Shared Precursors For An And Bn

Certain trends in contemporary Western and increasingly Eastern society [15] increase the risk for an essential precursor to occur, namely food restriction or dieting. Foremost among those trends is slimness as a beauty ideal for contemporary women. Thinness as a personal goal, linked to expectations that it will bring social approval and improved self-confidence, presents a challenge to all female adolescents who do not fit the ideal shape. Societal attitudes sensitize these young women to body dissatisfaction, enhancing chances for dietary restriction to bring about body weight loss. An equally important factor is the simplistic belief that everyone can ultimately attain a ''perfect'' body shape. This challenge to reshape the body is keenly experienced by female adolescents, who accumulate adipose tissue with the growth spurt of puberty. By contrast, male adolescents welcome weight increases and tend to exercise to increase muscle strength.

The emphasis on dietary restriction occurs in a population that has become heavier [16]. In 1983, the norms for body weights listed in the Metropolitan Life Insurance Tables were adjusted upward from the earlier 1964 version. The high prevalence of dieting among female adolescents, between 60% and 80% in the Western hemisphere [17,18], viewed against the low incidence and prevalence of eating disorders, suggest that the relative risk - the magnitude of the association between exposure and disease - is low for AN and somewhat higher for BN. As Bruch [19] aptly commented, ''there is an epidemic of dieting, but not an epidemic of eating disorders''.

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