In America, girls are given the message at a very young age that in order to be happy and successful, they must be thin. Given the value, which our society places on being thin, it is not surprising that eating disorders are on the increase. In America, thousands of teenage girls are dealing with emotional situations daily and eating behavior can be affected by the way they are feeling. Eating disorders affect over five million men and women in the United States, and sadly enough thousands of them will die from the physical problems caused by conditions that are linked with eating disorders. Most people think of the extremes of anorexia, bulimia, and binge eating; the truth is that almost every American, at some point in his or her lifetime, will suffer from issues of weight loss, body shape, or self-image, if not all three. Due to these factors, eating disorders are a major concern for psychologists today (Harmon, 1999). This trend, however, is found mainly in America and countries with western ideals.
Eating Disorders are primarily behavior disorders. Douglas Eagles (1987) states, “the behavioral disturbance leads to disorders of nutrition” (p. 71). The definition of Eating Disorders as defined by Harmon (1999), “a psychological disorder in which a person is unable or unwilling to maintain normal eating habits, and instead engages in self-starvation, binging, purging, or some combination of these behaviors (83). Eating disorders are not just about losing weight and the search for the ideal body, they are mainly about expressing difficult feelings (Abraham & Llewellyn-Jones, 1999). Eating Disorders affect over five million Americans and thousands will die from these conditions (American Anorexia Bulimia Association [AABA], 2001). The prevalence of eating disorders has increased in the last forty years. It is believed that extreme eating disorders occur in approximately 4 percent of American females (Costin, 1999).
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However, eating disorders can also be found in males. “Both anorexia and bulimia appear to be much more common in women than in men, from 90 to 95 percent of all patients are females” (Long, 1999). Eating disorders typically begin in adolescence between the ages of twelve and twenty-five, however, they may begin as early as seven and can continue until as late as fifty-nine. There are three main classifications of eating disorders, anorexia nervosa, bulimia nervosa, and binge eating. The general definition of anorexia nervosa is a severe restriction in the amount of food a person eats, avoidance of eating, and occasionally purging. Whereas bulimia is the occurrence of frequent episodes (at least two times per week) of binge eating combined with purging to rid their body of the large quantities of food (Harmon, 1999). A binge-eater, otherwise known as compulsive overeating, will eat large amounts of food, much like that of a bulimic, but will not engage in the purging behaviors (Costin, 1999).
Eating disorders are linked to several causes. One consideration is the perception of the ideal body image. Teens are given two messages when it comes to dieting and eating. First, they are bombarded with images of slim, successful women from the media. The media promotes the idea that one must be thin in order to be liked by peers and successful. The second message, as determined by Abraham and Llwvellyn-Jones (1999), “is that eating is a pleasurable activity which meets many needs, in addition to relieving hunger, and women have a right to have these needs met” (p. 38). In addition to the societal causes of eating disorders, there are biological considerations. Eating disorders may have a hereditary contribution. Eating disorders tend to run in families. It is noted that people from the same family have an increased risk of developing an eating disorder (Costin, 1999). However, Costin does not believe that there is a genetic link. “A mother who has anorexia nervosa may pass on her eating habits to her daughter through modeling behavior rather than bypassing on a genetic predisposition for developing the disorder”(p. 71).
One of the most proven causal factors for eating disorders is that of personality. Adolescents who develop the disease seem to have common personality characteristics. Women who are obsessed with their bodies also tend to be obsessed with emotional problems. They also tend to have low self-esteem, feelings of helplessness, diminished self-worth, feelings of emptiness, the quest for perfection, desire to be special, need to be in control, need for power, desire for respect and admiration, difficulty expressing feelings, need for escape, lack of coping skills, lack of trust, and terrified of not measuring up (Costin, 1999). In addition to personality characteristics, there tend to be patterns in families that may cause eating disorders. The family of an eating disorder patient tends to have mothers who are overly concerned with their child’s weight and physical appearance (Long, 1999). Mothers also tend to be too close to their daughters or sons thus making it harder for them to grow up.
The child feels responsible for their mother’s happiness or may be afraid to leave the shielding home environment. Also, The mothers may have trouble letting go of the adolescent because of their desire to be needed (Hall & Ostroff, 1999). Fathers, on the other hand, tend to be physically or emotionally absent from the child’s life thus creating a void. Without a father to guide and reassure them, they may create in unrealistic body image, food fears, and insecurity about their roles (Hall & Ostroff, 1999). Outside the US eating disorders are not as common. This is because in many non-western societies plumpness is considered attractive and desirable, and also associated with prosperity, fertility, success, and economic security (Nassar, 1988). Although in recent statistics more and more cases are showing up in nonindustrialized or pre-modern populations as they become more westernized (Hall & Ostroff, 1999).
In cultures in which female social roles are restricted (such as the Muslim societies) eating disorders are virtually unknown. This is thought to be because Muslim societies limit the social behavior of women according to the male dictates. This supports the idea that freedom for women as well as an influence is sociocultural factors that may predispose to the development of eating disorders (Bemporad, 1997). Due to the dangerous effects of eating disorders, it is necessary to find help for patients as soon as the disease is detected. The longer the eating disorder is present the harder it is to overcome the disorder and thus creating consequences for the individual (Long, 1999). Treatment for eating disorders usually consists of nutritional therapy, individual psychotherapy, group counseling, and family counseling. A team made up of pediatricians, psychiatrists, social workers, and nurses often administer treatment.
Some physicians hospitalize eating disorder patients until they are nutritionally stable, while others prefer to work with patients in a family setting. Individual psychotherapy is also necessary for the treatment of these disorders to help the patient understand the disease process and its effects (Long, 1999; Costin, 1999; Abraham & Llewellyn-Jones, 1999). Therapy focuses on the patient’s relationships with his/her family, friends, and the reasons she/he may have fallen into these patterns of destruction. As a patient learns more about her/his condition, she/he is often more willing to try to help herself/himself recover (Hall & Ostroff, 1999). Medications can also be used to treat eating disorders. However, in treating eating disorders, the APA’s general rule of thumb is to treat the nutritional factors first before using medications because mood disorders and other psychological symptoms that often go along with eating disorders may improve or even clear up with nutrition rehabilitation.
It is extremely important to remember that immediate success does not guarantee a permanent cure. Sometimes, even after successful hospital treatment and a return to normal weight, patients suffer relapses. Follow-up therapy lasting three to five years is recommended if the patient is to be completely cured (Costin, 1999). Anorexia, bulimia, and binge eating can cause physical problems and a great deal of unhappiness. It is important to remember that many people have worries about food and their own self-image at some point in their lives. This does not necessarily mean that they will go on to develop an eating disorder. But, it is important not to overlook the early warning signs. Although it is mainly a problem in the US, eating disorders are becoming a bigger and bigger problem throughout the world as western values are becoming more widely accepted. It is very important to get help for the patients as soon as their disease is detected, so they can start treating/them and get them back to their normal weight and state of mind.
- Abraham, S., & Llewellyn-Jones, D. (1999). Eating disorders: The facts. Oxford:
Oxford University Press.
- American Anorexia Bulimia Association, Inc. [online].Available: http: //www.aabainc.org/home.html [2001, March 5].
- Bemporad JR (1996), Self-starvation through the ages: a reflection on the prehistory of anorexia nervosa. Int J Eat Disord 19(3):217-237.
- Costin, C. (1999). Eating disorder sourcebook. Lincolnwood, IL: Lowell House.
- Eagles, D. A. (1987). Nutritional Diseases. New York: Franklin Watts.
- Hall, L., & Ostroff, M. (1999). Anorexia a guide to recovery. Carlsbad, CA: Gürze Books.
- Harmon, D. (1999). Anorexia nervosa: starving for attention. Philadelphia: Chelsea House. Long, P. W. (1999). Eating disorders. In Internet Mental Health [online].
- Available: http://mentalhealth.com/book/p45-eat1/html [2001, March 5].
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