Alexithymia is characterized by difficulties identifying feelings and differentiating between feelings and bodily sensations, difficulties communicating feelings, and a concrete cognitive style focused on the external environment. Individuals with eating disorders have elevated levels of alexithymia, particularly difficulties identifying and describing their feelings. A number of theoretical models have suggested that individuals with eating disorders may find emotions unacceptable and/or frightening and may use their eating disorder symptoms (i.e., restricting food intake, bingeing, and/or purging) as a way to avoid or cope with their feelings. The current critical review synthesizes the literature on alexithymia and eating disorders and examines alexithymia levels across eating disorders (i.e., anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified), the role of alexithymia in binge eating disorder, and the influence of alexithymia on the development of eating disorders as well as treatment outcome. The clinical implications of the research conducted to date and directions for future research are discussed.

When confronted with an anxiety-producing threat to self-esteem, restrained eaters (dieters) increase their food consumption. The functional explanation suggests that increased eating temporarily counteracts or masks dysphoria for the restrained eater; externality or stimulus sensitivity theories propose that distress shifts the dieter's attention to external stimulus properties (e.g., taste) and to activities stimulated by such external cues. In an attempt to distinguish between these two explanations, anxious and nonanxious restrained and unrestrained eaters were given palatable and unpalatable foods, and consumption was measured. Results support the functional explanations: Distressed dieters increased their intake of food regardless of taste properties. Theoretical and practical implications for both restrained eating and the behavior of eating disorder patients are discussed.

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