Eating disorders: identification and treatment in obstetrical patients

Eating disorders are well defined in females ages 14 to 24, and consist primarily of anorexia nervosa (AN) and bulimia nervosa (BN). Collectively, these two eating disorders are characterized by severe disturbances in eating behaviors and acute distress over body shape and weight. In AN, fear of weight gain coupled with a distorted body image leads to refusal to maintain a minimally accepted body weight (American Psychiatric Association [APA], 1994). Although women with BN also overvalue body size and shape, this disorder is characterized by episodes of binge eating followed by efforts to undo the binge episode (oral purging is the most widely known effort) (APA, 1994). Developmental, psychological, socioenvironmental and behavioral factors contribute to the complex development and persistence of AN and BN (Rosen & Neumark-Sztainer, 1998).