452 CHAPTER 10
Operant Conditioning: Reinforcing Disordered Eating
As with many disorders, operant conditioning plays a role in the development
and maintenance of symptoms—in this case, symptoms of disordered eating. Let’s
examine how.
First, the symptoms of eating disorders—anorexia, bulimia, or EDNOS—
may inadvertently be reinforced through operant conditioning. As Hornbacher
recounts:
Eating disorders provide a little private drama.... And they are distracting. You
don’t have to think about any of the nasty minutiae of the real world, you don’t get
caught up in that awful boring thing called regular life, with its bills and its break-
ups and its dishes and laundry and groceries and arguments over whose turn it is to
change the litter box and bedtimes and bad sex and all that, because you are having
areal drama, not a sitcom but a GRAND EPIC, all by yourself, and why would you
bother with those foolish mortals when you could spend hours and hours with the
mirror, when you are having the most interesting sado-masochistic affair with your
own image?
(1998, p. 281)
Hornbacher points out that the symptoms of eating disorders, such as
preoccupations with food and weight or bingeing and purging, can provide dis-
tractions from work pressures, family confl icts, or social problems. The never-
ending preoccupations with food, weight, and body are negatively reinforced
(remember that negative reinforcement is still reinforcement, but it occurs when
something aversive is removed, which is not the same as punishment) because
they can provide relief from what the person might otherwise be thinking about—
ongoing concerns about relationships, fi nances, or feeling social isolated.
Second, operant conditioning occurs when restricting behaviors are posi-
tively reinforced by the person’s sense of power and mastery over her appetite,
although such feelings of mastery are often short-lived as the disease takes over
(Garner, 1997). Hornbacher noted: “The anorexic body seems to say: I do not
need. It says: Power over the self” (1998, p. 85). A third way in which operant
conditioning affects eating disorders occurs when people are positively reinforced
for “losing control” of their appetite and bingeing. How can losing control be
positively reinforcing? Easy: They’ve set up the rules so that they get to eat cer-
tain foods they enjoy (positive reinforcement) only when they let themselves lose
control of their food intake. That is, during a binge, people eat foods that they
normally don’t eat at all or eat only in small quantities—typically fats, sweets,
or carbohydrates. This means that the only way some people can eat foods they
may enjoy—such as ice cream, cake, candy, or fried foods—is by being “out
of control.”
Fourth, like preoccupations with food, weight, and body, the act of bingeing
itself turns off unpleasant thoughts or feelings—and so bingeing is negatively rein-
forced because the binge provides a respite from these thoughts or feelings. Fifth,
bingeing can also induce an endorphin rush, which creates a pleasant feeling much
like a “runner’s high,” which is positively reinforcing. Sixth, operant conditioning
may occur because purging can be negatively reinforcing by relieving the anxiety
and fullness that are created by overeating.
Finally, operant conditioning can contribute to symptoms of eating disorders
because of the social isolation that can arise from the symptoms: Bingeing and purg-
ing are more often done alone, and people with restricting anorexia often prefer to
eat alone. To the extent that social interactions are stressful to people with eating
disorders, the isolation can be a relief, and thereby reinforcing.Personality Traits as Risk Factors
Particular personality traits are associated with—and are considered risk factors
for—eating disorders: perfectionism, harm avoidance, neuroticism, and low self-
esteem.Perfectionism is a persistent striving to attain perfection and excessiveP SN