Premorbid factors in adult disorders of weight, with particular reference to primary anorexia nervosa (weight phobia). A literature review

Perceptual Experiences in Anorexia Nervosa and Obesity*

“…Some argue that the neuroendocrine changes affecting menses and fertility in anorexia nervosa may be fundamental to the disorder (84), although many changes except the immature luteinizing hormone pattern, are largely secondary to a starvation syndrome (3). Although it has been shown that there is a degree of heterogeneity with anorexic patients in terms of symptoms (20,24,57), personality (20,24) and body image (33,35) there is evidence suggesting that obesity is an even broader disorder with many determinants. Mayer (63) has experimentally isolated 12 different procedures for producing obesity in rats.…”

Integration and Sequencing of Treatment Approaches for Eating Disorders

“…It has been our general clinical experience and that of others [Andersen, 1985;Crisp, 1970;Vandereycken and Meermann, 1984] that either outpatient or inpatient group psy chotherapy alone is ineffective for emaciated anorexic patients. In an inpatient milieu, structured groups aimed at training in social skills, assertiveness, nutrition, relaxation and body image development can play a valuable role as adjuncts to individual or family therapy.…”

“…Family therapy has been recommended as the primary clinical strategy in both an orexia nervosa [Minuchin et al, 1978] and bulimia nervosa [Schwartz et al, 1985], or as an adjunct to other methods [Andersen, 1985;Bruch, 1973;Crisp, 1970;, Family treatment focuses heavily on challenging the enmeshed and overprotective interactional styles. Sessions are aimed at identifying and examining assump tions implied by excessive intrusion, encour aging the direct expression of previously avoided emotions such as anger, depression and anxiety, supporting parental limit-set ting and attempting to defuse the pressures that have mounted as a result of months or years of frustration in contending with the eating disorder.…”

“…In contrast. Crisp [1970] has proposed that eating disorders represent a retreat from the psychosexual demands of adolescence. Minuchin et al [1978] have linked them to specific family interactional patterns.…”

Eating disorders: clinical features and the role of the general psychiatrist

“…A fear of normal body weight Several near-synonyms have been used to describe this specific attitude, including 'fear of fatness' (Russell 1970), 'weight phobia' (Crisp 1970) and 'the pursuit of thinness' (Bruch 1965). Indeed, the fear of normal body weight is so common in anorexia nervosa that it is seen as pathognomonic of the condition.…”