Most sufferers of bulimia are female. About two percent of them die every decade. And around a fifth of those deaths about
are due to suicide. Uncovering the multiple factors leading to bulimia nervosa is therefore very important, especially as the causes are largely unknown.
As a professor in Dalhousie University’s department of psychology and neuroscience,
I research personality traits and eating disorders. As a clinical psychologist, I also assess and treat eating disorders and associated problems, including perfectionism.
My lab just published the most complete
research study investigating the link between the personality trait of perfectionism and bulimia nervosa to date. Our results clearly show perfectionists have higher odds of developing bulimia and are at greater risk for developing the disease as time passes.
Building on this research, therapists may be able to improve treatments for some bulimic clients by focusing on their underlying perfectionism as well as their symptoms.
Harsh Self-Criticism
Perfectionism involves striving relentlessly for flawlessness and holding unrealistically high standards for oneself and others.To get a more comprehensive picture of whether perfectionism leads people to develop bulimia nervosa, we conducted a thorough literature search that identified 12 longitudinal studies involving a total of 4,665 participants.
We then analyzed results from these 12 studies using statistical means. Most of our participants were female (86.8 percent) and included adolescents, undergraduates, and adults from the community, with an average age of 19 years.
We found that perfectionism predicted increases in bulimia nervosa, even after controlling for baseline levels of the condition. This suggests perfectionists are at risk for developing bulimia nervosa as time passes.
In fact, our results indicate perfectionism is centrally important to the personality of people who go on to develop bulimia.
Previous research has already shown that external pressure from family, friends, and media can contribute to the disease by
fostering a desire to attain an “ideal” weight and shape. But the link between perfectionism and bulimia has never before been extensively explored.
A Dog-Eat-Dog World
Perfectionism is linked to
relationship problems and feeling sad. Perfectionists may turn to food to cope with sadness brought on by their lack of connection to other people.
It’s a dog-eat-dog world today. We have controlling and hyper-competitive helicopter parents. And in society at large,
self-interest and winning are emphasized. Rank and performance matter more than ever. These are conditions where perfectionism is likely to develop. So, we may see more and more perfectionism-linked cases of bulimia nervosa emerge.
Our results suggest treating perfectionism as early as possible may help to stop the development of bulimia nervosa. It is time to go beyond entirely symptom-focused treatments. Building on our research, clinicians may want to assess and to treat both bulimic symptoms (e.g., vomiting) and underlying perfectionism (e.g., self-criticism).
Clearly, more research is needed to understand and defeat this disease.
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