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Future Considerations in Research on Eating Disorders

In the last quarter of the 20th century, the research on eating disorders surged and anorexia and bulimia became household words. These serious disorders were the butt of jokes, the fodder for inappropriate advertising, and, for some, even convoluted status symbols. Inpatient clinics, residential treatment centers, and outpatient programs sprang into existence throughout the country, offering expertise and hope for those patients whose needs surpassed what could be provided to them on an outpatient basis. By the end of the century, the treatment options and the number of available and knowledgeable practitioners was certainly better than in the early 1980s, but as the articles in this special issue demonstrate, much remains to be learned about etiology, assessment, and treatment, much less prevention. And despite the field’s acknowledgment that anorexia nervosa and bulimia nervosa are not truly the “golden girl’s” disease but may increasingly be becoming an equal opportunity disorder, the field has little information on diverse populations to expand our understanding of etiology, assessment, and treatment of these disorders. The sociocultural basis for incubating eating disorders continues as thinness over fitness prevails while primary and secondary schools have deemphasized physical education. On a biological basis, the age of puberty has decreased, and the sexualization of youth has pressured a demand for a precocity that many early adolescents or preadolescents cannot manage (Elkind, 1989). The civil rights movement and the media have racially desegregated segments of our young populations, such that what was the default American culture, European-based and privileged, has become cross-pollinated with various ethnic influences. We do not have a grasp on how this change influences the role of weight and other physical features in standards of attractiveness for our youth across groups. Has it increased the risk for youth of color? Has it decreased the risk for some White youth? As we make progress in understanding etiology, new variables may become risk factors, or the weight of risk factors may change with each generation.