The importance of being thin : perceived expectations from self and others and the effect on self-evaluation in girls with disordered eating

The overall aims of this thesis were to examine personal standards, self-evaluation and attitudes to eating and weight in the development of disturbed eating in adolescent girls, and to examine how adolescent girls with a clinical eating disorder reflect upon and deal with perceived expectations in daily life. Studies I and II were quantitative studies, conducted in a population-based longitudinal study. Studies III and IV were qualitative interview studies of girls who were suffering from eating disorders and the data were analysed using a phenomenographic approach. Study I showed that high personal standards expressed in a competitive way were specific for the girls with disturbed eating. These girls also reported a negative physical self-evaluation and often believed that thinness would make them more popular. In study II variables concerning attitudes to eating and weight and physical self-evaluation emerged as risk factors for disturbed eating, whereas personal standards or self-evaluation in general did not. Protective factors were a low BMI, healthy eating attitudes, an accepting attitude towards body size and a positive self-evaluation. Three categories of perceived expectations were described in study III: expectations from others, self-imposed expectations and conflicting expectations. Many informants had problems identifying expectations that were not explicit and they interpreted them as self-imposed. In study IV the various ways in which the informants reflected on dealing with these expectations were summarized into three qualitatively different conceptions: being oneself, adapting to different situations and presenting oneself in a positive light. These conceptions were expressed in five patterns of action, which could have various functions for different individuals and in different situations. The results suggest that in order to prevent and treat eating disorders and related problems it is essential to integrate both intrapersonal and contextual factors that contribute to the development and maintenance of these conditions