Beyond Drive for Thinness: Drive for Leanness in Anorexia Nervosa Prevention and Recovery

Abstract

Anorexia nervosa is classified by the American Psychological Association as an eating-related mental disorder, which affects mostly young adult women and adolescent girls. Although refeeding programs are often used to recover bodyweight in patients with anorexia nervosa, treatment failures are high, and the determinants of the disorder remain unknown. The present paper uses a nutritional epidemiology perspective to examine determinants of anorexia nervosa from the patients’ point of view. A grounded-theory literature-review method was used to search and review research findings from the peer-reviewed literature related to the etiology of anorexia nervosa, including recent qualitative interviews with patients. Unlike a systematic review, a grounded theory method is more appropriate for developing a new theory to explain phenomena like the cause, recovery, and prevention of anorexia nervosa. Reviewed research suggests that anorexia nervosa may be a problematic body-change strategy rather than a mental disorder. Additionally, the present paper proposes that replacing the drive for thinness in anorexia nervosa with a drive for leanness may help patient recovery, especially when guided by easily accessible body-composition estimates. Fat-free mass restoration in the recovery of anorexia nervosa may also be facilitated by resistance training, which improves patients’ psychological status and body composition. Additionally, replacing a dysfunctional dieting strategy in anorexia nervosa with knowledge, skills, and experience in proper weight management has a potential preventive effect against the disorder. More research is needed to investigate the applied effects of the drive for leanness, body-composition assessments, resistance-training programs, and weight-management skills associated with the recovery and prevention of anorexia nervosa. Furthermore, successful application of the information in this paper may be adapted to peer role model programs to prevent anorexia nervosa.