AN ANNOTATED BIBLIOGRAPHY

                             Christy Valentine

This annotated bibliography was developed for professionals, 
students, and the general public in an effort to ascertain the 
prevalence and impact of eating disorders in adolescents.  Items 
researched for this bibliography were cited in electronic article 
and book indexes (i.e. Silver Platter/PsycLit; InfoTrac/Expanded 
Academic; FirstSearch Basic/Periodical Abstracts, ArticleFirst, 
Wilson Select, and BooksInPrint; and FirstSearch Premium/
HumanitiesAbs, SocialSciAbs, WilsonSelectPlus, and WorldCat).  
Inclusion was based on currency, new focuses, and new findings 
of eating disorders and adolescents in both scholarly and general 
works.  A list of Internet resources accompanies the annotated 

In addition to the items included in this bibliography, it is 
worth nothing several journals devoted to the research of 
eating disorders alone (i.e. Eating Disorders Journal of 
Treatment and Prevention, European Eating Disorders Review: 
The Journal of the Eating Disorders Association, and 
International Journal of Eating Disorders).  There are also 
several nursing textbooks with in-depth coverage of diagnosis 
and treatment for disordered eating.  A true gem published in 
the year two thousand is a book series entitled A Teen Eating 
Disorder Prevention Book.  Written to adolescents, this series 
comprehensively covers prevention, detection, related factors, 
and treatment of eating disorders.  What makes this series so 
valuable is the additional information and resources listed 
in the back of each book, allowing a teenager to seek help 

It has been documented that anorexia nervosa has the 
highest mortality rate of all psychiatric illnesses.  
Most bulimics, who use self-induced vomiting to purge, 
only rid their body of one third the calories they take in 
during a high caloric binge, resulting in little weight 
loss if any at all.  Traditional beliefs about eating 
disorders have been disproved by current longitudinal and 
cross-cultural studies.  Eating disorders are not confined 
to western, middle-class, white-females but cross cultures, 
social economic status, and gender.

In conclusion, it has been found that eating disorders are 
more complex than originally believed.  Due to the frequent 
incidences of these disorders, there is a strong need to 
continue the study of eating disorders, particularly 
long-term physical effects, cross-culture differences, and 
the impact of prevention programs.  A conscious effort to 
develop intervention strategies to stop eating disorders 
before they start, needs to be the responsibility of society 
as a whole.


      American Psychiatric Association. (2000). 
Diagnostic criteria from DSM-IV-TR. Washington, DC: Author.

The American Psychiatric Association provides diagnostic 
criteria for anorexia and bulimia nervosa (with their 
various sub types), and eating disorder not otherwise 
specified (including binge eating disorder).  The outlined 
criteria is used to determine prognosis and treatment by 
medical personnel as well as psychologists and counselors.

     Antisdel, J.E., & Chrisler, J.C. (2000). 
Comparison of eating attitudes and behaviors among 
adolescent and young women with type 1 diabetes mellitus 
and phenylketonuria. Journal of Developmental Behavioral 
Pediatrics, 21, 81-86.

In determining the effect of chronic diseases on 
eating attitudes and behavior, 84 women (ranging in 
age from 11-34) diagnosed with type 1 diabetes mellitus 
or phenylketonuria (PKU) were surveyed.  Seven 
questionnaires were administered and analyzed.  
Results imply no difference between diseases in 
relation to the development of eating disorder symptoms, 
but there was a significant difference between diseases 
in eating patterns and behavior.  Overall, chronic 
diseases may influence the pathology of eating disorders.

     Carruth, B. & Skinner, J. (2000). Bone mineral status 
in adolescent girls: Effects of eating disorders and 
exercise. Journal of Adolescent Health: Official 
Publication of the Society of Adolescent 
Medicine, 26, 322-329.

Carruth and Skinner hypothesized measures for bone 
mineral density, energy levels, and body mass index 
would be significantly lower in adolescents with a 
history of an eating disorder.  Based on their study 
of 25 adolescents with a history of an eating disorder and 
50 without such a history, it was determined that except 
for body fat (one measure for BMD) there wasn’t a 
significant difference between the two groups of 
adolescents in respect to BMD, energy, and BMI.  
Therefore, teenage girls who have fully recovered from 
an eating disorder are capable of attaining normal bone 
mass and body composition.

      Daigneault, S. D. (2000). Body talk: A school-based 
group intervention for working with disordered eating 
Journal for Specialists in Group Work, 25, 191-213.

Half of today’s teenagers believe they are overweight 
and diet without information on healthy weight and 
nutrition.  Onset of eating disorders is occurring 
among younger youth than previously recorded.  One 
high school has taken the initiative in developing 
a new intervention and counseling technique.  
By combining a narrative and feminist approach, Body 
Talk was created to recognize teens at risk, provide 
guidelines, develop personal agency and empower self.  
Structure and content of sessions are broken down and 
thoroughly explained.  In the future, research will 
need to be conducted to determine the effectiveness 
of Body Talk.

     Dalzell, H.J. (2000). Whispers: The role of family 
secrets in eating disorders. Eating Disorders: The Journal 
of Treatment and Prevention, 8, 43-61.

A review of literature on family secrets and their 
influence on familial communication and relationships 
is introduced.  Both positive and negative components 
of secrets are provided.  Families of anorexics and 
bulimics are compared and contrasted to determine the 
rationale of family secrets and their influence on the 
development of eating disorders.  Counseling entails 
airing out secrets in order to establish healthy 
communication among family members needed to combat 
eating disorders.

     Dare, C., & Eisler, I. (2000). A multi-family group 
day treatment programme for adolescent eating disorder. 
European Eating Disorders Review, 8, 4-18.

Dare and Eisler introduce a new treatment for teens 
suffering from eating disorders.  They address the 
shortcomings of traditional family therapy, 
particularly the incidence of relapse upon therapy 
conclusion.  An alternative therapy that integrates 
typical day treatment and family therapy is presented.  
Context and structure of a multi-family group day 
treatment is laid out for the reader.  Currently, there 
is not enough data to draw any strong conclusions on 
the effectiveness of this new therapy, but it has been 
noted that patients have experienced improved symptom 
management, decreased family tension, and positive 
group exchange.

     Emans, S.J. (2000). Eating disorders in 
adolescent girls. Pediatrics International: Official 
Journal of the Japan Pediatric Society, 42, 1-7.

It is difficult to measure the true incidence rate 
of eating disorders due to denial and secrecy 
associated with these conditions.  They are 
multifactoral disorders characterized by 
psychological (comorbidity), biological 
(neurotransmission, low leptin levels), 
environmental (family and peer pressure), genetic 
(twin studies, disorder history), and social 
(media and the "ideal" image) components.  Health 
concerns, related to eating disorders, range from 
dental erosion to sudden death.  Comprehensive 
prevention programs that address the factors or 
components of eating disorders help to ensure 
partial and full recovery.

     Gullotta, T.P., Adams, G.R., & 
Markstrom, C.A. (2000). The adolescent experience 
(4th ed.). San Diego, CA: Academic Press.

In the adolescent world, looks determine social 
status.  Good looks are defined socially through 
the media as thin.  The ideal is thinness but 
reality includes genetic and environmental factors 
that determine the normal weight of an individual.  
Losing weight to fit the ideal and gain social status 
can all to often become an obsession among teenagers.  
Five theories of eating disorders defined in this 
book include psychoanalytic, behavioral, family 
perspective, sociological, and genetic.  Along with 
these theories, prevention and treatment programs 
are outlined.  It is believed that increasing 
society’s knowledge on eating disorders will lead 
to a change in societal attitudes and behavior.

     Harrison, K. (2000). The body electric: 
thin-ideal media and eating disorders in adolescents. 
Journal of Communication, 50, 119-143.

The purpose of this study was to determine the 
overall relationship between thin-ideal media 
exposure and eating disorders among adolescence.  
Three hundred sixty six teens (male and female 
from grades 6-12) were given a self-report survey 
of television viewing, magazine exposure, and 
body assessment.  It was found that overall 
exposure to the thin-ideal via media predicted 
eating-disorder symptoms for older females 
and body dissatisfaction among younger males.  It 
can be inferred that the media plays a strong 
role in perpetuating the thin-ideal notion among 

     Heinze, V., Wertheim, E.H., & Kashima, Y. (2000). 
An evaluation of the importance of message source and 
age of recipient in a primary prevention program for 
eating disorders. Eating Disorders: The Journal of 
Treatment and Prevention, 8, 131-145.

Current prevention programs often increase 
adolescent knowledge of eating disorders but 
has little if any impact on negative 
eating attitudes and behavior.  In looking 
at the influence of four different presenters 
on 191 girls from the 7th and 10th grade, a 
pre and post questionnaire was used to measure 
eating disorder knowledge, nutrition, eating 
attitudes, and intentional behavior.    
The results indicate that primary prevention 
was more effective on the younger students 
based on the four variables measured, but the 
identity of the presenter had no impact.

      Huon, G. (2000). The gender and ses context 
of weight-loss dieting among adolescent females. 
Eating Disorders: The Journal of Treatment 
and Prevention, 8, 147-155.

This study was performed to determine contextual 
differences among female teenagers of various 
dieting levels.  In an effort to locate adolescents 
at high-risk for eating disorders, 311 girls 
representing four social groups (upper-middle class 
of single sex schools, upper-middle class of coed 
schools, working-middle class of single sex schools, 
and working-middle of coed schools) were studied.  
Results implied that more "serious" dieters existed 
among females in the working-middle class of coed 
schools group.  These findings can be used to target 
preventive measures to those most at risk.

     Irving, L.M., & Cannon, R. (2000). 
Starving for hope: Goals, agency, and pathways in 
the development and treatment of eating disorder. 
In  C.R. Snyder (Ed.), Handbook of hope: Theory, 
measures, and applications (pp. 261-283).  
San Diego, CA: Academic Press.

Irving and Cannon provide a thorough description 
of various eating disorders and their subtypes.  
A treatment is devised by combining cognitive 
behavior therapy (positive reinforcement 
techniques targeting distorted thoughts about 
food, eating, weight, and body shape) and feminist 
therapy (identifies factors that perpetuate eating 
disorders) into hope therapy.  Hope therapy uses 
goals, agency, and pathways to develop and 
maintain treatment for and recovery of eating 

      Karwautz, A., & Treasure, J. (2000). 
Eating disorders. In P. Aggleton, J. Hurry, 
& I. Warwick (Eds.), Young people and mental health (pp.73-90). 
Chichester, England: John Wiley & Sons, LTD.

This chapter provides distinctive definitions for anorexia, 
bulimia, and binge eating, as well as alarming statistics 
associated with each eating disorder.  Compounding factors, 
early childhood characteristics, and comorbidity associated 
with each disorder are discussed in an effort to determine 
teens at risk for an eating disorder.  Intervention tactics 
ranging from self-help books and techniques to inpatient care 
are broken down based on the intensity of the eating 
disorder.  It is suggested that prevention programs should 
address risk factors related to specific disorders more 
thoroughly to achieve a higher success rate.

     Katzman, D.K., Golden, N.H., Neumark-Sztainer, D., 
Yager, J., & Strober, M. (2000). From prevention to 
prognosis: Clinical research update on adolescent 
eating disorders. Pediatric Research, 47, 709-712.

Based on the biopsychosocial model, professionals 
in the field of psychology report on the 
characteristics, prevention models, and 
intervening possibilities of eating disorders.  
Characteristics, or factors of disordered eating, 
covered in this article include genetics, brain 
structure, and the possible role of leptin 
influencing eating behavior.  Widespread prevention 
at an individual, school, community, and societal 
level is highly emphasized.  The potential of 
full recovery as a result of intervention concludes 
this report.

      Kendall, P.C. (2000). Childhood disorders. 
Hove, East Sussex, UK: Psychology Press.

Eating disorders are described as an abnormal 
desire to be thin.  The emotional, behavioral, 
and physical components of anorexia nervosa and 
bulimia nervosa are explained in the text.  In an 
effort to understand anorexia and bulimia, a 
diathesis-stress model is applied.  A multifaceted 
treatment that focuses on family, behavior, and 
cognitive factors is prescribed.

     Lask, B., & Bryant-Waugh, R. (2000). Anorexia 
nervosa and related eating disorders in childhood 
and adolescence (2nd ed.). 
Hove, East Sussex, UK: Psychology Press.

Various eating disorders of adolescents are 
studied in depth.  Key characteristics that 
distinguish this book from any other include 
thorough explanations of epidemiology, aetiology, 
and clinical therapy techniques.  A complete 
description of physical assessment and 
complications of eating disorders are 
also provided.

     Miller, K.J., & Mizes J.S. (Eds.). (2000). 
Comparative treatments for eating disorders. 
New York, NY: Springer Publishing Company, Incorporated.

Miller and Mize provide an in-depth comparison of treatments 
developed from various psychological perspectives.  Clinicians 
were asked to describe their diagnosis and therapy for a given 
case study.  Professionals representing numerous fields of 
psychology defined their assessment, conceptualization, therapy, 
client-patient relationship, treatment implementation, and 
expected outcome.  It was concluded an integrative approach 
that understood a client’s interpersonal relationships, core 
beliefs about self and other, and cognitive processes could be 
implemented to increase client’s motivation to overcome a given 
eating disorder.

     Mitchell, K., & Carr, A. (2000). Anorexia and bulimia. 
In A. Carr (Ed.), What works for children and adolescents? 
A critical review of psychological interventions with children 
(pp. 233-257). London: Routledge.

Provided in this chapter, are definitions and diagnostic criteria 
for eating disorders based on the DSM IV and ICD 10.  Key physical 
deterioration linked to anorexia nervosa and bulimia nervosa are 
examined.  Yet the main aspect of the chapter is to relate key 
findings of a study performed to rank the success rate of various 
treatments.  Intervention programs that are included in this 
research are family therapy, individual psychotherapy, family 
and individual therapy combined, cognitive behavioral therapy, 
multimodal inpatient treatment, and concurrent group therapy.  
The pros and cons of each treatment are laid out in a clear format, 
including tables, for the reader’s interpretation.

     Mizes, J.S., & Miller, K.J. (2000). Eating disorders. 
In M. Hersen & R.T. Ammerman (Eds.), Advanced Abnormal Child 
Psychology (2nd ed., pp. 441-465). Mahwah, NJ: Lawrence 
Erlbaum Associates.

In the Western World there is an unrealistic weight ideal that 
young women strive to meet.  Women feel emotional, depressed, 
ineffective, and body distress as they repeatedly fail to meet 
this ideal.  Eating disorders become a coping tool for their 
immense psychological stress.  Mizes and Miller examine the 
onset, treatment, lapses, and recovery of those who suffer 
from anorexia nervosa, bulimia nervosa, and binge eating disorder.   
Social, psychological, and biological factors at each stage are 
provided as a guide for disorder prediction and progression.

     Moreno, J.K., Selby, M.J., Aved, K., & Besse, C. (2000). 
Differences in family dynamics among anorexic, bulimic, obese 
and normal women. Journal of Psychotherapy in Independent 
Practice, 1, 75-87.	

Past research indicates a significant relationship between poor 
family communication and eating disorders.  Two studies were 
performed in an effort to eliminate interfering methodological 
procedures and determine true family dynamics of anorexic, 
bulimic, obese, and normal women.  The first study used 
FACES (Family Adaptability and Cohesion Scales) and the 
second used PACS (Parent-Adolescent Communication Scale) 
to measure family communication among the various groups 
of women.  Both studies indicated bulimic and obese women 
reported more family dysfunctional communication than anorexic 
women, who continually reported normal family cohesion.   
Researchers provide a thorough explanation for their results 
and suggest areas for further research.

     Mussell, M.P., Binford, R.B., & Fulkerson, J.A. (2000). 
Eating disorders: Summary of risk factors, prevention programming, 
and prevention research. Counseling Psychologist, 28, 164-196.

Studying prevention programs is essential to develop an 
effective intervention for eating disorders.  Current programs 
have demonstrated the ability to increase adolescents’ 
knowledge but has little impact, if any, on their attitudes 
towards eating.  By focusing on factors associated with disordered 
eating (i.e. socioculture, personality, athletics, trauma, family, 
and physiology), programs can be implemented to address the 
environment eating disorders thrive within.  The ideal prevention 
program not only increases an adolescent’s knowledge, but also 
promotes a positive attitude towards food and supports modifying 
one’s environment to discourage disordered eating.

     Neumaerker, K. (2000). Mortality rates and causes of death. 
European Eating Disorders Review, 8, 181-187.

Although the origin or cause of an eating disorder is unclear, 
it is still possible to gather statistics on the mortality 
rate of eating disorders.  It has been well documented that 
anorexia nervosa carries the highest death rate of all 
psychiatric illnesses.  There are many health complications 
associated to anorexia and bulimia making it difficult to 
determine cause of death, but it is believed that complications 
related to starvation and/or cahexia as well as suicide are 
the main causes of death.  Still a high percentage of 
unexplained deaths exist among individuals who suffered 
from an eating disorder.

     Nicholls, D., & Stanhope, R. (2000). 
Medical complications of anorexia nervosa in children 
and young adults. 
European Eating Disorders Review, 8, 170-180.

Bridging the physical and psychological aspects of anorexia 
nervosa, Nicholls and Stanhope describe the medical complications 
of this eating disorder.  Suggestions for intervention and weight 
gain are also provided.  Medical complications should be 
considered in the evaluation of adolescents with eating 
disorders and used as a tool to educate those who are found 
to be anorexic. 

     O’Dea, J. (2000). School-based interventions to 
preventing eating problems: First do no harm. Eating 
Disorders: The Journal of Treatment and Prevention, 
8, 123-130.

Prevention of eating disorders among adolescents is 
a key focus of health educators today.  This article 
suggests that traditional information-based programs 
inadvertently promote poor body image that leads to 
eating problems and/or eating disorders.  It is 
recommended that a self-esteem approach to improve 
body image, create healthy eating habits, and introduce 
regular physical activity will result in a higher 
success rate of deterring eating disorders without 
harmful or adverse effects.

     Pearce, J. (2000). Eating disorders. In P. Aggleton, 
J. Hurry, & I. Warwick (Eds.), Young people and mental 
health (pp. 73-90). New York, NY: J. Wiley.

Pearce focuses on the demographics of eating disorders and 
describes compounding factors found in teens at risk.  Genetics, 
early characteristics, comorbidity, and intervention programs 
are discussed.  It is believed that most prevention programs 
today increase one’s knowledge about eating disorders but is 
ineffective in changing attitudes towards eating.  In this 
chapter and example of a program that addresses the development 
of risk factors is offered as an alternative.

     Pike, K.M., Wolk, S.L., Gluck, M., & Walsh, B.T. (2000). 
Eating disorders measures. In American Psychiatric 
Association (Ed.), Handbook of psychiatric measures 
(pp.647-671). Washington, DC: American Psychiatric Association. 

Currently there are seven main instruments used to measure 
eating disorders, eating pathology, behavior, and attitudes 
in relation to assessment.  Six self-report measures include 
Eating Disorder Inventory, Body Shape Questionnaire, Three 
Factor Eating Questionnaire, Mizes Anorectic Cognitions 
Questionnaire, Bulimia Test-Revised, and Questionnaire on 
Eating and Weight Patterns.  The final measure is an interview.  
A guide to selecting the appropriate measure is provided along 
with a full description, practical issues in interpretation, 
psychometric properties, clinical use, and suggested readings 
related to each measure. 

     Rossier, V., Bolognini, M., Plancherel, B., & 
Halfon, O. (2000). Sensation seeking: A personality trait 
characteristic of adolescent girls and young women with 
eating disorders? European Eating Disorders Review, 8, 245-252.

This study was performed to determine the relationship 
between sensation seeking and eating disorder in all its 
forms.  Believing that binge eaters would have high 
sensation seeking and restrictive anorexics would have 
low sensation seeking, researchers interviewed 141 subjects 
and analyzed their self-report sessions.  No significant 
difference was found between the various forms of binge 
eaters but there was a significant difference in sensation 
seeking between the bulimic, anorexic, and control group.  
Bulimics scored unusually high on Thrill and Adventure 
Seeking while anorexics scored particularly low on 
Experience seeking.  The implications of these results 
include criteria for diagnosis, psychological trait for 
aetiology and new techniques for therapy.

     Schebendach, J., & Reichert-Anderson, P. (2000). 
Nutrition in eating disorders. In L.K. Mahan, & 
S. Escott-Stump (Eds.), Krause’s food, nutrition, & diet 
therapy (pp. 516-533). Philadelphia, PA: W.B. Saunders.

Traditional topics, such as history, diagnostic criteria, 
epidemiology, and cormorbidity are defined.  Yet, the main 
focus is the pathophysiological aspect of eating disorders.  
Before treating the emotional and mental symptoms of eating 
disorders, the physical component must be addressed.  
A nutritional assessment based on diet history, eating 
behavior, and lab work is needed.  Nutrition management 
can be achieved through behavior modification but will not 
be maintained unless an individual is educated about healthy 
nutrition.  A successful outcome of an eating disorder is 
based on improvements in weight and diet habits, menstruation, 
as well as in sexual, psychological, and social attitudes.

     Sobanski, E., & Schmidt, M.H. (2000). 
Body dysmorphic disorder: A review of current knowledge. 
Child Psychology and Psychiatry Review, 5, 17-24.

Body dysmorphic disorder and eating disorders are 
related in that they are characterized by a distorted 
body image.  The difference lies in that eating 
disorders distort the whole body where body 
dysmorphic disorder distorts a single aspect 
of the body.  It is possible that eating disorders 
proceed BDD as a solution or treatment to improve 
one's appearance.  

     Steinhausen, H.C., Boyadjieva, S., Grigoroiu-Serbanescu, 
M., Seidel, R., & Winkler-Metzke, C. (2000). 
A transcultural outcome study of adolescent eating disorders. 
Acta Psychiatrica Scandinavica, 101, 60-66.

Studying eating disorders across three cultures to compare 
and contrast amount of treatment, disorder outcome and 
psychosocial functioning, and predictability of clinical 
variables was the purpose of this study.  Based on the 
eating disorder criteria of the ICD-10, 156 patients 
from Berlin, Sofia, and Burcharest were interviewed 
in a 5-year follow up study.  As a result, it was found 
that eating disorders are similar across cultures but 
psychosocial functioning differed according to cultural 
background.  Most patients spent a great deal of time 
in treatment with a 68% recovery rate.  The younger 
the patient is at onset, the better the prognosis.  
Unfortunately, clinical features had a low predictable 
value meaning that the prognosis of a patient is 
individualistic and problematic.

     Striegel-Moore, R.H., & Smolak, L. (2000). 
The influence of ethnicity on eating disorders in women. 
In R.M. Eisler, M. Hersen (Eds.), Handbook of gender, 
culture, and health (pp. 227-253). 
Mahwah, NJ: Lawrence Erlbaum Associates.

The chapter focuses on a correlation between ethnicity 
and eating disorders.  Generalities of eating disorders 
are based on studies of white middle class young women.  
Currently there is little research to draw conclusions 
about ethnic impact on eating disorders, not to mention 
levels of impact between various ethnic groups.   
It has been documented that minorities experience 
greater stressful life conditions due to discrimination, 
identification, and acculturation.  What is not known 
is whether or not such conditions are associated with 
eating disorders among minorities.

     Teaching students with mental health disorders: 
Resources for teachers. (2000). [Victoria]: British Columbia, 
Ministry of Education, Special Programs Branch.

The goal of this book is to promote an understanding of eating 
disorders among teachers.  Information about students and 
disorders can be used to identify students at risk and develop 
support strategies.  The book is divided into five sections 
that define eating disorders, suggest identification and 
referral tactics, provide teaching techniques for the topic 
of eating disorders, present intervention strategies, and 
offers a lengthy list of resources for additional information.  

     Thomsen, P.H. (2000). Obsessions: The impact and 
treatment of obsessive-compulsive disorder in children 
and adolescents. 
Journal of Psychopharmacology, 14, s31-s37.

Obsessive-compulsive disorder can be broken down into two 
characteristics, obsession and compulsion.  The obsession 
is explained as distressful reoccurring thoughts and/or 
mental images.  Compulsions are repetative and somewhat 
ritualistic behavior.  Two percent of the population meets 
the criteria for obsessive-compulsive disorder and of that 
2%, females are at a high risk for developing comorbid 
eating disorders.

     Tomori, M., & Rus-Makovec, M. (2000). Eating behavior, 
and self-esteem in high school students. 
Journal of Adolescent Health, 26, 361-367.

In studying the eating habits of the general high 
school population and diagnosed high school population, 
researchers reported significant findings.  Four 
thousand seven hundred teens completed a self-report 
questionnaire that categorized them as satisfied or 
dissatisfied with their current weight.  Next they 
completed Zung’s Self-rating Depression Scale and 
Rosenberg’s Self-Esteem Scale.  Data Analysis suggests 
that teens that are dissatisfied with their weight 
are more likely to demonstrate pathological eating 
habits.  The frequency of dysfunctional families, 
low self-esteem, depression, suicidal thoughts, and 
drug use are also more common among adolescents 
dissatisfied with their weight.  Whether weight 
dissatisfaction leads to poor mental and physical 
health or vice versa is debatable.

     Turner, J., Batik, M., Palmer, L.J., 
Forbes, D., & McDermott, B.M. (2000). Detection and 
importance of laxative use in adolescents with anorexia 
nervosa. Journal of the American Academy of Child and 
Adolescent Psychiatry, 39, 378-385.

Abusing laxatives is one form of purging found among 
bulimics resulting in severe physical complications 
due to electrolyte imbalances. This study focuses on 
the relationship of laxative use among anorexics and 
psychopathology, physical condition, and role of urinary 
screening in assessment.  Forty-three patients suffering 
from anorexia nervosa were assessed via interviews, 
self report questionnaires, physical exams, and urinary 
screenings.  It was found that laxative use (1) was 
associated with longer duration and severity of disorder, 
(2) resulted in medical complications, and (3) determined 
largely by urinary screening in contradiction to 

     Tyrka, A.R., Graber, J.A., & Brooks-Gunn, J. (2000). 
The development of disordered eating: Correlates and 
predictors of eating problems in the context of 
adolescence. In A.J. Sameroff, M. Lewis, & S.M. Miller 
(Eds.), Handbook of developmental 
psychopathology (2nd ed., pp. 607-624). 
New York, NY: Kluwer Academic/Plenum Publishers.

When the predisposing factors associated with eating 
disorders are plotted on a continuum or course of an 
eating disorder, it is found that severity corresponds 
with disordered eating.  Adolescence is a critical 
period of rapid physical, social, and psychological 
change.  An individual’s inability to cope with the 
changes associated with puberty can be represented on 
a continuum that measures eating patterns.  Interpreting 
the continuum is useful in defining the subtypes of 
disordered eating and predicting full-scaled eating 

     Vincent M.A., & McCabe, M.P. (2000). Gender 
differences among adolescents in family, and peer 
influences on body dissatisfaction, weight loss, and 
binge eating behaviors. 
Journal of Youth and Adolescence, 29, 205-221.

Studying the influence of family and peers on adolescent 
body dissatisfaction, weight loss, and binge eating behavior, 
researchers surveyed 306 teens.  Survey analysis was 
performed to determine whether the nature of interaction 
or quality of relationship could predict an eating disorder.  
In boys it was found that encouragement to lose weight from 
parents and friends was a leading variable to developing an 
eating disorder.  Among girls, discussion about weight loss 
with parents and peers was a strong variable.  Therefore the 
nature of interaction is a stronger variable than quality 
of relationship in teens developing an eating disorder.

     Wassenaar, D., le Grange, D., Winship, J., 
& Lachenicht, L. (2000). The prevalence of eating disorder 
pathology in a cross-ethnic population of females students 
in South Africa. 
European Eating Disorders Review, 8, 225-236.

A small percentage of teens are used in this study of 
ethnicity and social economic status in relation to eating 
disorder pathology and body mass index.  Marked differences 
were found among various ethnic groups from various economic 
classes.  These findings contradict the widely accepted 
theory of eating disorders being a Western societal illness.  

     Weeramanthri, T., & Keaney, F. (2000). What do inner 
city general practitioners want from a child and adolescent 
mental health service? 
Psychiatric Bulletin, 24, 258-160. 

It is estimated one in five children suffer from a 
psychological disorder, yet only a small percentage 
see a mental health specialist.  Since most disorders 
carry a physical component, general practitioners are 
sought out first for treatment and have an opportunity 
to diagnose disorders.  Most practitioners though have 
little or no training in children and adolescent 
mental health.  An interview of 25 general practitioners 
revealed that few referrals were made to mental health 
centers and training in diagnosing child abuse and eating 
disorders was desirable as well as quick access to centers.  
Suggestions for improving communication between primary 
and secondary care are included in this research.

     Wright, K. (2000). The secret and all-consuming 
obsessions: Eating disorders. In D. Capuzzi, & 
D.R. Gross (Eds.), Youth risk: A prevention resource 
for counselors, teachers, and parents (3rd ed., 
pp. 197-242). Alexandria, VA: American Counseling 

Historically, society has influenced the body image of 
the ideal women from voluptuous to emaciated.  Today the 
media defines feminine self-worth based on thinness and 
attractiveness.  A longitudinal study of Playboy and Miss 
America has concluded that models and contestants are 
decreasing in weight and size while increasing in height.  
The goal of this article is to explore the occurrence of 
eating disorders among diverse populations of ethnicity, 
gender, sexuality, and athletics.

Net Resources:

Academy for Eating Disorders

American Anorexia Bulimia Association, Inc.

American Psychiatric Association

Eating Disorders Association

Eating Disorders Association (QLD) Resource Center

Eating Disorders Awareness and Prevention

Internet Mental Health

Medem - Healthcare Information from National Medical Societies

Mind (National Association for Mental Health)

National Institute of Mental Health

- - -

Christy Valentine currently works as a reference librarian in 
the Science Library at the University of Wyoming in Laramie, Wyoming.  
Her main interests lie in accessing information pertinent to the 
study of human nature.  Christy is affiliated with the American 
Library Association, Association of College and Research Library, 
Mountain Plains Library Association, and Wyoming Library Association.  
In the future, Christy intents to continue a study of information 
resources related to adolescent development.