If at an early stage one can see a relation between dieting and neurotic disturbances, an intervention should have a preventive effect against the development of anorexia nervosa. The case reports in this study show that the girls who developed anorectic behaviour or anorexia nervosa had multifactorial backgrounds as regards their personality components, family situation and relations with comrades. This may be reflected in their worries about body weight. Most of the subjects were able to discuss their problems in connection with the primary study but some were unable, until the follow-up study, to admit that they had been seriously troubled by feelings of insecurity for a long time before that. These were also the girls who had not sought assistance. The commonest reason given for dieting is dissatisfaction with personal appearance, whether the girl was really overweight or merely felt overweight, though she was normalweight or underweight. For a physically and mentally healthy girl such a voluntary dieting does not lead to symptoms of AN type. However, the situation is different for those girls who have symptoms of anxiety neurosis; for them dieting may lead to anorexia nervosa. The reason for this is probably the force and intensity with which they do their dieting. Accordingly it may be said that, for a girl with a neurotic disorder, dieting may be the factor that triggers an anorectic development, a trigger mechanism for the neurosis in itself. The significance of dieting then becomes of a secondary nature but it may nevertheless be the reason why AN develops.
Chedtha Intaravitak, Ernawati Munadi