The eating disorders: anorexia nervosa and bulimia nervosa
This chapter addresses the multidimensional nature of eating disorders by exploring sociocultural issues and individual predispositions, including traumatic stress and family factors. It provides a detailed description of the kinds of nutritional assessments used at the time of diagnosis. Laboratory investigations should be as indicated by a patient’s condition and presenting complaints, if an eating disorder has not yet been diagnosed. Eating disorders are dynamic and multifactorial in their etiology. In contrast, research and clinical experience have supported a multidimensional model which looks at a combination of societal, individual and family factors which play a role in the development and maintenance of anorexia nervosa and bulimia nervosa. While neither anorexia nervosa nor bulimia nervosa are glamorous, these disorders have become associated with upper social class, fame and achievement. The clinical expression of anorexia nervosa is associated with emotional, cognitive and behavioral inhibition and rigidity and the ability to demonstrate extreme control over food intake.