Eating Disorders

The media’s obsession with weight and its relentless portrayal of ‘desirable’ women with unrealistically thin figures has made eating disorders one of the leading health concerns of modern-day living, especially among young women. With as many as 11 million Americans currently suffering from eating disorders and about 80% of women reporting dissatisfaction with their appearance, it is no exaggeration to say that eating disorders have now reached epidemic levels in the United States (“Media’s Obsession…” 2008). In this research paper, I shall present an overview of eating disorders, including a discussion of their types, symptoms, causes, treatment and prevention.

Types of Eating Disorders

The three most common types of eating disorders are: anorexia nervosa, bulimia nervosa and binge eating disorder (BED). These are briefly explained below:

Anorexia Nervosa: According to the National Eating Disorders Association, “Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.” (“Anorexia Nervosa” 2008). Being characterized by “self-starvation” means that the disorder is brought on by a deliberate and sustained weight loss and is to be distinguished from “anorexia” in which a symptomatic loss of appetite or disinterest in food occurs. The four primary symptoms of anorexia nervosa include a deliberate resistance to maintaining a ‘normal’ body weight for the age and height; an intense fear of gaining weight or being fat, even while being underweight; suffering from a distorted body image; and loss of menstrual periods in post-menarchal females (Levey, 2006).

Associated symptoms of the disorder may include depressed mood, social withdrawal, irritability, insomnia, and diminished interest in sex. Other features such as an exaggerated concern about eating in public, feelings of ineffectiveness, a strong need to control one’s environment, inflexible thinking may also be present (Ibid.)

In the United States, anorexia nervosa has been found to occur in 1 out of 100-200 females, mostly in late adolescence and early adulthood and the incidence rates have shown an increasing trend in recent years. The rate of occurrence follows a similar pattern in economically developed countries with the disorder occurring far more frequently in industrialized societies where food is abundant and thinness is considered to be a feature of feminine beauty. The affliction has been found to occur mostly in the white population. However, this may well be due to the economic reasons rather than for reasons of race since the white population in the U.S. And elsewhere is economically more prosperous than populations of other races. Anorexia nervosa can be termed as a disease of ‘young females’ since more than 90% of cases occur in females and it is more common in early adolescence (13~18 years) and early adulthood (Ibid).

Some of the negative health consequences of the condition include an abnormally slow heart rate and low blood pressure, making the sufferer susceptible to heart failure; osteoporosis or a reduction in bone density that results in brittle bones; muscle loss and weakness; episodes of fainting, fatigue, and overall weakness; severe dehydration, which can result in kidney failure; as well as hair loss.

The seriousness of the anorexia nervosa as a disease is reflected in the disturbing statistic that it has the highest premature mortality rate of any psychiatric disorder; in addition, for females (aged between 15 and 25) suffering from anorexia nervosa, the mortality rate is twelve times higher than the death rate of ALL other causes of death (“Statistics: Eating Disorder and their Precursors,” 2008).

Bulimia Nervosa: Bulimia nervosa is an eating disorder characterized by periods of binge eating, followed by guilt and periods of over-compensation for the overeating through forced vomiting; misuse of laxatives, diuretics, or enemas; fasting; and/or excessive exercising. Some features of bulimia nervosa overlap those of anorexia nervosa such as an extreme concern with body weight and shape; however, it is different in other aspects as most individuals with bulimia maintain a normal or above-normal body weight and the condition involves a greater ‘loss of control’ in the individual.

Because an individual suffering from bulimia nervosa usually maintains a normal weight, the condition is often more difficult to diagnose. Warning signs that would indicate presence of the disorder include evidence of binge eating such as disappearance of large amounts of food in short periods of time; evidence of purging behavior such as frequent trips to the bathroom after meals; signs or smells of vomiting; discarded wrappers of laxatives or diuretics; excessive exercise regimens. (“Bulimia Nervosa”(2008) — National Eating Disorders) Substance abuse, bad breath and eroded tooth enamel are other tell-tale signs of the condition.

Bulimia nervosa affects 1-2% of adolescent and young adult women in the U.S. And other developed countries, and a majority (80%) of bulimia nervosa patients is female. The number of cases of bulimia have risen dramatically in recent decades with a 3-fold increase seen in women aged 10-39 between 1988 and 1993. The Academy for Eating Disorders reports that there is a 50% recovery rate of bulimia sufferers, while 30% show some improvement and 20% show no recovery at all (“Statistics: Eating Disorders…”)

Bulimia nervosa, like anorexia nervosa, can have devastatingly harmful effects on the body. The recurrent binge-and-purge cycles are particularly harmful for the digestive system and often result in electrolyte and chemical imbalances in the body that, in turn, affect the heart and other major organ functions (Ibid.). Other harmful effects on the body of a person suffering from bulimia nervosa include inflammation and possible rupture of the esophagus from frequent vomiting; tooth decay from the effect of stomach acids released during frequent vomiting; and irregular bowel movements and constipation as a result of laxative abuse (Ibid).

Apart from exhibiting extreme behavior in their eating habits, people suffering from the disorder, are also known to behave compulsively in other spheres of their lives by engaging in sexual promiscuity, pathological lying, and shoplifting.

Binge Eating Disorder

Binge Eating Disorder (BED) is one of the most common types of eating disorders, but it is still not officially considered as a distinct medical condition because of its non-specific nature and its similarity to bulimia nervosa. However, BED can be clearly distinguished from bulimia, since people with binge-eating disorder do not try to rid themselves of the extra calories consumed during their binge periods by self-induced vomiting, over-exercising or other methods.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) which is used by mental health professionals to diagnose mental conditions says that more research is needed before determining whether binge eating is truly a distinct medical condition. It does, however, offer some criteria for diagnosing BED, including:

Recurrent episodes of binge eating, including eating an abnormally large amount of food and feeling a lack of control over eating

Binge eating that is associated with at least three of these factors: eating rapidly; eating until one is uncomfortably full; eating large amounts when not hungry; eating alone out of embarrassment; or feeling disgusted, depressed or guilty after eating

Distress about your binge eating

Binge eating occurs at least twice a week for at least six months

Binge eating isn’t associated with inappropriate methods to compensate for overeating, such as self-induced vomiting (“Binge Eating Disorder” 2008)

The health consequences of BED are similar to the ones associated with clinical obesity and include problems such as high blood pressure, high cholesterol levels, heart disease, and diabetes mellitus. Other complications such as depression, anxiety, panic attacks, and substance and alcohol abuse may also accompany BED.

Binge Eating Disorder is estimated to be present in approximately 1-5% of the general population and affects women more often than men in a ration of 60:40.

Causes of Eating Disorder

Eating disorders are complex conditions and may emanate from a combination of causes including behavioral, emotional, psychological, interpersonal, and social factors. Scientists and researchers are still in the learning-process about the underlying causes that give rise to a full blown eating disorder. However, the current state of knowledge about the causes of eating disorders indicates that several factors are common in the development of most types of eating disorders that were discussed above.

Negative Family Influences Negative influences within the family are believed to play a major role in triggering and perpetuating eating disorders. An insecure infancy, for example, in which a safe and secure foundation for a child is absent, may foster eating disorders in her later life. Inappropriate parental behaviors such as being over-critical of a child or over-involvement in a child’s life have been found to be major factors in causing eating disorders. Children in families having a history of addictions (alcohol or substance abuse) and/or emotional disorder are also prone to develop eating disorders. Women with eating disorders, particularly bulimia, appear to have a higher incidence of sexual abuse with some studies reporting sexual abuse rates as high as 35% in women with bulimia (“Causes of Eating Disorders” 2006).

Problems Surrounding Birth Some studies have shown that there is a co-relation between eating disorders and certain problems encountered by a mother during pregnancy or by an infant immediately after birth. For example, a study conducted in 2006 suggested that specific obstetric complications that affected mothers and newborn infants may increase the risks for anorexia nervosa and bulimia in the child. These conditions include maternal anemia, maternal diabetes, and maternal high blood pressure during pregnancy, which increase the risk of anorexia in the child. After-birth complications in the newborn infant such as heart problems, low response to stimuli, early difficulties in eating, and below-normal birth weight have also been found to increase the risk of anorexia and bulimia (Ibid.)

Genetic Reasons Some experts consider genetics to be the root cause of most cases of eating disorders and anorexia has been found to be “eight times more common in people who have relatives with the disorder” (Ibid., para on Genetic Factors). Certain specific chromosomes (e.g., regions chromosome 10) have been identified that may be associated with bulimia and anorexia. In addition, genetic factors may be responsible for certain behavioral patterns such as anxiety and obsession or traits such as minimum body mass index that are precursors to development of eating disorders.

Psychological Reasons: Psychological factors such as low self-esteem, feelings of inadequacy or lack of control in life, depression, anxiety, anger, or loneliness are believed to be major reasons behind the development of eating disorders (“Causes of Eating Disorders” 2008).

Cultural Pressures: Cultural pressure in Western societies, where ‘thinness’ especially in women is depicted as beautiful, is one of the main reasons for triggering eating disorders. The media, in particular, glorifies thinness, presents anorexic young models as the paradigm of sexual desirability, and bombards the consumers with advertisements of weight-reducing products almost non-stop.

Treatment and Prevention

Treatment of eating disorders is difficult because the patients suffering from anorexia or bulimia, in particular, consider their emaciated condition as normal or even desirable and show resistance to any treatment. The first step in treatment of eating disorders, therefore, is the necessity of impressing upon the patient and/or her family the serious harmful effects of the condition. The other important aspect of treatment of eating disorders is that it is often long drawn out and does not offer instant cure; hence the patient or her family should not be given or have unrealistic expectations about a treatment.

In general, treatment of most eating disorders involves some type of psychiatric or psychological therapy along with a regimen of medications; the type and dosage of medicine depending on the type disorder and the severity of the condition.

In an anorexic patient, nutritional intervention is necessary for restoring normal weight to help reduce bone loss and raise energy levels and to enable the patient to benefit from a psychotherapeutic treatment program that may follow. Dietary supplements such as Calcium and multivitamins are often given to underweight patients; in more severe cases, tubal or intravenous feeding may become necessary.

Psychological treatment includes family therapy employing cognitive-behavioral techniques for younger patients and individual support therapy for older patients. Drug therapy for anorexia nervosa and bulimia nervosa includes the use of anti-depressants such as fluoxetine (Prozac), anti-anxiety drugs, and sometimes even anti-psychotic drugs in severe cases. It is also important to restore normal menstruation in anorexic women and girls; this is achieved by restoring normal weight and/or hormonal drugs containing estrogen and progestin (“Treatment for Anorexia”)

Because of the seriousness of the problem and the difficulty and expense involved in effective treatment of eating disorders, it is important to concentrate on the prevention of the condition. Of course, the most effective ‘prevention’ of anorexia in particular would be a change in our cultural obsession with slenderness. At the individual level, children should be regularly checked for body mass index (BMI) and their eating habits monitored by parents in order to provide early warning of problems. Parents can also inculcate a healthy body image in their children by protecting them from being teased about their appearance and teaching them the pitfalls of dieting. Symptoms of anxiety, depression or other mood disorders in children, which often accompany eating disorders, should not be ignored (“Treatment for Anorexia” 2006).

Conclusion

As we saw in this paper, eating disorders in the U.S. And other developed countries have assumed alarming proportions in recent times. Increasing cases of anorexia and bulimia among adolescent girls, in particular, are a cause of major concern. The health effect of these eating disorders is very serious in most cases and their diagnoses and treatment are difficult. It is best, therefore, to try and prevent the condition by fighting the unhealthy obsession with slenderness in our society and inculcating healthy eating habits in our children.

References

Anorexia Nervosa.” (2008). National Eating Disorders Association. Retrieved on December 6, 2008 at http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=41142

Binge Eating Disorder.” (2008). Mayo Clinic.com. Retrieved on December 6, 2008 at http://www.mayoclinic.com/health/binge-eating-disorder/DS00608/DSECTION=tests-and-diagnosis

Bulimia Nervosa” (2008). National Eating Disorders Association. Retrieved on December 6, 2008 at http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=41141

Causes of Eating Disorders.” (2006). University of Maryland: Medical Center. Retrieved on December 6, 2008 at http://www.umm.edu/patiented/articles/what_causes_eating_disorders_000049_3.htm

Levey, Robert. (2006). “Anorexia Nervosa.” e-Medicine. Retrieved on December 6, 2008 at http://www.emedicine.com/med/topic144.htm

Media’s Obsession with Weight puts Women in Danger.” (2008). The Spectrum & Daily News. Retrieved on December 6, 2008 at http://www.thespectrum.com/article/20081112/OPINION/811120328

Statistics: Eating Disorder and their Precursors.” (2008). National Eating Disorders Association. Retrieved on December 6, 2008 at http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=41138

Treatment for Anorexia.” (2006). University of Maryland: Medical Center. Retrieved on December 6, 2008 at http://www.umm.edu/patiented/articles/what_specific_treatments_patients_with_anorexia_000049_10.htm

Other eating disorders, not yet officially recognized as medical conditions include, orthorexia nervosa — an unhealthy obsession with eating only healthy food; hyperphagia — an abnormal appetite and excessive ingestion of food; and pica — a craving for non-nutritive substances such as soil, coal, feces, chalk, paper or soap.

The electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body — a natural consequence of the purging behavior

Eating Disorders