nervosa, with

altered activity or functioning of associated brain structures in each ( Friedrich et al.,

2013; Kaye et al., 2009; Kaye et al., 2013). Research continues to investigate genetic

components for eating disorders, as they account for 40 to 60 percent of the risk for

anorexia, bulimia, and binge-eating disorder, and although several genes have been

implicated, the exact ones to focus on have not yet been identified (Trace et al., 2013;

Wa d e e t a l. , 2 0 1 3 ).

Although many researchers have believed eating disorders, especially anorexia,

are cultural syndromes that only show up in cultures obsessed with being thin (as

many Western cultures are), eating disorders are also found in non-Western cultures

(Miller & Pumariega, 1999). What differs between Western and non-Western cultures is

the rate at which such disorders appear. For example, Chinese and Chinese American

women are far less likely to suffer from eating disorders than are non-Hispanic white

women (Pan, 2000). Why wouldn’t Chinese American women be more likely to have

eating disorders after being exposed to the Western cultural obsession with thinness?

Pan (2000) assumes that whatever Chinese cultural factors “protect” Chinese women

This young model is not merely thin;
by medical standards, she is probably
at a weight that would allow her to be
labeled as having anorexia. The “thin
is in” mentality that dominates the field
of fashion design models is a major
contributor to the Western cultural
concept of very thin women as beautiful
and desirable. The model pictured here
is a far cry from the days of sex symbol
Marilyn Monroe, who was rumored to be
a size 12.

binge-eating disorder
a condition in which a person overeats,
or binges, on enormous amounts
of food at one sitting Dut unliMe
bulimia nervosa, the individual does
not then purge or use other unhealthy
methods to avoid weight gain.