Co-occurrence of Anxiety Disorders and Eating Disorders
Considering the growing preoccupation of teenage girls with their weight and their bodies, eating disorders have become even more of a concern. In light of the fact that mortality in anorexia nervosa is among the highest of all psychiatric disorders, it is increasingly important to understand what causes eating disorders and how best to treat them (Herzog et al., 1996). A meaningful area of research to consider when trying to understand eating disorders is comorbidity. Such psychiatric disorders such as anxiety disorders, affective disorders, personality disorders, and substance abuse have been found to coexist, at least to some degree, with the eating disorders anorexia nervosa and bulimia nervosa. This paper will examine how anxiety disorders have been found to interact with both anorexia nervosa and bulimia nervosa.
II. Definitions of the Eating Disorders and Anxiety
The DSM-IV outlines four criteria for anorexia nervosa (APA, 1994). One, a refusal to maintain body weight over a minimal normal weight for age and height (i.e., weight loss leading to maintenance of body weight less than 85% of that expected). Two, an intense fear of gaining weight or becoming fat, even though underweight. Three, a disturbance in the way in which one’s body weight, size, or shape is experienced (i.e., denial of the seriousness of current low body weight, or undue influence of body shape and weight on self-evaluation). Four, in post-menarcheal, amenorrhea (the absence of at least three consecutive menstrual cycles). Two types of anorexia nervosa are defined. The binge eating/purging subtype means that the individual engages in recurrent episodes of binge eating or purging during the episodes of anorexia nervosa. The restricting subtype means that the person does not engage in binge eating or purging during the episodes of anorexia nervosa.
The DSM-IV outlines five criteria for bulimia nervosa (APA, 1994). One, there are recurrent episodes of binge eating. Binge eating is defined as eating in a discrete period of time an amount of food that is definitely larger that most people would consume in a similar period of time. The binge eating must also be characterized by a sense of lack of control over eating. Two, there are recurrent inappropriate compensatory behaviors in order to prevent weight gain such as self-induced vomiting, the misuse of laxatives or diuretics, fasting, or excessive exercise. Three, the binge eating and inappropriate compensatory behavior both occur, on average, at least twice a week for three months. Four, self-evaluation is unduly influenced by body shape and weight. Five, the disturbance does not occur exclusively during episodes of anorexia nervosa. There are two types of bulimia nervosa: the purging type (the person regularly engages in self-induced vomiting or the misuse of laxatives or diuretics) and the nonpurging...