The confluence of perfectionism, body dissatisfaction, and low self esteem predicts bulimic symptoms: Clinical implications

We present abrief overview of empirically supported risk factors of bulimic behav-ior. We then propose an empirically supported, interactive, three-factor model of bu-limic symptom occurrence from which we derive clinical implications for assessment, treatment, and prevention. Our research finds that perfectionism, body dissatisfaction, and self-esteem interact o predict bulimic symptoms. In particular, women who consider themselves overweight and who have elevated levels of per-fectionism and lower levels of self-esteem show the greatest risk for bulimic symp-toms. Thus, our model identifies three theoretically related targets for intervention: perfectionism, body dissatisfaction, and low self-esteem. Assessment of these fac-tors is recommended. The extent o which cognitive-behavioral therapy for bulimia and interpersonal therapy for bulimia address these factors is reviewed and evalu-ated, and theory-based recommendations are made for prevention efforts. An empirically supported theory of the occurrence of bulimic symptoms would have great clinical value because such a theory would highlight point