Childhood Body-Focused Behaviors and Social Behaviors as Risk Factors of Eating Disorders

Abstract

Background: The risk factors for adolescent eating disorders are poorly understood. It is generally agreed, however, that interactions with one’s body and interactions with others are two important features in the development of anorexia and bulimia nervosa. Therefore, we assessed a variety of childhood body-focused behaviors and childhood social behaviors in eating-disordered patients as compared to non-eating-disordered subjects. Method: We compared 50 female inpatients with eating disorders (anorexia or bulimia nervosa), 50 female inpatients with polysubstance dependence, and 50 nonpatient female control subjects with no history of eating or substance abuse disorders (all defined by DSM-IV criteria), using a semi-structured interview of our own design. We asked questions about (1) childhood body-focused behaviors (e.g. thumb-sucking) and body-focused family experiences (e.g. bodily caresses), and (2) childhood social behaviors (e.g. numbers of close friends) and family social styles (e.g. authoritarian upbringing). Results: Many body-focused measures, such as feeding problems, auto-aggressive behavior, lack of maternal caresses, and family taboos regarding nudity and sexuality, characterized eating-disordered patients as opposed to both comparison groups, as did several social behaviors, such as adjustment problems at school and lack of close friends. However, nail-biting, insecure parental bonding, and childhood physical and sexual abuse were equally elevated in both psychiatric groups. Conclusion: It appears that eating-disordered patients, as compared to substance-dependent patients and healthy controls, show a distinct pattern of body-focused and social behaviors during childhood, characterized by self-harm, a rigid and ‘body-denying’ family climate, and lack of intimacy.

Childhood Eating and Weight in Eating Disorders: A Multi-Centre European Study of Affected Women and Their Unaffected Sisters

“…Our study had well-defined AN and BN groups, an older population group and focused on differences in specific feeding/eating problems. Higher rates of childhood feeding problems were also found in inpatients with ED compared to polysubstance dependence individuals and normal controls in a recent study [22]. …”

Menarche, puberty, and first sexual activities in eating‐disordered patients as compared with a psychiatric and a nonpsychiatric control group

“…a Kruskal-Wallis (overall) and Mann-Whitney U-test (pairwise) for continuous variables; Fisher's exact test (overall) and v 2 test (pairwise) for binary variables. b Data on frequency of childhood sexual abuse were previously published [20].…”

Mid-Term Effectiveness of Behavioral and Psychodynamic Inpatient Treatments of Severe Obesity Based on a Randomized Study

“…Based on a review of 36 randomized controlled trials, the NHLBI [12] have concluded in their treatment guidelines that behavior therapy has a beneficial effect regarding long-term weight loss in addition to nutrition counseling, physical training, dietary, and pharmacological intervention. Multimodal treatments taking into account the complex biopsychosocial nature of obesity [13] have therefore been recommended by the NHLBI and other guidelines [2, 12]. …”