Eating Disorders: Developmental Psychological and Developmental Psychopathological Perspective

The present article deals with various eating disorders such as anorexia, bulimia, and obesity with a focus on anorexia and bulimia, which have a clear onset in adolescence. Because disturbed eating and weight control are also phenomena in normal girls of this age, eating disorders have to be considered from the perspective of developmental psychology and developmental psychopathology. Body image disorders, disturbed eating habits, and the influence of the family are placed in the context of normal girl development. Since 40 years, a more negative body image of girls as compared with boys has been found in research. Further, the more negative effect of early maturation on body image and dieting in girls is a robust finding in many studies since decades. The role of fathers in establishing a more positive body image and as a stress buffer, especially in early maturing girls, has been frequently overlooked in the past, but was, however, established in more recent studies. These studies also show the long-term effects of a positive body concept for partnerships in the future, in young adulthood. Thus, long-term outcomes of a negative body concept are far more significant and affect not only nutrition and weight control. Family support and nonjudgmental, non-body-related commentary on weight and attractiveness given by parents are very important here. Even with non-eating-impaired adolescents, extreme dieting, fearful body control, as well as problematic parental communication styles have been found. Recent studies revealed a rather high prevalence of psychological disturbances of mothers of anorexic and bulimic patients. This underscores that the mothers are particularly challenged when dealing with their daughters' extreme diets and weight control, which is certainly hard for the mother being diagnosed as depressed, anxious, or having a personality disorder. In this overview, the influence of friends and the new media is also assessed. This indicates often stressful interactions with peers, which are quite typical even in normal girls. Extreme social comparison and rumination as a negative form of communication between girls were described. Therefore, it is difficult to limit the issue to pathological phenomena. In this context, it is important to note that there are high comorbidities between different eating disorders and with internalizing and externalizing mental disorders. The high comorbidity makes it difficult to develop a treatment plan. Historical phenomena such as the "holy anorexia" of the past centuries, the currently observable increase in eating disorders in boys, and the desire to change gender (transgender) are considered, as well as cultural influences ("Is fat beautiful?"). In this context, the question is raised of whether eating disorders have increased and what contribution the new media may have.