Anorexia And Bulimia Research Paper

Types of Eating Disorders

"Look how thin and beautiful she is!" A common sentence uttered in the fashion industry, not just in the United States but also around the globe. It is safe to say that thin is in, and thinner is always better--aesthetically that is. The growing concern about appearance is not overestimated--disorders such as anorexia nervosa and bulimia nervosa are plaguing our world.

Individuals are diagnosed as anorexic (according to the DSM-IV-TR) if they refuse to maintain the appropriate body weight (according to age and height), and have an intense fear of gaining any more weight - even though they are already underweight (Keel & Klump, 2003). Concisely, if patient "X" is significantly underweight, yet does not want to do anything to correct this then patient "X" is anorexic.

Bulimia nervosa, as defined by the DSM-IV-TR, is just as terrifying as anorexia nervosa. The criteria is as follows: Recurrent episodes of binge-eating--consuming an amount of food which is much larger than most would eat during a similar period of time--at least once a week for three months. A lack of control over binge eating. Recurrent and inappropriate behavior aimed at compensating for the weight gain, self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. The subject�s self-evaluation is based on and influenced mainly by body shape and weight. (Keel & Klump, 2003) In short, a diagnosis of bulimia nervosa is if subject "X" eats more then he or she should, and then inappropriately extinguishes the weight because the subject is not the weight he or she fantasizes to be.

These two disorders, anorexia nervosa and bulimia nervosa, are alarming. Do they have particular risk factors? Can culture, socioculture or genetics cause them? What is their prevalence? These are questions which this paper addresses.

Causes of Eating Disorders

What is more effective than curing an eating disorder? Preventing it. The only way this is possible is by knowing what causes the specific disorder. Everything from macro causes, culture, and sociocultural attitudes, to micro causes, substance abuse and genetic relationships are all possible causes of eating disorders.

To determine if an eating disorder is culture bound data must be collected and sorted from various cultures along a timeline of many years. Are Eating Disorders Culture-Bound Syndromes? Implications for Conceptualizing Their Etiology, by Pamela Keel and Kelly Klump did just that. They attained statistics from an assortment of cultures and along a timeline of sixty years. The experiment was done for anorexia nervosa and duplicated for bulimia nervosa. The results were surprising. Anorexia nervosa does not seem to be a culture-bound syndrome. Bulimia nervosa on the other hand does seem to be culture-bound. There has been a significant increase in bulimia nervosa during the later half of the twentieth century. One striking fact is that every non-western nation that had evidence of bulimia nervosa also had evidence of western influence. The authors do not take this to be a coincidence (Keel & Klump, 2003).

Cashel, Cunningham, Cokley, and Muhammad, in Sociocultural Attitudes and Symptoms of Bulimia: Evaluating the SATAQ with Diverse College Groups, tested the affect of sociocultural attitudes on eating disorders. The method was to question an array of students from a Midwestern University in the United States. The participants consisted of both men and women. The procedure consisted of having the subjects fill out a structured questionnaire, the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ). After the questionnaire was finished a correlation between Caucasian women, all men, African American women, Hispanic American women, Caucasian sororities and Caucasian non-sororities to body dissatisfaction, drive for thinness, and bulimia was calculated.. SATAQ Internalization was significantly correlated with EDI-2 (a self-report measure developed to assess a variety of symptoms reflective of eating disorders), Body Dissatisfaction and Drive for Thinness. SATAQ Awareness scores were extensively correlated with the Body Dissatisfaction and Drive for Thinness scales for the Caucasian American and Hispanic American female groups. The SATAQ Awareness scores for African American women and men were not considerably related to scores from the EDI-2. The extent of the correlations with eating disorders was the strongest for Caucasian and Hispanic American women (Cashel, Cunningham, Cokley, & Muhammad, 2003). To get to the point, this study proves that there is an affect of sociocultural attitudes on eating disorders.

A third possible cause for eating disorders is substance abuse by the parents. Von Ranson, McGue, and Lacono (2003) tested 674 females and their parents. Daughters underwent assessment of eating disorders while their parents underwent assessment of substance abuse. The results of this study show no correlation between parents with past substance abuse problems and their daughters� eating disorders.

Another possible cause for eating disorders is heredity. If a mother has an eating disorder does it mean her child will as well? Von Ranson et al. (2003) tested this possibility. The findings were chilling. The results show a high correlation between mothers that have eating disorders and daughters that have eating disorders. This strengthens the theory that eating disorders can be passed down from generation to generation.

Genetic relationships could be a cause of eating disorders. The most accurate way to study this hypothesis is by examining monozygotic and dizygotic twins. Monozygotic twins have identical genes, while dizygotic twins do not. The higher the correlation between monozygotic twins points to greater genetic causes and less environmental causes. A study by Klump, K., McGue, M. & Lacono, W titled: Genetic Relationships between Personality and Eating Attitudes and Behaviors was undertaken. The study showed an extremely high correlation between genetic influence and eating disorders for the monozygotic twins and a low correlation for the dizygotic twins. Data can be viewed in Chart G in Appendix I. This strengthens the idea that there is a significant genetic influence in eating disorders.

As presumed, there are many things that can cause an eating disorder. Sociocultural attitudes, heredity, and genetics are much stronger influences then substance abuse and culture causes. This is not enough. Factors such as parent-child bonds, economic status, and intelligence must be studied. Unfortunately they have not. In light of this, we seem to know very little about what actually causes eating disorders.

Prevalence of Eating Disorders

Prevalence: The total number of cases of a disease in a given population at a specific time. Is it important to know how many people have a specific disease? Without a doubt, yes. Having an accurate number of the population with a certain disease along a timeline will help to determine trends. It will also help scientists to alienate specific "hot zones", or places where the disease tends to occur more frequently. Knowing the prevalence of a disease can only help to cure it. The following will investigate the prevalence of eating disorders on three sublevels � gender, age, and sexual orientation.

Table 1 shows the point prevalence (1 year) of adolescent males and females. Table A-2 shows the lifetime prevalence of the same adolescents (Andrews, Hops, Roberts, Seeley & Lewinsohn, 1993).

The data in tables A-1 & A-2 was collected by interviewing 10,200 adolescents (under the age of 18) and their parents that lived in a population of 200,000. They were interviewed two times by clinical psychologists or certified social workers. The second interview was about one year (13.3 month mean) after the first. The results of the experiment are divided into anorexia nervosa and bulimia nervosa and further broken down by gender.

Focusing on the point prevalence (Table A-1), neither the adolescent males nor females were diagnosed with anorexia. With regards to bulimia nervosa, a significant number of females in interview one were diagnosed (Andrews, Hops, Roberts, Seeley & Lewinsohn, 1993). During the second interview, just one year later, the amount of females with bulimia nervosa rose.

The results of the lifetime prevalence show that during the one-year gap between the interviews the number of adolescent females diagnosed with anorexia nervosa almost doubled. The adolescent males show no signs of anorexia nervosa. Bulimia nervosa, just as anorexia nervosa, nearly doubles for the female subjects. For males, a small portion were diagnosed with bulimia nervosa; and had a small rise in one year (Andrews, Hops, Roberts, Seeley & Lewinsohn, 1993).

Assessing these results shows the researcher that adolescents are at risk of developing an eating disorder. Females are obviously more at risk (Table A-1 & A-2), but males cannot be omitted. This also shows that adolescents were diagnosed with bulimia nervosa two times more then with anorexia nervosa.

Table B-1 shows the lifetime prevalence of adults with anorexia nervosa (Zhang, & Snowden, 1999). The full chart can be viewed in Appendix I Chart J. The results come from a study of 18,151 American adults (18 years and older). They are broken down into four groups of white, black, Hispanic, and Asian. The results show that white Americans are more vulnerable to be diagnosed with anorexia nervosa then minority groups.

Table C-1 shows the lifetime prevalence of adults with bulimia nervosa divided by sexual orientation. (Siever, 1994) 250 adults participated in the study. The full chart can be viewed in Appendix I Chart K. The results of these findings show that homosexuals, both male and female are at a higher risk of being diagnosed with bulimia nervosa.

In contrast of these prevalence findings you can conclude that anyone is at risk for becoming diagnosed with an eating disorder. In all cases women are at more risk then men. However, men should not be overlooked as victims, as they usually are. The "Eating Disorder Information Board" says that one out of six people with an eating disorder is a man (http://www.eatingdisorderinfo.org/men_eating_disorders.htm). Therefore, eating disorders should be taken very seriously by men, women, and parents of adolescents.Conclusion Do you know someone that has ever had an eating disorder? You answer is more then likely yes. This paper has proved that no sets of people are immune, and that there is a wide variety of ways to contract this disease. There are many causes of eating disorders � genetics, and sociocultural factors are the most relevant. Anyone is at risk for being diagnosed with an eating disorder, however adult women face the highest risk. In contrast, be aware. Learn if you are at high risk for catching this disease. Study the symptoms. If you are experiencing any of them, seek professional help. "Knowing is not enough; we must apply. Willing is not enough we must do" (Johann Wolfgang von Goethe).

References

Agras, W. S., Linehan, M. M., & Telch, C. F. (2002). Dialectical behavior therapy for binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 1061-1065.

Andrews, J., Hops, H., Lewinsohn, P., Roberts, R., & Seeley J. (1993). Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. Journal of Abnormal Psychology, 102, 133-144.

Carson, R. C., Butcher, J. N., & Mineka, S. (2002). Fundamentals of abnormal psychology and modern life. Boston: Allyn and Bacon.

Cashel, M., Cokley, K., Cunningham, D., & Muhammad, G. (2003). Sociocultural attitudes and symptoms of bulimia: Evaluating the SATAQ with diverse college groups. Journal of Counseling Psychology, 50, 287-296.

Dev, P., Elredge, K., Eppstein, D., Taylor, B., Wilfley, D., & Winzelberg, A. (2000). Reducing risk factors for eating disorders: Comparison of an internet- and a classroom-delivered psychoeducational program. Journal of Consulting and Clinical Psychology, 68, 650-657.

Dohm, F., Pike, K. M., Striegel-Moore, R. H., & Wilfley, D. E. (1998). Bias in binge eating disorder. Journal of Consulting and Clinical Psychology, 69, 383-388.

Field, A., Heathernton, T., Keel, P., Mahamedi, G., & Striepe, M. (2001). A 10-year longitudinal study of body weight, dieting, and eating disorder symptoms. Journal of Abnormal Psychology, 106, 117-125.

Fitzgerald, L., & Harned, M. (2003). Understanding a link between sexual harassment and eating disorder symptoms: A mediational analysis. Journal of Consulting and Clinical Psychology, 70, 1170-1181.

Halmi, K. A., et al. (1991). Comorbidity of psychiatric diagnoses in anorexia nervosa. Archives of General Psychiatry, 48, 712-718.

Kaye, W.H., Weltzin, T., & Hsu, L. K. G. (1993). Relationship between anorexia nervosa and obsessive compulsive behaviors. Psychiatric Annals, 23, 365-373.

Keel, P., Kelly, L., Klump, L., & Pamela K. (2003). Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology. Psychological Bulletin, 129, 747-769.

Klump, K., Lacono, W., & McGue, M. (2002). Genetic relationships between personality and eating attitudes and behaviors. Journal of Abnormal Psychology, 111, 380-389.

Lacono, W., McGue, M., & Von Ranson, K. (2003). Disordered eating and substance use in an epidemiological sample: II. Associations within families. Psychology of Addictive Behaviors, 17, 193-202.

Michel, D. (2002). Psychological assessment as a therapeutic intervention in patients hospitalized with eating disorders. Professional Psychology: Research and Practice, 33, 470-477.

Siever, M. (1994). Sexual orientation and gender as factors in socioculturally acquired vulnerability to body dissatisfaction and eating disorders. Journal of Consulting and Clinical Psychology, 62, 252-260.

Skodol, A. E., et al. (1993). Comorbidity of DSM-III-R eating disorders and personality disorders. International Journal of Eating Disorders, 14, 403-416.

Snowden, L., & Zhang, A. (1999). Ethnic characteristics of mental disorders in five U. S. communities. Cultural Diversity and Ethnic Minority Psychology, 5, 134-146.

Stice, E., Presnell, K., & Bearman, S. K. (2003). Relation of early menarche to depression, eating disorders, substance abuse, and comorbid psychopathology among adolescent girls. Developmental Psychology, 37, 608-619.

Stice, E., & Whitenton, K. (2001). Risk factors for body dissatisfaction in adolescent girls: A longitudinal investigation. Developmental Psychology, 38, 669-678.

Subich, L., & Tylka, T. (1998). A preliminary investigation of the eating disorder continuum with men. Journal of Counseling Psychology, 49, 273-279.

Von Ranson, K. M., Iacono, W. G., & McGue, M. (2003). Disordered eating and substance use in an epidemiological sample: I. Associations within individuals. International Journal of Eating Disorders, 31, 389-404.

Wilson, T. (1998). Stepped care treatment for eating disorders. Journal of Consulting and Clinical Psychology, 68, 564-572.

eating disorders

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We have all heard the typical stereotypes of the “perfect body.” Who really has a perfect body anyways, and what does it look like? Are all girls supposed to be tiny and twig like, and are all guys supposed to be macho muscle men? No, and if this were true then that’s how we would have been created, but were not, so be proud of who you are. Thanks to media and today’s culture people are destroying their bodies. We cannot put all the blame on the media though, psychological and mental disorders such as depression, anxiety, guilt, the loss of control, and the need for attention, are among some of the factors that can lead to eating disorders. The three disorders commonly referred to are obesity, anorexia, and bulimia. Each disorder is dangerous to the body, and in many cases can lead to death. Eating disorders affect 70 million people worldwide, and in a single persons life approximately 50,000 people will die because of this terrifying disease.
Obesity is the increase in body weight caused by excessive accumulation of fat. It can be caused by many factors including the ingestion of excessive calories, inactivity, and insufficient exercise. Overeating may also result as a pattern established by family and cultural environments, leading to an emotional dependence on food. Some experts, however, may say that obesity is based upon genetics and physiology, rather than a behavioral or psychological problem. There are many myths regarding obesity, for instance, those who are obese eat more than the non obese. A study in 1979 proved that 19 out of 20 obese individuals eat the same amount as the non obese. People believe that obese individuals are emotionally disturbed, but although they deal with immense social pressures, they do not posses more or less emotions then others. Body fat is said to be unhealthy but in actuality some body fat is beneficial. Another myth is that the obese are at greater risk of cardiovascular disease. This is true with yoyo diets which cause weight to fluctuate throughout adult life. It is thought that obese people are lazy and unfit, but many do exercise and live longer than those who are thin, unfit, and do not exercise. Everyone gets “fat” with old age. Weight increases with age because people become less active, metabolism slows, and you loose muscle mass. Obesity is not untreatable; radical treatments include shutting the jaw, stapling the stomach, and intestinal bypass operations.

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More traditional treatments include a diet limiting fat calories, exercise, emotional support, and support programs including over eaters anonymous.
On the opposite end of obesity is anorexia, a disease which causes people to become severely skinny. It is an illness that usually occurs in teenage girls. People with anorexia are obsessed with being thin. They lose drastic amounts of weight, and are terrified of gaining the weight back. They will continue to believe they are fat even though they are extremely thin. Anorexia is not just a problem with food and weight; it’s an attempt to use food and weight to deal with emotional problems. Most anorexic people are depressed and unhappy with their weight. People with anorexia have side effects of dry skin, thin hair, and tend to feel cold all the time. The difference between anorexia, and another known eating disorder bulimia, is that people with anorexia starve themselves. They avoid high-calorie foods and exercise constantly. People with bulimia eat huge amounts of food, but they throw up soon after eating. People with anorexia think that there is not anything wrong with them. If you know someone who is anorexic the most important thing you can do to help is to love them because it makes them feel safe, secure, and comfortable with their illness. Anorexia is also a curable disease as long as the person is willing to accept that they have it. Doctors and treatment centers are available, but it’s up to the person to act before it’s too late.
Similar to Anorexia, as stated before, is Bulimia Nervosa. Bulimia is characterized by a cycle of binge eating followed by purging. This is done to try to rid the body of unwanted calories. The binge is different for all people. Some will consume thousands of calories, others will consume very few. Purging methods also range from self-inflicted vomiting, use of laxatives, excessive exercise, fasting, diet pills, and enemas. Bulimics are usually people who feel insecure about themselves. They seek the approval from others, and often food becomes their sense of comfort. People with bulimia are harder to identify than anorexics because they do eat. Diagnostic criteria includes recurrent episodes of binge eating and recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as vomiting, or use of laxatives. The behaviour occurs at least twice a week for three months, and self-evaluation is unduly influenced by body shape and weight. There are drugs available that bulimics use to stay thin, but they can have dangerous effects. For example, Ipecac Syrup is a substance that helps to induce vomiting, and repeated use can cause heart muscles to weaken. Laxatives can also be used but have little or no effect on reducing weight. Laxative abuse can cause bloody diarrhoea, electrolyte imbalances, and dehydration. Other physical and medical complications caused by bulimia include: fatigue, irregular menstruation, depression, irregular heartbeats, edema, development of peptic ulcers and pancreatitis, cardiac arrest, and ultimately death.
Eating disorders are all very serious and should not be looked over lightly. Each disorder has its gruelling effects, and in turn can kill someone you love or care about. They are all treatable with the right help, but please avoid becoming a victim. Love yourself, and your body, and don’t compare yourself with media figures. The average woman is 5'4" tall and weighs 140 pounds. The average model is 5'11" tall and weighs 117 pounds. Most fashion models are thinner than 98% of women. Remember that beauty is only skin deep, but true beauty comes from within.



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