Eating Disorders When people think of disorders the usually tend to think of mental or physical disorders, but eating disorders go right along with these disorders also. Eating disorders are characterized by a compulsive fixation with food, body weight, or self-image. This disorder is becoming more and more prevalent in the United States partially due to the media’s portrayal of what might be considered attractive. But the images of unrealistic “skinny” women that is shown on television, in magazines and across the Internet is only a small part of the contributing factors to eating disorders. Other contributing factors include “…low self-esteem, depression, substance abuse, and suicidal ideation” (Sue, Sue & Sue, 2009, p.445). Eating disorders not only affect adolescents but adults also. Both men a and women suffer from eating disorders, however women and girls are more likely to have a negative self image and engage in disordered eating patterns. Even though the population of the United States is becoming heavier, women are increasingly putting an emphasis on being thinner. Men also affected by distorted eating patterns, however with male adolescents and college-aged boys weight dissatisfaction revolves around being heavier and more muscular. When a person has a distorted eating pattern it could lead to other serious disorders like bulimia nervosa, anorexia nervosa, or binge eating. Anorexia nervosa is an “eating disorder characterized by low body weight, an intense fear of becoming obese, and body image distortion” (Sue, Sue & Sue, 2009 p.446). Some of the symptoms of Anorexia Nervosa is a refusal to maintain a body weight above the minimal normal weight for ones age and height, an intense fear of becoming obese, and not having the ability to recognize one’s thinness. Bulimia Nervosa is characterized by, “recurrent episodes of rapid consumption of large quantities of food, a sense of loss of control over eating combined with purging” (Sue, Sue & Sue, 2009 p.449). Some of the symptoms of Bulimia Nervosa are recurrent episodes of binge eating, loss of control of eating, using vomiting, exercise, laxatives, or dieting to control weight, two or more binge eating episodes occurring for more than three months and an over concern with body, weight and shape. Binge Eating Disorder is an eating disorder that “involves the consumption of large amounts of food over a very short period of time, an accompanying feeling of loss of control, and distress over the excess eating without regular inappropriate compensatory behavior” (Sue, Sue & Sue, 2009 p.451). The symptoms of Binge Eating Disorder are loss of control when eating, marked distress over binge eating, recurrent episodes, and occurring two or more times a week for six months. Some of the physical complications the can arise from anorexia are cardiac arrhythmias, low blood pressure and slow heart attacks. Suffers of Anorexia Nervosa can also have dry skin, brittle hair, and hypertrophy of the parotid glands, and hypothermia. Other complications of Anorexia can include irreversible osteoporosis, vertebra contraction, and stress fractures. Heart muscle damage can also occur due to the body using the muscles as a source of protein during periods of starvation. Some of the physical complications that can occur from individuals that suffer from Bulimia Nervosa are tooth erosion from recurring vomiting, gastrointestinal disturbances such as inflammation of the esophagus, gastric and rectal irritation and cardiac arrest. There are also a number of mental disorders associated with bulimia nervosa, seasonal affective disorder, borderline personality, and substance abuse. People affected with Binge Eating Disorder can also be affected with a host of other mental disorders, obsessive-compulsive disorder, and avoidant personality disorders are just a couple. The etiologies of eating disorders are believed to be determined by biological, psychological, social, and sociocultural factors. The biological factor incorporates genetic factors neurological or neurotransmitter vulnerabilities along with obesity, overweight, and pubertal weight gain. From the psychological dimension there is body image, or body distortions, low self-esteem, perfectionism, and childhood sexual abuse or physical abuse. In the social dimension the factors include parental attitudes and behaviors, parental comments regarding appearance, weight concerned mothers, a history of being teased about size or weight, and peer pressure regarding weight. In the sociocultural dimension the factors include social comparison, media presenting distorted images, cultural definitions of beauty, and objectification; male and female bodies evaluated through appearance. “These dimensions interact with each other and combine in different ways to result in an eating disorder” (Sue, Sue & Sue, 2009 p.454) over the past 25 years there has been a dramatic increase in eating disorders largely due to our society’s emphasis on thinness and attractiveness. While other countries do not place such a great emphasis on thinness, there are still some that suffer from eating disorders. For those outside of the U.S. that do suffer from eating disorders, studies show that that society has been drawn to western standards of thinness. According to the American Psychiatric Association, there is a treatment plan that can help those that suffer from anorexia. The treatment of physical complications includes symptoms related to starvation and physiological reactions during refeeding. Encouraging sufferers to participate in treatment programs, and psychoeducation about healthy eating patterns and nutrition. The identification of sufferer’s attitudes, dysfunctional thoughts and beliefs, and conflicts and feelings that underlie the eating disorder. They also suggest that there are provisions of psychotherapy to deal with emotional disturbances related to eating, family support and family therapy and relapse prevention. The treatment goals for bulimia nervosa include reducing binge eating, treating physical complications, motivating the client to participate in healthy eating patterns, providing education regarding eating and nutrition, identifying dysfunctional thoughts and moods associated with eating, providing psychotherapy, obtaining family support, and preventing relapses. The treatment for binge eating is similar to the treatment of bulimia however the treatment is usually done in two stages. First cognitive factors underlying the eating disorder are identified and the client is taught to use strategies to reduce eating binges. Second the cognitive strategies are employed to change the distorted belief about eating. Obesity is also an eating disorder and it is defined as, “a body mass index greater than 30” (Sue, Sue & Sue, 2009 p.467). The body mass index is an estimate of body fat calculated on the basis of a person’s height and weight. There are also four dimensions of the etiology of obesity. The biological dimension includes genetic influence on appetite, dopamine receptors and pleasure in eating, and the “thrifty genotype”. The psychological dimension includes negative mood states, binge eating, and poor self-esteem due to harassment. The social dimension includes, teasing, overweight friends, and parental attitudes regarding eating. And the sociocultural dimension includes, cultural influences on body preferences, poorer neighborhoods and less access to healthy foods, and the advertising of high-calorie foods. Treatment options for obesity include dieting, lifestyle changes, medications, and surgery. It is thought that dieting alone only produces short-term weight loss but tends to be ineffective in the long term and some individuals gain back more weight than was lost.

In conclusion, eating disorders and obesity are a heterogeneous group of disorders. It has only been recently that scientists began to focus on how genetics influence neurochemistry. Eating disorders are very complex and are rooted in emotional issues that revolve around self-esteem and persistent societal messages that correlate thinness with happiness. Eating disorders usually surface in adolescents but can diagnosed in adults also, and most of those that suffer from eating disorders are female although the disorder is increasing in males also. Eating disorders are neither completely physical nor completely psychological, but a combination of both so effective treatments must include both medical management and psychotherapy. The sooner a diagnosis is made and treatment is started, the better the chances of a successful conclusion.

References

Sue, D., Sue, D. W., & Sue, S. (2009). Understanding abnormal behavior. (9th ed., p. 44). Boston: Wadsworth.