Abstract

Bulimia nervosa appears to be a significant medical condition and a serious social problem since it requires long term and multi-dimensional treatment, and its incidence rates among young generation (predominantly women), has incresed significantly in recent years. The results of scientific research described in psychological and psychiatric literature point to a variety of factors that contribute to development of this eating disorder [Fairburn, Harrison, Lacey, Evans, Thompson, Cash, Pruzinsky, Garner, Jozefik, Glebocka, Rabe Jablonska, Dunajska, Mikolajczyk, Samochowiec, Schier]. The most significant underlying factors include: biological disturbance of hunger and satiety sensing, familial factors (early childhood emotional deficits and traumatic experiences), socio-cultural factors (body image disturbances which develop as a consequence of the “terror” of a slim body, which is being promoted as the only way to success in life), as well as some individual factors such as impulse regulation disturbances, impulsivity, low frustration tolerance, neuroticism, perfectionism, obsessive-compulsive, borderline or histrionic personality disorders [Lacey, Mikolajczyk, Samochowiec]. Lacey and Evan, who defined the concept of Multi Impulsive Personality Disorder, included bulimia nervosa among its major symptoms [Lacey]. In the light of the recent psychological literature, cognitive and emotional body image disturbances are regarded as significant factors behind development of anorexia and bulimia nervosa [Thompson, Cash, Glebocka, Kulbat, Rabe Jablonska, Schier]. However, far less scientific research is devoted to body image and the body self distortions in individuals suffering from bulimia nervosa [Rabe-Jablonska, Dunajska]. The recently observed higher incidence of bulimia nervosa (especially among women), compared to anorexia nervosa, seems to point to a multitude of factors that determine development of this disorder. It also indicates the spread of the cultural cult of “ideal and perfect” body image, and the tendency to conform to social norms regarding physical appearance (“what I should look like”) and to disapprove of one’s current body shape, which is being promoted as a key to success in life. Thus it can be stated that adequate medical care as well as the quality of family, professional and social roles performed in life significantly support a psychological diagnosis of the body self structure, and determine effective therapy for bulimia nervosa. It is a psychological diagnosis of body experiences and body image in anorexia and bulimia nervosa that I have focused on in my many years of scientific research and therapeutic work with bulimic and anorectic patients [Izydorczyk, Bienkowska, Klimczyk].

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