Beliefs of women concerning causes and risk factors for bulimia nervosa

Objective: To examine the beliefs of women concerning causes and risk factors for eatingdisordered behaviour.

Method: Face-to-face interviews were conducted with a community sample of 208 women aged 18–45 years. Respondents were presented with a vignette describing a fictional person meeting diagnostic criteria for bulimia nervosa (BN) and were asked to indicate whether each of several factors was ‘very likely’, ‘likely’ or ‘not likely’ to be a cause of the problem described, which factor was most likely to be a cause, and whether particular subgroups of people would be ‘more likely’, ‘less likely’ or ‘equally likely’ to have or develop the problem described.

Results: ‘Having low self-esteem’ was considered very likely to be a cause of BN by 75.0% of respondents, and the most likely cause by 40.5% of respondents. Other factors perceived as significant were ‘problems from childhood’, ‘portrayal of women in the media’, ‘being overweight as a child or adolescent’ and ‘day-to-day problems’, while genetic factors and preexisting psychological problems were perceived to be of minor significance. Most respondents believed that women aged under 25 years were at greatest risk of having or developing BN.

Conclusions: Women’s beliefs concerning causes and risk factors for BN are generally consistent with empirical evidence. However, information concerning the increased risk associated with pre-existing anxiety and affective disorders might usefully be included in prevention programs. Systematic investigation of the benefits of addressing individuals’ beliefs concerning risk factors for eating disorders – as opposed to risk factors per se – would be of interest.