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Evolutionary Psychopathology: A Unified Approach

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Marco del Giudice

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“Ferguson and colleagues also reviewed that thin models in the media have comparatively small effects on body dissatisfaction, and mainly on women with preexisting weight concerns and/or high neuroticism. Instead, the largest and most consistent effects are those of mating competition in the peer network -that is, the number of attractive and available women in one's inmediate social environment (for example, friends and colleagues).”

“The pubertal surge of sex hormones plays a major role in the onset of eating symptoms in females, as shown by the fact that the heritability of Eating Disorders increases sharply at mid-puberty in girls, but not in boys. In particular, binge eating is strongly modulated by the interaction of estrogens and progesterone acrosss the menstrual cycle, consistent with the role played by these hormones in the regulaion of hunger and feeding. Both the frequency of bingeing and its heritability peak after ovulation, in tandem with rising progesterone levels.”

“A thinness ideal at the social and individual levels is not the only precondition for the bingeing-purging cycle: bingeing require easy access to large amounts of high-calorie food, and most purging methods are impractical without modern plumbing and sanitation.”

“Food restriction does not necessarily lead to self-starvation; in fact, a common effect of sustained weight loss is a tendency to binge whenever food is available (typically with feelings of automaticity and loss of control). Common triggers for binges include tempting food and excessive hunger, but also interpersonal stressors and strong emotions. To compensate for impulsive overeating, some people start to adopt purging behaviors such as vomiting and laxative use. The combination of bingeing and purging may lead to the onset of a self-reinforcing cycle. Especially in the early stages of the cycle, bingeing and purging cause intense guilt, shame and anxiety. Those negative emotions may then trigger more binges or prompt renewed attempts to restrict food, which ultimately end up strengthening the cycle. Bingeing and purging can be rewarding on a number of levels. On the one hand, these symptoms relieve anxiety, boredom, emptiness, and other negative feelings; on the other hands, they prevent stressful interactions with other people (e.g. staying home from school or work to binge), attract attention from family and friends, and may provide a way to communicate one's ill-defined psychological distress in concrete terms. Over time, the behavioral sequence of bingeing and purging becomes more automatic and less emotionally intense, but also harder to interrupt.”

“The self-starvation cycle has been documented across time and cultures, including non-Western ones. In modern Western societies, concerns with fat and thinness are the main reason for weight loss and probably explain the moderate rise of Anorexia Nervosa incidence across the second half of the 20th century. However, cases of self-starvation with spiritual and religious motivations have been common in Europe at least since the Middle Ages (and include several Catholic saints, most famously St. Catherine of Siena). In some Asian cultures, digestive discomfort is often cited as the initial reason for restricting food intake, but the resulting syndrome has essentially the same symptoms as anorexia in Western countries.”

“I spent many late nights during medical school using my brain to think about the brain and then using my mind to ponder the irony of it. How exactly do we separate and distinguish the mind from the brain? I can operate on the brain but not on the mind, but operating on the brain can forever alter the mind. It's a dilemma of causality - a circular reference problem like the perennial question of what came first, the chicken or the egg.”