FAMILY AND CULTURAL FACTORS IN THE DEVELOPMENT OF EATING DISORDERS: A STUDY OF FEMININE IDENTITY IN TWENTY-FOUR BULIMIC WOMEN

In this study twenty-four bulimic women participated in a questionnaire and semi-structured interview designed to examine their perceptions of themselves, their eating problems, and their families. In accord with the literature in the field, the questionnaire and interview were structured and data analyzed to facilitate a comparison of bulimia and anorexia nervosa. The analysis suggests that eating patterns and family experiences of bulimics and anorexics differ in significant ways. There was no one significant or common eating pattern for all subjects. However, all the women engaged in secretive eating binges which did not appear to be motivated by hunger. Unlike anorexics, all women were acutely aware of their eating problem and shared an obsessive concern with food and body size. None were hyperactive. Most striking was the significance of the late adolescent transition of leaving home. Unlike anorexics for whom entering adolescence is a central conflict, bulimics experience mildly troubled adolescence and more severe difficulty entering adult womenhood. However, for bulimics the problems of adolescence centered on their emerging sexuality and peer relations. These problems highlighted certain characteristics of their relationships with parents. Subjects reported relationships with mothers to be overinvolved and conflict avoidant. Identification with mothers was problematic and conflictual for all women. Subjects described their fathers as emotionally unavailable. Alcohol abuse was present in a significant minority of fathers. During the transition from family of origin to living autonomously dysfunctional eating patterns intensified. It was suggested that conflicts between family culture and the larger culture played a significant role in the development of bulimia. It was concluded that the entire field of eating disorders is in need of further conceptual clarification. Current classification schemes fail to discriminate amongst phenomena that may be discrete in origins and dynamics. A comparison of the early dynamics of individuals suffering from a variety of eating disorders could provide some of the clarification needed