Although some consider eating disorders like bulimia to be the over-hyped, Hollywoodian maladies of the wealthy and superficial, the fact is that they are serious psychiatric disorders. Bulimia seems to be particularly complex from a psychological standpoint.
A recent article in the East Bay Express focused on the disorder and discussed research by Stanford's James Lock, MD, PhD, psychiatric director of the Comprehensive Eating Disorders Program at Lucile Packard Children’s Hospital. Lock's research suggests that bulimia is an impulse-control disorder (where the impulse is binge eating), a class of disorders that also includes shoplifting and drug addiction:
As young women with bulimia grow older, destructive impulses like bingeing and purging may become more powerful while parts of the brain that govern impulse control may weaken. And according to... studies, the bulimic brain is more likely to succumb to a variety of self-destructive impulses, making the disorder a sort of psychological Hydra. Over time, these impulses may turn into compulsions, or bad habits, much like drug addiction.
Lock, who has been working with eating-disordered youth at Stanford's clinic for nine years, noticed that his patients often exhibited behavior consistent with impulse-control issues. Such behavior included sexual promiscuity and kleptomania. In a study requiring both healthy and bulimic girls to avoid performing a task, Lock noticed that bulimic girls had significantly more difficulty controlling their impulse to perform the forbidden task. Moreover, Lock noticed increased brain activity in the sections of these girls' frontal lobes responsible for impulse control. His findings seemed to suggest that the girls' brains were working overtime to manage impulses that healthy girls had no trouble controlling.
Eating disorders and many other mental disorders are medically elusive, since their physiological causes are practically unknown. Research like Lock's, which considers disorders like bulimia to be serious psychiatric conditions and attempts to link them to other psychological disparities, is a crucial step in solving the mystery.