**7. Conclusions**

Analysis of the data obtained as a result of this research revealed diversity in terms of the body self characteristics among bulimia sufferers experiencing a variety of destructive symptoms (e.g. episodes of binge eating and purging). Different configurations of the body self characteristics in bulimic individuals can be determined by a variety of major factors. They include socio-cultural determinants (e.g. the social pressure related to the commonly approved cult of thinness regarded as the key to success and positive self-assessment), which significantly contribute to development of bulimic tendencies. The major distortions in body perception and evaluation of physical appearance which develop in bulimia sufferers as a result of socio-cultural pressure, lead to developmental dysfunctions and disturbances of body experience. However, other components of the body self remain undisturbed (i.e. an appropriate body schema, an adequate level of interoceptive awareness and appropriate bodily functions, as well as lack of anxiety related to the process of transition into adult life and performing roles based on a female model of psychosexual maturity). The aforementioned dysfunctions are triggered by extrinsic (environmental) factors.

A different configuration of the body self characteristics emerges as a result of an inadequate process of psychological separation and individuation, disturbed by emotional deficits and psychological traumas during childhood. It is characterized by a higher, compared to the socio-cultural type, degree of cognitive and emotional dysfunctions of all the investigated components of the body self. The disturbances are determined by intrinsic (personality-based) factors, and correlate with inadequate separation and individuation in bulimic individuals.

A psychological differential diagnosis, aimed at distinguishing various types of the body self structure in the population of females suffering from bulimia nervosa, supports psychological diagnostic techniques, and thus improves the effectiveness of therapy in patients exhibiting this kind of disorder.

#### **8. References**


A Psychological Profile of the Body Self Characteristics in Women Suffering from Bulimia Nervosa 165

164 New Insights into the Prevention and Treatment of Bulimia Nervosa

subjects. It was discovered that evaluation of body image in this sample is determined by social-cultural factors and the cult of thinness. As a result of examination of the individuals' body self characteristics it was found that although the women do not exhibit any significant developmental dysfunctions (they display an average level of emotional and cognitive body acceptance, appropriate interoceptive awareness and adequate current body perception), they reveal a strong desire for a much slimmer (ideal) body. It is likely that the research data were affected by the fact that the examined females had been undergoing regular medical treatment and psychotherapy. The socio-cultural type is also characterized by an average sense of security related to the process of entering the stage of maturity and accepting "farewell to childhood". The research data demonstrate that the females are aware of their adequate feelings regarding the body, and they are generally satisfied with their actual appearance. However, a certain discrepancy was detected between the individuals' cognitive evaluation of their current body shape ("what I look like") and the so called ideal body image ("what I would like to look like"). This finding might point to slight distortions

Analysis of the data obtained as a result of this research revealed diversity in terms of the body self characteristics among bulimia sufferers experiencing a variety of destructive symptoms (e.g. episodes of binge eating and purging). Different configurations of the body self characteristics in bulimic individuals can be determined by a variety of major factors. They include socio-cultural determinants (e.g. the social pressure related to the commonly approved cult of thinness regarded as the key to success and positive self-assessment), which significantly contribute to development of bulimic tendencies. The major distortions in body perception and evaluation of physical appearance which develop in bulimia sufferers as a result of socio-cultural pressure, lead to developmental dysfunctions and disturbances of body experience. However, other components of the body self remain undisturbed (i.e. an appropriate body schema, an adequate level of interoceptive awareness and appropriate bodily functions, as well as lack of anxiety related to the process of transition into adult life and performing roles based on a female model of psychosexual maturity). The aforementioned

A different configuration of the body self characteristics emerges as a result of an inadequate process of psychological separation and individuation, disturbed by emotional deficits and psychological traumas during childhood. It is characterized by a higher, compared to the socio-cultural type, degree of cognitive and emotional dysfunctions of all the investigated components of the body self. The disturbances are determined by intrinsic (personality-based) factors, and correlate with inadequate separation and individuation in bulimic individuals. A psychological differential diagnosis, aimed at distinguishing various types of the body self structure in the population of females suffering from bulimia nervosa, supports psychological diagnostic techniques, and thus improves the effectiveness of therapy in

[1] FairburnCG.HarrisonP.J., Eating disorders.Lancet.1.Feb.2003, Vol.361, 9355, pp.407-16; [2] FairburnCG. et al. The natural course of bulimia and binge eating disorder in young

women. Arch. Gen. Psychiatry.Jul.2000, Vol. 27, pp.659-665

in the real body image observed in this group of research subjects.

dysfunctions are triggered by extrinsic (environmental) factors.

patients exhibiting this kind of disorder.

**8. References** 

**7. Conclusions** 


**11** 

 *Norway* 

Solfrid Bratland-Sanda1,2

**Physical Activity and Exercise in** 

*2Research Institute, Modum Bad Psychiatric Centre, Vikersund,* 

**Bulimia Nervosa: The Two-Edged Sword** 

*1Department of Sport and Outdoor life sciences, Telemark University College, Bø in Telemark,* 

Physical activity and exercise has a widely known positive effect on various physiological and psychological variables, and lack of physical activity has been shown as an independent factor for obesity, type 2 diabetes, hypertension, certain types of cancer and other diseases (Pedersen & Saltin, 2006). However, in the Diagnostic and Statistical Manual for Mental Disorders version four (DSM-IV) (APA, 1994) excessive amounts of exercise is listed as one possible weight compensatory behavior among patients with bulimia nervosa (BN). In this chapter I will describe the effects of physical activity, and the motives for physical activity among patients with BN. Furthermore, the two-edged sword aspect of physical activity among patients with BN will be explored. This duality comes to show on one hand because of the excessiveness and the abuse of physical activity, and on the other hand the beneficial

Physical activity is defined as any type of bodily movement produced by skeletal muscles which results in an increased metabolism above resting level (Caspersen, Powell, & Christenson, 1985). Exercise is the planned, structured and repeated physical activity performed with the aim to improve performance, fitness and/or health (Bouchard, Blair, & Haskell, 2007). The term physical activity includes occupational physical activity, transport physical activity, housework and leisure time physical activity, whereas exercise refers to leisure time physical activity. Physical activity therefore includes all the terms exercise, work out and sports. In this chapter, the terms physical activity and exercise will be used

Effects of physical activity can be divided into acute effects and long term effects. The acute effects include physical responses such as increased ventilation and breathing frequency, increased heart rate, stroke volume, systolic blood pressure, body temperature, and reduction in blood lipoproteins and glucose (Bouchard, et al., 2007). The immediate elevations in levels of endorphins, serotonin and dopamine are suggested as a reason why many report a positive impact of physical activity on mood, positive and negative affects

and therapeutic effects of correctly dosed physical activity in treatment of BN.

**1.1 Definition of physical activity and exercise** 

**1.2 General effects of physical activity** 

**1. Introduction** 

interchangeably.

