Perceptions of the Body in Anorexia Nervosa

  • Paul E. Garfinkel
  • David M. Garner


The clinical features of anorexia nervosa are fairly similar, whether one reads descriptions from Morton (1694) or Gull (1868) or one sees patients today. Because of this clinical similarity, people have erred in looking for a single pathogenesis to the illness. In the sense of shared symptomatology, anorexia nervosa is clearly a discrete psychiatric syndrome, but as for other syndromes this does not imply a single pathogenesis. Rather, in any population there will be a group of individuals at risk for anorexia nervosa because of the presence of a specific combination of predisposing factors. It is the interaction and timing of these phenomena within a given individual which are necessary for the person to become ill. In this sens, anorexia nervosa is a final common pathway, the product of a group of interacting forces.


Body Image Anorexia Nervosa Gastric Emptying Eating Disorder Body Dissatisfaction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Beck A.T. (1978) Depression Inventory. Center for Cognitive Therapy, PhiladelphiaGoogle Scholar
  2. 2.
    Berscheid E., Walster E., Hohrnstedt G. (1973) The happy American body: A survey report. Psychology Today November 119–31Google Scholar
  3. 3.
    Bruch H. (1962) Perceptual and conceptual disturbances in anorexia nervosa Psychol Med 24:187–194Google Scholar
  4. 4.
    Bruch H. (1973) Eating Disorders: Obesity, Anorexia Nervosa and the Person Within. Basic Books New YorkGoogle Scholar
  5. 5.
    Cabanac M., Duclaux R. (1970) Obesity: Absence of satiety aversion to sucrose. Science 168:496–497CrossRefGoogle Scholar
  6. 6.
    Campbell R.G., Hashim S.A., Vanltallie T.B. (1971) Studies of food intakte regulation in man: Responses to variations in nutritive density in lean and obese subjects. N Engl J Med 285:1402–1407CrossRefGoogle Scholar
  7. 7.
    Cannon W.B., Washburn A.L. (1912) An explanation of hunger. Am J Physiol 29:441–454Google Scholar
  8. 8.
    Casper R.C., Halmi K.A., Goldberg S.C., Eckert E.D., Davis J.M. (1979) Disturbances in body image estimation as related to other characteristics and outcome in anorexia nervosa. Br J Psychiatry 134:60–66PubMedCrossRefGoogle Scholar
  9. 9.
    Chapman L.F., Chapman J.P., Raulin M.L. (1976) Scales for physical and social anhedonia. J Abnorm Psychol 85:374–382PubMedCrossRefGoogle Scholar
  10. 10.
    Coddington R.D., Bruch H. (1970) Gastric perceptivity in normal, obese and schizophrenic subjects. Psychosomatics 11:571–579PubMedGoogle Scholar
  11. 11.
    Crisp A.H. (1967) The possible significance of some behavioural correlates of weight and carbohydrate intake. 3 Psychosom Res 11:117–131Google Scholar
  12. 12.
    Crisp A.H., Kalucy R.S. (1974) Aspects of the perceptual disorder in anorexia nervosa. Br 3 Med Psychol 47:349–361CrossRefGoogle Scholar
  13. 13.
    Derogatis L., Lipman R., Rickeis K., Uhlenhuth E.H., Covi L. (1974) The Hopkins Symptom Checklist (HSCL): A self report symptom inventory. Behav Sci 19:1–15PubMedCrossRefGoogle Scholar
  14. 14.
    Dubois A., Gross H.A., Ebert M.H., Castell D.O. (1979) Altered gastric emptying and secretion in primary anorexia nervosa. Gastroenterology 77:319–323PubMedGoogle Scholar
  15. 15.
    Fisher S., Cleveland S.E. (1958) Body Image and Personality. Dover Publications New YorkGoogle Scholar
  16. 16.
    Garfinkel P.E., Garner D.M. (1982) Anorexia Nervosa: Multidimensional Perspective. Brunner Mazel New YorkGoogle Scholar
  17. 17.
    Garfinkel P.E. (1974) Perception of hunger and satiety in anorexia nervosa. Psychol Med 4:309–315PubMedCrossRefGoogle Scholar
  18. 18.
    Garfinkel P.E., Moldofsky H., Garner D.M. (1977) Prognosis in anorexia nervosa as influenced by clinical features, treatment and selfperception. Can Med Assoc 3 117:1041–1045Google Scholar
  19. 19.
    Garfinkel P.E., Moldofsky H., Garner D.M., Stancer H.C., Coscina D.V. (1978) Body awareness in anorexia: Disturbances in body image and satiety. Psychosom Med 40:487–498PubMedGoogle Scholar
  20. 20.
    Garfinkel P.E., Moldofsky H., Garner D.M. (1979) The stability of perceptual disturbances in anorexia nervosa. Psychol Med 9:703–708PubMedCrossRefGoogle Scholar
  21. 21.
    Garfinkel P.E., Kaplan A.S., Garner D.M., Darby P.L. (in press) The differentiation of vomiting and weight loss as a conversion disorder from anorexia nervosa. Am J PsychiatryGoogle Scholar
  22. 22.
    Garfinkel P.E., Garner D.M., Rose J., Darby P.L., Brandes J.S., O’Hanlon J., Walsh N. (in press) A comparison of characteristics in the families of patients with anorexia nervosa and normal controls. Psychol MedGoogle Scholar
  23. 23.
    Garner D.M., Garfinkel P.E. (1981) Body image in anorexia nervosa: Measurement, theory and clinical implications. Inter 3 Psychiat Med 11:263–284CrossRefGoogle Scholar
  24. 24.
    Garner D.M., Garfinkel P.E., Stancer H.C., Moldofsky H. (1976) Body Image disturbances in anorexia nervosa and abesity. Psychom Med 38:227–236Google Scholar
  25. 25.
    Garner D.M., Olmsted M., Garfinkel P.E. (in press) A comparison between weight preoccupied wumen and anorexia nervosa. Int J Eating DisordersGoogle Scholar
  26. 26.
    Garner D.M., Garfinkel P.E., O’Shaughnessy M. (in press) A comparison between bulimia with and without anorexia nervosa. New Directions in Anorexia Nervosa. Report of the Fourth Ross Conference on Medical ResearchGoogle Scholar
  27. 27.
    Garner D.M., Garfinkel P.E. (1979) The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychol Med. 9:1–7CrossRefGoogle Scholar
  28. 28.
    Garner D.M., Bemis K. (1982) A cognitive-behavioral approach to anorexia nervosa. Cognitive Therapy and Research 6:1–27CrossRefGoogle Scholar
  29. 29.
    Glucksman M.L., Hirsch J. (1969) The response of obese patients to weight reduction. Psychosom Med 31:1–7PubMedGoogle Scholar
  30. 30.
    Gull W.W. (1868) The address in medicine delivered before the annual meeting of the BMA at Oxford Lancet 2:171Google Scholar
  31. 31.
    Head H. (1920) Studies in Neurology. Hodder Stoughton, LondonGoogle Scholar
  32. 32.
    Herman C.P., Polivy J. (1975) Anxiety, restraint and eating behaviour. J Personal 84:666–672Google Scholar
  33. 33.
    Holt S., Form M.J., Grant S. (1981) Abnormal gastric emptying in primary anorexia nervosa. Br J Psychiatry 139:550–552PubMedCrossRefGoogle Scholar
  34. 34.
    Hsu L.K. (1982) Is there a disturbance in body image in anorexia nervosa. J Nerv Ment Dis 170:305–307CrossRefGoogle Scholar
  35. 35.
    Janis I.L., Field P.B. (1959) Sex differences and personality factors related to persuasibility. In: Houland C.I., Janis I.L. (Eds) Personality and Persuasibility. Yale University Press, New Haven, p 55–68Google Scholar
  36. 36.
    Kolb C. (1975) Disturbances of body image. In: A Arieti (Ed) American Handbook of Psychiatry. Basic Books, New York, p 810–831Google Scholar
  37. 37.
    Lasegue (1873) De l’anorexie hysterique. Reprinted in Kaufman R.M., Heiman M. (Eds) Evolution of Psychosomatic concepts. Anorexia Nervosa: A. Paradigm (1964). Internation Universities Press, New YorkGoogle Scholar
  38. 38.
    Morton R. (1694) Phthisiologica: Or a Treatise of Consuptions. Sam Smith and Benjamin Wolford, LondonGoogle Scholar
  39. 39.
    Nisbett R.E. (1972) Eating behaviour and obesity in men and animals. Adv Psychosom Med 7:173–193PubMedGoogle Scholar
  40. 40.
    Penick S.B., Smith G.P., Wieneke K. Jr., Hinkle L.E. Jr. (1967) An experimental evaluation of the relationship between hunger and gastric motility. Am J Physiol 205:421–426Google Scholar
  41. 41.
    Reid D.W., Ware E.E. (1974) Multidimensionality of internal versus external control: addition of a third dimension and nondistinction of self versus others. Can J Behav Sci 6:131–142CrossRefGoogle Scholar
  42. 42.
    Russell D. McR, Freedman M.L., Feiglin D.H.I., Jeejeebhoy K.N., Swinson R.P., Garfinkel P.E. (in press) Delayed gastric emptying in anorexia nervosa—improvement with domperidone. Am J PsychiatryGoogle Scholar
  43. 43.
    Saleh J.W., Lebwohl P. (1980) Metoclopramide-induced gastric emptying in patients with anorexia nervosa. Am J Gastroenterol 74:127–132PubMedGoogle Scholar
  44. 44.
    Schacter S. (1971) Emotions, Obesity and Crime. Academic Press, New YorkGoogle Scholar
  45. 45.
    Schilder P. (1935) Image and Appearance of the Human Body. Kegan, Paul, Trench, Trubner and Company, LondonGoogle Scholar
  46. 46.
    Secord P.F., Jourard S.M. (1953) The appraisal of body cathexis: Body cathexis and the self. Consult Psychol 17:343–347Google Scholar
  47. 47.
    Silverstone J.T., Russell G.F.M. (1967) Gastric hunger in contractions in anorexia nervosa. Br J Psychiatry 13:257–263CrossRefGoogle Scholar
  48. 48.
    Stunkard A.J., Fox S. (1971) The relationship of gastric motility and hunger: A summary of the evidence. Psychosom Med 33:123–134PubMedGoogle Scholar
  49. 49.
    Traub A.C., Orbach J. (1964) Psychological studies of body image: An adjustable body distorting mirror. Arch Gen Psychiatry 11: 53–66PubMedCrossRefGoogle Scholar
  50. 50.
    Underwood P.J., Belton E., Hulme P. (1973) Aversion to sucrose in obesity. Proc Nutr Soc 32:94CrossRefGoogle Scholar
  51. 51.
    Wylie R. (1968) The present status of self-theory. In: Borgatta E.G., Lambart W.W. (Eds). Handbook of Personality Theory and Research. Rand McNally, ChicagoGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1985

Authors and Affiliations

  • Paul E. Garfinkel
    • 1
  • David M. Garner
    • 1
  1. 1.Department of PsychiatryToronto General HospitalTorontoCanada

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