Frances Smith


Although various factors associated with eating disorders have been studied, no comprehensive source of research findings was identified in this review. The purpose of this study was to identify and synthesize research findings of factors associated with eating disorders in women published from 1992-2008. These findings may be useful to nurses, other professionals, families, and the public to facilitate the prevention, recognition, treatment, and rehabilitation of women with eating disorders.

The factors most closely associated with eating disorders identified through this review were depression, sexual abuse, substance abuse, anxiety disorders, early pubertal onset and the personality traits of perfectionism and impulsivity. No factor was identified as causal, but sexual abuse and anxiety disorders most commonly preceded the eating disorder. Findings varied among eating disorder subtypes, with sexual abuse and substance abuse more common with bulimic symptomology, while depression and anxiety disorders were commonly associated with both anorexia and bulimia nervosa. Perfectionism was most common in anorexics; in one study, it was identified independent of stress and persisted after recovery.

Limitations noted in the research reviewed included using self-report questionnaires, some small samples, exclusion of some eating disorder sub-types, and a predominant use of cross-sectional and clinical samples. Recommendations for further research included using large epidemiological samples containing multiple sub-types and males, as well as longitudinal studies and methods to determine causal relationships among eating disorders and the associated factors identified. Implications for nursing education, practice, and policy development focused on improving screening during physical examinations and interviews, posing questions to facilitate disclosure, addressing emotions elicited, and suggestions for routine monitoring of patients in clinical settings.


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