Anorexia Nervosa

Etiology

Anorexia often develops in early to midadolescence following a successful weight loss attempt that subsequently spirals out of control. It is rare, but possible, for prepubertal children to develop the disorder as well. Individuals diagnosed with AN are most often female; only 5% to 10% are male. Estimates of prevalence in the population of those meeting full diagnostic criteria range from 0.28% to 1.0%, although the numbers may be greater in special high-risk populations, such as ballet dancers or those in appearance-conscious professions. Historically, eating disorders were considered to affect primarily middleto upper-class Caucasian women in Western cultures. Recent research suggests that a trend of body [Page 84]image dissatisfaction is rising among many ethnic minority groups in the United States, particularly Hispanics and Asian Americans (e.g., Cachelin, Veisel, Barzegarnazari, & Striegel-Moore, 2000). Cross-cultural rates of eating disorders appear to be increasing as well. This increasing diversity of people with eating disorders introduces additional challenges for research and treatment.

There are multiple possible contributors to the development of AN. Genetics appears to play an important role. Twin studies show that the concordance rate of AN is 55% among monozygotic twins and 5% in dizygotic twins (Treasure & Holland, 1989). Other research indicates that a genetic predisposition for leanness or particular personality traits (e.g., perfectionist or obsessive personality) may also contribute to the development of AN. Environmental factors, such as societal emphasis on thinness and appearance or familial attitudes toward weight are also likely to play a role. Further research is needed in this area to aid in efforts to prevent eating disorders.

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