In an investigation of eating disorders from an object relations and self psychological perspective, which originally began as a personal inquiry into bulimia, the psychoanalytic framework for anorexia and bulimia is examined. Although these theories tend to generalize all disturbed relationships with food as “eating disorders” and discuss the category as a whole, considering the differences between anorexia and bulimia, in symptom manifestation, causation, and treatment, provides a more complete understanding of the eating disordered patient in her psychic structure and relationship with reality, the external world, and others. Ultimately, these differences complicate the approach to psychoanalytic treatment, but recognition of where anorexic and bulimic patients diverge may imbue the therapeutic space with new hope.
This paper investigates the hypothesis of rational addiction theory as it pertains to Bulimia Nervosa. Bulimia is currently classified as a mental health disorder, and while psychological studies often allude to the addictive nature of the disorder, it is imperative to reinforce theory with empirical data. A rational addiction model is derived through the maximization of the agent’s utility function, which incorporates measures of bulimia and bulimic risk factors that are supported by the existing literature. The theoretical model was tested on an empirical data set collected from a study conducted by the National Heart Lung and Blood institute. The dependent variable was an index constructed for the purpose of measuring one’s severity of bulimic behaviors and tendencies. Emphasis was placed on the significance of the lagged variable on bulimia as a method of capturing persistence in behavior over time. The results found that lagged and lead variables of the bulimic index each accounted for about 12% - 20% of current bulimic behavior.