Body Image and Bulimia Nervosa
Bulimia nervosa is a prevalent and chronic psychiatric disorder associated with marked comorbid psychopathology. In addition, bulimic pathology increases the risk for subsequent onset of obesity, substance abuse, and major depression. Accordingly, it is important to elucidate the processes that result in the onset and maintenance of this serious psychiatric disturbance so that optimally effective preventive and treatment interventions can be developed.
Body image disturbances have emerged as one of the most potent risk factors for the development and maintenance of bulimia nervosa. The broad construct of body image disturbances refers to (1) internalization of the socioculturally prescribed body image ideal (thin-ideal internalization), (2) negative subjective evaluations of one's physical appearance (body dissatisfaction), and (3) distorted perceptions of body image (body image distortions). Body image disturbances should be distinguished from the overemphasis placed on weight and shape in determining self-worth, which is a symptom of bulimia nervosa. The importance of understanding the adverse effects of body image disturbances is underscored by the fact the majority of women in Western cultures report at least moderate body dissatisfaction. This chapter describes the theoretical accounts of the origins and consequences of body image disturbances, summarizes extant empirical findings, notes conceptual and methodological limitations of this literature, discusses clinical implications of these findings, and suggests potentially profitable directions for future research.