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Eating disorders involve critical attitudes, emotions, and eating behaviors such as reduced food intake, overeating, and distorted perceptions of body image, weight, and shape. These disorders can be classified into three types: binge eating disorder, anorexia nervosa, and bulimia nervosa. Anorexia nervosa and bulimia nervosa are the most common forms. According to the National Eating Disorder Association (NEDA), around 25% of girls aged 12-18 engage in problematic food and weight behavior. Similarly, data from the nimh.nih.gov website shows that one in four cases of preadolescent anorexia occur in boys while both males and females are equally affected by binge-eating disorder.
The causes of eating disorders can vary and include cultural factors, personal characteristics, stress events, life changes, family dynamics, peer influence, and media influence. Low self-esteem and feelings of uselessness significantly contribute to the development of an eating disorder. Adolescents often compare themselves to others and may feel pressured to fit in. If their friends have an eating disorder, they may develop one as well.
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Stressful events like teasing or transitioning from middle school to high school can also trigger the development of an eating disorder in some adolescents. Experiencing a traumatic event such as rape can have the same effect. Family dynamics also play a role; constant fighting or contemplating divorce by parents can lead some adolescents to control their parents through restricting food intake or inducing vomiting as a way to regain attention and control within the household.
According to the National Eating Disorder Association, adolescents who feel their life is spinning out of control may turn to eating disorders in order to regain a sense of control.
Family studies have shown a strong familial connection to anorexia nervosa, bulimia nervosa, and binge eating disorders. The heritability rates for these disorders are approximately 60% for anorexia nervosa, ranging from 28% to 80% for bulimia nervosa, and 41% for binge eating disorder. Research conducted in various countries also suggests that genetic factors contribute to the development of eating disorders. Additionally, societal perspectives play a significant role in these disorders as our culture influences what is considered acceptable.
If our culture promotes the notion that being thin is equivalent to beauty, certain individuals may feel inadequate if they do not possess a slim physique. This belief is particularly likely to be internalized by girls, who are often primarily valued for their physical appearance. The media, including models and movie stars, play a significant role in shaping societal and cultural norms. Models frequently appear in magazines, billboards, and commercials; meanwhile TV shows such as America's Next Top Model influence perceptions of beauty from an early age. Furthermore, many film actors tend to possess a slender body shape, which can contribute to both males and females experiencing insecurity about their own bodies.
The development of an eating disorder can be attributed to three types of aspects: behavioral, mental, and physical. According to the National Eating Disorder Association, fixation on weight and appearance can lead to emotional and physical problems.
The mental aspect of an eating disorder revolves around self-perception and self-esteem. Body image is closely linked to one's self-esteem regarding their body. Additionally, eating disorders involve not only mental and behavioral factors but also physical factors that contribute to health complications.
Anorexia and Bulimia can cause severe health issues such as kidney failure, heart problems, dehydration, and in extreme cases, malnutrition leading to death. A study by the National Association of Anorexia Nervosa and Associated Disorders found that the mortality rate associated with Anorexia nervosa is twelve times higher than the overall death rate for females aged 15-24 years old. Anorexia nervosa is characterized by extreme thinness resulting from starvation.
Anorexia nervosa, the psychological disorder with the highest mortality rate, is not well understood in terms of its causes. The main causes of death associated with this disorder are a combination of starvation and suicide. It is classified as a visible eating disorder because most affected individuals appear noticeably thin, although some may hide their thinness by wearing oversized clothing or layering. In this condition, individuals fail to maintain a healthy weight based on their age, height, and gender.
Anorexia nervosa manifests itself in two forms: starvation or restricting. Individuals intentionally reduce their calorie intake and increase physical activity to maintain an abnormally low weight. Prolonged undernourishment can lead to significant bodily changes as the body enters starvation mode. The second form of anorexia nervosa may involve either binge eating, purging, or both.
More than 50% of individuals in the early stage of anorexia nervosa exhibit these behaviors, leading to a weight that is less than 85% of their ideal body weight. Typically occurring during early adolescence (around 10-12 years old), anorexia not only causes physical illness but also results in cognitive impairment, body-checking, low self-esteem, self-absorption, ritualistic behaviors, extreme perfectionism, and self-consciousness. Depression and anxiety are the most common psychiatric disorders associated with anorexia. Over time, electrolyte imbalances (sodium and potassium levels), osteoporosis (reduced bone density), lanugo hair growth, dry brittle hair, low body temperature, low blood pressure, slowed heart rate, growth retardation, bloating,constipation,fidgeting,and loss of tooth enamel and dentin may occur or worsen due to anorexia,resulting in dehydration.
Females with anorexia nervosa are diagnosed when they go through amenorrhea, which means not having a period for at least three months in a row. This happens because of starvation and losing weight, which affects the body's reproductive functions. Treatment plans for anorexia nervosa vary depending on each person's needs and may include medical care, supervision, nutritional counseling, and therapy. Severe cases require hospitalization to regain a healthy weight. People with this disorder need help in changing their thoughts about eating habits. Detecting it early helps make the treatment shorter since everyone's recovery process is different.
The National Association of Anorexia Nervosa and Associated Disorders reports that only 1 in 10 individuals with eating disorders seek treatment, and just 35% of those people receive specialized facility treatment. Bulimia nervosa is an eating disorder characterized by the cycle of bingeing and purging. Despite being within a normal weight range, individuals still have a fear of gaining weight and are unhappy with their body image. Unlike anorexia, bulimia may not be visibly apparent as individuals can have either a normal weight or be overweight. Binge episodes can vary in caloric intake from around 1,000 to as high as 20,000 calories. Typically occurring during late adolescence or early adulthood (between ages 18 and 22), bulimia involves consistent engagement in bingeing followed by compensatory behaviors aimed at reversing the effects of the binge or preventing weight gain.
Compensatory behaviors related to bulimia, such as self-induced vomiting, laxative misuse, diuretic abuse, fasting, and excessive exercise, are often performed covertly due to feelings of shame and illness. These behaviors typically happen several times per week in individuals with the disorder. Research indicates that those born after 1960 have a higher risk for bulimia, particularly in urban areas, suggesting a contribution from environmental exposure and social learning.
Bulimia is significantly more common in females than males, occurring nine times more frequently. It is commonly accompanied by psychiatric and physical symptoms. Additionally, around 80% of individuals with bulimia also have another psychiatric disorder.
Bulimia is characterized by a range of psychiatric symptoms, including depression, anxiety, low self-esteem, extreme perfectionism, self-consciousness, irritability, impulsive spending, shoplifting, and potential substance abuse issues. The most common psychiatric disorders associated with bulimia are anxiety disorders, major depression, substance use disorders, and personality disorders. Individuals with bulimia often exhibit traits such as perfectionism and low self-esteem similar to those with anorexia nervosa. They also tend to display impulsive behavior and have a higher inclination for seeking stimulation. Moreover, they frequently demonstrate erratic and impulsive characteristics. In addition to the psychiatric symptoms mentioned above that characterize bulimia nervosa patients also present physical manifestations such as dehydration electrolyte imbalance kidney problems inflammation and discomfort in the throat from purging acid reflux swollen parotid glands gastrointestinal complications irregular menstruation constipation bloating sensitive teeth and tooth enamel decay caused by stomach acids. Treatment for bulimia is crucial for the well-being of individuals affected by it. It involves strategies such as reducing or stopping bingeing and purging patterns receiving nutritional counseling cognitive behavioral therapy medication prescription and exploration of underlying causes of the illness.
Approximately 70% of individuals with Bulimia have the potential to recover from this disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM) provides specific criteria for diagnosing anorexia nervosa and bulimia nervosa, but many people with eating disorders do not meet these criteria. Instead, they are diagnosed using a different method called Eating Disorder Not Otherwise Specified (EDNOS). In the textbook Abnormal Psychology, there are six examples from the DSM-IV that illustrate the distinctions in symptoms between EDNOS and other disorders. These examples include: 1. exhibiting all symptoms of anorexia nervosa except amenorrhea, 2. displaying all symptoms of anorexia nervosa except significant weight loss, 3. meeting all criteria for bulimia nervosa except frequency of binge eating or purging or duration of 3 months, 4. engaging in regular inappropriate compensatory behavior after consuming small amounts of food, 5. practicing chewing and spitting out food (also known as purging disorder), 6. experiencing binge eating disorder without accompanying compensatory behavior.
Binge eating disorder (BED) is characterized by regular episodes of binge eating, without the compensatory behaviors seen in other eating disorders. Although BED is a recent addition to the Diagnostic and Statistical Manual of Mental Disorders (DSM), it has not yet been officially recognized as a psychiatric disorder. Consequently, little is known about its impact on morbidity and mortality. Research indicates that BED can persist for an average of 14.4 years, suggesting that it may not be a transient condition.
Depression and anxiety commonly accompany BED, similar to other eating disorders. About 3.5% of females meet the criteria for BED, while only 2% of males do so. Furthermore, around 5 to 8% of obese individuals have BED.
Eating disorders affect males and females differently; for example, anorexia nervosa is more prevalent among women and girls than men and boys at a ratio of 9 to 1. Various theories have been proposed to explain why women are more affected by this disorder, with societal pressure for females to achieve an ideal appearance or "perfection" in their bodies being one prominent explanation.
Similarly, bulimia nervosa exhibits a slightly sex-biased distribution with approximately a 9 to 1 ratio of women compared to men.
After binge eating, men tend to engage in nonpurging forms of compensatory behavior rather than excessive exercise. This is especially true for male athletes who feel pressured to maintain a thin and fit physique, leading them to excessively focus on their weight and body shape. The sex ratio for binge eating disorder is balanced, indicating that both genders are affected equally. Developmental factors play a significant role in the causes of eating disorders. While anorexia nervosa is generally uncommon during childhood, its prevalence is increasing. On the other hand, bulimia nervosa rarely occurs before puberty. Anorexia nervosa not only isolates individuals from peers and family but also has negative emotional and financial impacts on the family unit. Parents often struggle to understand why their children are harming themselves and their bodies, causing extreme anxiety. Dealing with this stress along with the financial burden of treatment can weaken or even break apart a family's functioning. For girls with bulimia who develop mature figures earlier than their peers, disappointment may lead them to experiment with controlled eating habits and weight management at an early age, thereby increasing the risk of developing an eating disorder.
Binge eating typically begins in late adolescence or early adulthood. There are different treatments available for eating disorders, but the treatment goals vary depending on the specific disorder. For anorexia nervosa, the aim is to increase calorie intake and promote weight gain to address the psychological aspects of the disorder later on. In the case of bulimia nervosa, the focus is on restoring normal eating habits, eliminating binge eating and purging behaviors, and improving psychological well-being. For individuals with binge eating disorder who are overweight, the goal is to stop binge eating and establish a regular pattern of eating. Weight stabilization or loss can also be beneficial in these cases. Successful inpatient treatment for anorexia nervosa requires a disciplined team approach.
The first step in the treatment process is to help the patient regain their weight. However, there are other factors to consider such as medical complications, suicidal thoughts or actions, lack of progress with outpatient treatment, disruption to school, work, or family life, and pregnancy. Hospitalization can be challenging for both the patient and their family due to the patient's fear of letting go of their symptoms and potential food phobia. It is essential for the doctor to create a safe environment and build trust with the patient for successful hospitalization. Biological treatments may involve medications that help treat or minimize symptoms of the disorder. Currently, medications prescribed for anorexia nervosa have shown no effectiveness. Nevertheless, fluoxetine (Prozac) has proven effective in reducing core symptoms like binge eating and purging in bulimia nervosa as well as associated psychological issues such as depression and anxiety. Fluoxetine has been approved by the FDA specifically for treating bulimia nervosa but not any other eating disorders.
Although fluoxetine may alleviate symptoms, it has not been proven to provide long-term relief or cure for eating disorders. Nutritional counseling is necessary but not sufficient for all eating disorders. One additional treatment that addresses the thought patterns contributing to the problem is cognitive-behavioral therapy (CBT). CBT has shown recovery rates ranging from 35-75% at follow-ups of five or more years. In the case of anorexia nervosa, CBT may help prevent relapses in adults after weight restoration, but its effectiveness for extremely underweight individuals remains uncertain. For bulimia nervosa, self-monitoring forms the foundation of CBT, where individuals track their eating habits, situations, thoughts, and feelings. CBT places significant emphasis on preventing relapses for all eating disorders and is also a successful treatment for binge eating disorder.
Binge eating disorders can be addressed through the use of a help-book or an online cognitive-behavioral program that individuals can engage with at their own pace. To tackle the family-related aspects of anorexia nervosa, a family-based intervention is employed to address and rectify any dysfunctional dynamics within the family unit. This form of therapy aids in promoting a healthier environment and fostering open communication among family members.
Contemporary approaches to family therapy for anorexia nervosa encompass various methods such as conjoint family therapy, separated family therapy, parent training, and the Maudsley method. The Maudsley method specifically emphasizes parental control during the initial stages of renutrion. These therapeutic interventions adhere to seven fundamental values:
In summary, I have discussed three types of eating disorders - anorexia nervosa, bulimia nervosa, and binge eating disorder - along with the factors that can contribute to their development. I have examined the mental, behavioral, and physical aspects of these disorders and provided definitions for each. Additionally, I have explored the various personalities and psychological dysfunctions that can accompany eating disorders, as well as the sex ratios and developmental factors associated with them. Lastly, I have outlined some treatment options for reducing symptoms and preventing relapse, including inpatient treatment, biological treatments, nutritional counseling, cognitive-behavioral therapy, and family-based interventions.
Works Cited
The National Association of Anorexia Nervosa and Associated Disorders website provides information about eating disorders. You can find information about bulimia nervosa at the following link: http://www.anad.org/get-information/about-eating-disorders/bulimia-nervosa/. On The National Women’s Health Information Center website, you can find information about body image and loving yourself inside and out: http://www.womenshealth.gov/bodyimage/eatingdisorders/. The National Eating Disorder Information Centre website offers information about eating disorders: http://www.nedic.ca/. The U.S. Library of Medicine, U.S. Department of Health and Human Services, National Institutes of Health website provides information about anorexia nervosa, binge eating, and bulimia nervosa: www.nlm.nih.gov/medlineplus/eatingdisorders.html. You can find eating disorder statistics on the website: [source].
The Impact of Eating Disorders on Adolescents. (2016, Aug 17). Retrieved from https://studymoose.com/eating-disorders-research-paper-essay
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