Eating disorders: an overview

Eating disorders (ED) include three main categories, according to DSM-IV (American Psychiatric Association, APA, 1994): Anorexia Nervosa (AN),

Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS). Eating disorders are characterised by serious disturbances in eating behaviour and overvalued attitudes about body weight and shape for selfevaluation (APA, 1994). Eating disorders occur primarily in female adolescents and young women with only approximately 10 percent of cases occurring in males (APA, 1994). Researchers propose that during the past 50 years, ED have been on the increase (Hsu, 1996; Hartley, 1998). Until recently, ED were mainly found in Western societies. However, accumulative research suggests that ED are becoming more widespread globally, especially in Japan and Hong Kong (e.g., Lee, 1993). Eating disorders are complex, serious and potentially life threatening conditions. There can be a number of health consequences involving both emotional and physical health. Eating disorders, especially AN, commonly have their onset in adolescence which is a time of rapid growth and development (APA, 1994). Eating disorders can thus seriously interfere with normal physical development. Everyday living can also be dramatically impaired affecting ability to continue school or work and socialise with family and friends.

Reports of disordered eating date back to the end of the 17th century where a description of a disorder apparently like AN was documented by Richard Morton (Vandereycken, 1995). However, the disorder was not recognised as a clinical condition until approximately two centuries later when explicit accounts of AN were given almost simultaneously in 1873 by a clinician named Ernest-Charles Las├Ęgue in Paris and in 1874 by a physician named William Withey Gull in London (Bemporad, 1996). Bulimia nervosa was first distinguished from AN by a British psychiatrist named Gerald Russel in 1979 (Ziolko, 1996). These early historical accounts of ED have led some researchers to question whether ED are solely phenomenon of contemporary societies (Bemporad, 1996). Self-starvation throughout history has served as expressions of religious devotion, detachment from the material world and rejection of bodily needs, in different cultures and at different time epochs (Bemporad, 1996). However, research findings of an increase in the incidence of ED over the last 50 years (Hsu, 1996; Hartley, 1998) parallel the trend of progressively slimmer female body ideals in Western societies (Stice, 1994). This, in combination with ED being highly gender and age specific suggests contribution of socio-cultural factors. However, it is important to note that multiple factors contribute to the development of ED where different factors can play a role, in varying degrees, for different individuals