You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The increased incidence of bulimia has spurred considerable research but little consensus on the etiology, definition, and treatment of the disorder. Investigators have cited numerous etiological factors associated with bulimia, including epileptic disorders, social/cultural factors, and psychopathological conditions. Affective disorders, depression, and anorexia nervosa have all been explored as potential causes of bulimia. Bulimia has also been conceptualized as a variant of obesity. While there is some evidence to suggest that each model has some explanatory power, no single approach or understanding has been proved superior. Bulimia takes on multiple forms, from a relatively benign social bingeing followed by vomiting, to more severe forms that are long-term and out of control. Different categories of bulimia have been proposed, such as neurotic, anorexic, and borderline schizophrenic types. Multiple approaches to intervention are advocated, including psychopharmacological treatment, psychoanalytic and behavioral psychotherapies, and various combinations of these. Mixing treatment approaches makes it extremely difficult to assess treatment outcomes. However, the optimal psychotherapeutic treatment appears to be a combination of behavioral interventions (to bring symptoms under control) and psychoanalytic treatment (to maintain symptom-free functioning and to facilitate further growth).