Competing Paradigms for Anorexia Nervosa

The contributors to the April 2007 American Psychologist special issue on eating disorders are to be commended for acknowledging lack of progress in understanding, classifying, and treating anorexia nervosa (AN). They highlighted the acute need to refine diagnosis (Wonderlich, Joiner, Keel, Williamson, & Crosby, 2007), understand comprehensive causal mechanisms to tune treatments and transcend “hodgepodge diagnoses” (Striegel-Moore & Bulik, 2007, pp. 181–182), study functional neural circuits and link behavior with “genomic, cellular, and systems data” (Chavez & Insel, 2007, p. 164), and develop effective treatments (Wilson, Grilo, & Vitousek, 2007, p. 201). Specifically, Chavez and Insel (2007) wrote that “present-day treatments are significantly limited” and that identifying underlying pathophysiology “will be critical for developing more effective treatments and preventive strategies” (p. 160). This state of the field could suggest that a new paradigm is needed, but new paradigms are often resisted by the established scientific community (Kuhn, 1962), of which the contributors to the special issue are internationally recognized leaders.

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Guisinger AP Comment 2008