Family Structure & Eating Disorders The purpose of this paper is to ex

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM III, 1980) provides five defining diagnostic criteria for Anorexia Nervosa:

(1)Intense fear of becoming obese, which does not diminish as weight loss progresses; (2) Disturbance of body image (e.g. claiming to "feel fat" even when emaciated); (3) Weight loss of at least 25 percent of original body weight; (4) Refusal to maintain body weight over a minimal normal weight for age and height; and (5) No known physical illness that would account for the weight loss.

Although the diagnostic criteria seem clear, Herzog and Copeland (1985) have pointed out that there is controversy surrounding the cause, prevalence, and even treatment of Anorexia Nervosa; further, there is a good deal of disagreement as to whether it represents a distinct disorder or a variant of other disorders.

Onset of the illness usually begins before age 25, and often before age 15 (Habermas, 1989). Prevalence rates are at about one out of every 170 girls; and extrapolations into adulthood put one in every 450 to 750 adult women at risk for life-long chronic primary anorexia (Halmi, 1988). B

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emain in control over eating. Most bulimics feel that even ingesting a small amount of desired food will cause them to binge. Family Structure Several studies have examined familial structures of people diagnosed with anorexia nervosa (e.g. Kalucy, Crisp & Harding, 1977; Minuchin, Rosman & Baker, 1978). In general, these studies have uncovered what seem to be etiological factors such as: (1) early difficulties in the mother-child relationship resulting in separation and individuation problems; and (2) enmeshed, overprotective family environments with rigid modes of behavior and low ability to resolve conflicts. In an examination for contributive family variables to both bulimia nervosa and anorexia nervosa, Strober (1981) compared 22 bulimic anorexic subjects with 22 restricting anorexic families. Findings showed that the bulimic anorexic families evidenced significantly higher levels of conflictual interactions and expressions of negativity than did the families of restricting anorexic individuals. The restrictive anorexic families were also found to demonstrate more mutual support and concern, and more clarity of family rules and responsibility than did the anorexic bulimic families. Further, data showed significant
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