And increasingly, research has focused on brain chemistry and the role of neurotransmitters in the regulation of both appetite and self-image. And we all know how pervasive cultural influences can be, especially in the media, and its narrow-profile definition of beauty. For whatever reasons, people with eating disorders feel powerless. Anorectics often see dieting as a form of personal control. Breaking a diet, even to sip water or swallow a few bites, can seem a shattering sign of weakness.
Bulimics are different, and are more likely to binge on food after a period of dieting.
Guilty and depressed about eating, they purge to get rid of calories. Still, the main problem involves a breakdown in self-image and the resulting inability to see one's body as it really is. People with eating disorders typically overestimate their body size by 25-50 percent. Anorectics in particular see themselves as being overweight, insisting that they're still too heavy, even as they starve themselves. There's no easy answer to that question, either.