Impulse regulation in anorexia nervosa and bulimia nervosa: some formulations.

Empirical observations imply that impulsivity is specifically associated with poor prognosis in eating disorders. The present paper cites studies suggesting that this factor is predominantly associated with the bulimic pattern of eating disturbance, while "restriction" may be associated rather with hypercontrol of behaviour. Further evidence is cited suggesting that the relationship between hyper- and hypocontrol is actually very intimate, both on a behavioural and biochemical level. Rather than bulimics being generally impulsive and "restrictors" generally hypercontrolled, future studies may reveal impulse regulation difficulties of both kinds in both groups. Single-minded preoccupation with dieting may be an ill-equipped individual's effort to simplify life in periods of change and environmental challenge that demand capacity for flexible impulse regulation.