ABSTRACT
The starvation syndrome itself contributes behaviourial effects such as bingeing, hoarding and stealing food, and cognitive effects such as preoccupation with food, awareness of hunger. The range of defensive strategies employed to resist the impulse to eat and gain weight include: dietary restriction, excessive exercise, vegetarianism, and protective ritualistic behavior. The strains of sustaining this stance and the isolation and lack of fulfilment that go with it lead sooner or later to exhaustion and despair. On the other hand any failure to protect against even minor weight gain can generate panic and disgust and lead to self-damaging behaviour, e.g. cutting/overdoses. The anorectic is in a no-win situation although she may attempt to represent her state as fulfilling since it is her last refuge and, as already indicated, suicide may be preferable to weight gain. So-called ‘depression’ may therefore be a prominent feature at any stage but especially so as the disorder becomes chronic.
