ABSTRACT
Within the Diagnostic and Statistical Manual (4th ed.; DSM-IV) definitions of anorexia nervosa (AN) and bulimia nervosa (BN), one cognitive symptom is shared: the undue influence of weight and/or shape on selfevaluation (APA, 2000). As discussed in chapters 13 and 14, the cognitive imperative for both AN and BN is to control body weight or shape. The consequence of a failure to do so is a devaluation of the self. However, in understanding cognitive vulnerability to eating disorders, the distinction between etiological risk factor and symptom arises. Is it fair to conclude that overconcern with weight and shape represents a cognitive vulnerability factor when overconcern is part of the phenomenon for which it is supposed to increase risk? Leon, Keel, Klump, and Fulkerson (1997) addressed this question by noting that some risk factors may differ from the phenomenon they predict by degree rather than quality. Indeed, longitudinal research by Killen et al. (1996) demonstrated that weight concerns prospectively predicted development of bulimic symptoms in high school girls after controlling for levels of bulimic symptoms at baseline. Although stating that weight and shape concerns increase risk for disorders characterized by weight and shape concerns may seem tautological, there is merit in exploring the nature of these cognitive factors as has been done by Abramson and her colleagues (Bardone, Vohs, Abramson, Heatherton, & Joiner, 2000; Vohs, Bardone, Joiner, Abramson, & Heatherton, 1999; Vohs et al., 2001). Such work has revealed why weight and shape concerns contribute to the development of eating disorders in only a minority of women who wish to lose weight.
