Eating Disorders 451
And once an eating disorder develops, the thoughts and behaviors associated with it
can take on a life of their own, as Hornbacher reveals:
I stood in the kitchen after school, scarfi ng down food without tasting it, staring at the
television without seeing it. I would go through the perfunctory motions: washing my
dishes, going into the bathroom, puking. In the bedroom, I’d stare at the mirror. When
I entered junior high, at twelve, I’d been throwing up almost daily for three years. In
the seventh grade, it increased to two or three times a day. I began to do it whenever
I got the chance.
(1998, p. 59)
Many risk factors are not uniquely associated with eating disorders. Factorssuch as gender (female), ethnicity (White), negative self-evaluation, sexual abuse and
other adverse experiences, the presence of comorbid disorders (e.g., depression and
anxiety disorders; Jacobi et al., 2004), and using avoidant strategies to cope with
problems (Pallister & Waller, 2008; Spoor et al., 2007) are also associated with psy-
chological disorders more generally. Thus, many researchers have focused on fac-
tors that are specifi cally related to symptoms of eating disorders: factors associated
with food, weight, appearance, and eating. In the following sections we examine
research fi ndings about these factors.
Thinking About Weight, Appearance, and Food
Based on what you’ve already read about eating disorders, it shouldn’t come as
a surprise to learn that people with eating disorders have irrational and illogical
thoughts about weight, appearance, and food. Specifi cally, these automatic and irra-
tional thoughts tend to be about their own weight and appearance and their moral
evaluation of eating (Garfi nkel et al., 1992; Striegel-Moore, 1993). We consider
these two kinds of thoughts in the following sections.
Excessive Concern With Weight and Appearance
Some people with eating disorders have excessive concern with and tend to over-
value their weight, body shape, and eating (Fairburn, 1997; Fairburn, Cooper, &
Cooper, 1986). For instance, they may weigh themselves multiple times a day and
get depressed when the scale indicates that they’ve gained half a pound. The two
characteristics that are among the most consistent predictors of the onset of an eat-
ing disorder are dieting and being dissatisfi ed with one’s body (Thompson &
Smolak, 2001). Some people are so concerned with weight and appearance that
their food intake, weight, and body shape come to defi ne their self-worth. Such
concerns help maintain bulimia in that people believe that their compensatory
behaviors reduce their overall caloric intake (Fairburn et al., 2003).
Abstinence Violation Effect
Many people who have an eating disorder engage in automatic, illogical, black-
or-white thinking about food: Vegetables are “good,” whereas desserts are “bad.”
They may come to view themselves in the same way: They are “good” when acting
to lose weight, “bad” when eating a “bad” food or when they feel that their eating
is out of control. Once they are “bad” in a given situation, they might allow them-
selves to continue to be “bad.” Because they have violated their rules for abstain-
ing from “bad” eating behavior, they then proceed to ignore the rules and binge.
This pattern illustrates the abstinence violation effect (Polivy & Herman, 1993),
in which the violation of a self-imposed rule about food restriction leads to feeling
out of control with food, which then leads to overeating. For instance, having taken
a taste of a friend’s ice cream, an individual thinks, “I shouldn’t have had any ice
cream; I’ve blown it for the day, so I might was well have my own ice cream—in
fact, I’ll get a pint and eat the whole thing.” Then, after she eats the ice cream, she
tries to negate the calories ingested during the binge by purging or using some other
compensatory behavior. Thus, the abstinence violation effect explains bingeing that
occurs after the individual has “transgressed.”
Abstinence violation effect
The condition that arises when the violation
of a self-imposed rule about food restriction
leads to feeling out of control with food,
which then leads to overeating.