REVIEW OF THE EVIDENCE FOR A SOCIOCULTURAL MODEL OF BULIMIA-NERVOSA AND AN EXPLORATION OF THE MECHANISMS OF ACTION

Although numerous studies have examined the role of sociocultural pressures in the etiology and maintenance of bulimia nervosa, a comprehensive review that synthesizes the current knowledge is needed. The primary aim of the present paper was to review the available evidence implicating sociocultural factors in the promotion of bulimia. Overall, the research supported the contention that sociocultural pressures play a role in perpetuating bulimia. The secondary aim of the paper was to propose a model that links these nebulous pressures to the actual development of bulimic behavior. This model first delineates probable carriers of these cultural messages, including the family, peers, and the media. Second, variables thought to mediate the relation between these societal pressures and eating pathology were examined. Internalization of these pressures, body dissatisfaction, restrained eating, and negative affect were considered as potential mediators. Finally, factors that possibly moderate the enumerated mediational pathways were explored. Implications for prevention and future research are discussed.