Disturbances in identity and self-regulation in bulimia nervosa: Implications for a metaphorical perspective of “body as self”

Abstract

This study investigates a metaphorical account of bulimia that proposes that bulimics lack a clearly defined sense of self, and subsequently utilize their physical bodies as a means of self‐definition and regulation. Three major aspects of this perspective were assessed: identity disturbance; use of the binge and purge as means of emotional regulation; and sensitivity to interpersonal contact. Differences among bulimics, binge eaters, and normal controls were explored. Bulimics reported greater amounts of identity confusion, enmeshment, and overall instability in self‐concept than normal controls and binge eaters. The binge led to an escape from self‐awareness for bulimics, and the purge served to manage negative affect. Bulimics also showed greater sensitivity to interpersonal contact with positive people, and with their mother than both binge eaters and controls. Implications of the findings are discussed as well as future directions for research. © 1993 by John Wiley & Sons, Inc.

The Relationship between (binge) Eating and Identity Issues in Pre-bariatric Patients

“…First, emotional eating, that is, eating driven by emotions, is positively associated with identity confusion in patients with binge eating, and positively related to being female in patients without binge eating. These results is in line with earlier studies [29][30][31][32]37] which state that binge eating is a way to cope with the distress coming from identityrelated decisions. This is also confirmed by the finding that we found no significant relation between identity synthesis and emotional eating for those patients who engage in binge eating, suggesting that binge eating is not a way to cope with negative emotions in general, but is specifically used to deal with identity-related distress among those with a more confused identity.…”

“…Our results showed that patients who engage in binge eating have a more confused identity than patients without binge eating, whereas no significant difference was found for identity synthesis. These results are in line with the findings of Schupack Neuberg and Nemeroff [30], who reported higher levels of identity diffusion in university students with binge eating. These findings also confirm prior studies which link the presence of identity confusion to more maladaptive psychological functioning [27,28], and eating disorder-related behaviors in particular [41].…”

“…Such a mechanism may result in disinhibition and, subsequently in binge eating. Relatedly, Schupack-Neuberg and Nemeroff [30] found that university students with binge eating report higher levels of identity confusion than normal controls. They also found that identity confusion is positively related to escape from the self during a binge.…”

“…First, we investigate whether pre-bariatric patients with binge eating show higher levels of identity confusion and/or lower levels of identity synthesis compared to pre-bariatric patients without binge eating controlled for gender and age, given that they may struggle more with identity-related issues and comorbid psychopathology. Based on the literature [30], we hypothesize that pre-bariatric patients with binge eating will score higher on identity confusion compared to patients without binge eating. Given that no literature is available on identity synthesis, we tentatively explore this dimension as well.…”

Pathoplasticity of bulimic features and interpersonal problems

“…Empirical research has consistently demonstrated that bulimic symptoms are associated with a host of interpersonal difficulties, [1][2][3][4][5][6][7][8][9] and that elevated interpersonal problems persist many years after an initial diagnosis. 10 Research also suggests that, like eating disorders themselves, the eating disorderinterpersonal problem relation is stronger in women than men, 11 and that women with bulimia nervosa tend to experience more interpersonal difficulties than women with anorexia nervosa.…”