ABSTRACT
When studying eating disorders, it is important to distinguish the processes that may have caused the problem to start from those that ensure its persistence (the so-called maintenance factors of eating disorders). Unfortunately, the causes of eating disorders have yet to be demonstrated, although data suggests that they seem to arise through a complex interaction of genetic and environmental risk factors. Some specific psychological theories have attempted to explain how eating disorders persist. Among these, cognitive behaviour theory is the one that has influenced treatment in the most significant way. According to this theory, a distinctive self-evaluation scheme—i.e., the overvaluation of shape, weight, eating, and their control—is of central importance in maintaining eating disorders. Indeed, the other specific clinical features of eating disorders appear to derive directly from this core feature and, in turn, maintain in a state of continuous activation the preoccupation with and overvaluation of shape, weight, and eating control. As a result, the eating-disorder mindset becomes locked in the sufferer’s mind. Enhanced cognitive behaviour therapy, a psychological treatment derived from this theory and described in Part II of this book, has been designed to address the processes of maintaining eating disorders.
