and Eating Disorders
RUTH H. STRIEGEL-MOORE
The pronounced gender differences in the distribution of anorexia nervosa and bulimia nervosa (see Chapter 33) have prompted the question of why eating disorders are so disproportionately more common among girls and women than among boys and men. The answer likely lies in gender differences in both biological and environmental factors. However, research on the contribution of biological factors is in its infancy. Evidence concerning genetic influences is inconclusive (see Chapters 42 and 43), and current pharmacological treatments have limited efficacy (see Chapters 58 and 64), raising the possibility that biological factors are not at the core of eating disorders. Little prospective research establishes that hormonal or neurotransmitter dysfunction predate eating disorders. One of the most promising findings, that dieting may trigger lowered 5-HT in women but not in men, underscores the interaction of a culturally induced behavior (dieting) and biological vulnerability.
Research on gender differences has focused largely on cultural factors. In this line of research, risk for the development of an eating disorder has been hypothesized to derive from women’s subordinate position in society, female gender role socialization, and the contemporary female beauty ideal of extreme thinness. Few would dispute the validity of the cultural model’s core assertions that, as a group compared to males, females are more likely to have less access to positions of power, earn less money, experience more sexual abuse and harassment, and be socialized toward adopting traditionally feminine behaviors of caring for and nurturing others and of pursuing physical attractiveness. There also is substantial empirical evidence linking some of these experiences, especially the internalization of the culturally defined thin ideal and exposure to sexual harassment and abuse, to risk for developing an eating disorder.
The emphasis on the role of cultural factors in the etiology of eating disorders is often justified further by the observation that eating disorders are significantly less common