1) Eating disorders
a)
ANOREXIA
Special characteristics:
- Emaciation (abnormally thin and weak)
- Unending dissatisfaction with body weight, unwillingness to maintain acceptable weight
- Distortion of body images; an intense fear of gaining weight
- Unstable menstruation (females)
- Disturbing eating behaviour e.g., extreme dieting
- Excessive exercise
Most with anorexia see themselves as overweight even when they look malnourished. Food intake and weight control takes central place in life. They weigh themselves regularly and eat very small quantities of only certain foods.
Some studies have found that anorexia sufferers are 10 times more likely to die as a result of their illness due to cardiac arrest resulting from laxatives abuse, cardiovascular and neurological complications, and also fluid imbalances. Others have psychiatric illnesses such as depression, anxiety, which may lead to suicide. (National Institute of Mental Health, 2009).
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b)
BULIMIA
Characterized by:
- Recurrent and frequent episodes of eating unusually large amounts of food, feeling a lack of control over eating
- This binge-eating is followed by a type of behaviour that compensates for the binge, such as purging e.g., vomiting, abusing laxatives or diuretics), fasting and/or excessive exercise.
People with bulimia can have normal body weight. However, similarly to anorexia, they fear gaining weight, are extremely unhappy with their own body weight, suffer from depression, anxiety and substance abuse problems. Other conditions can also emerge, such as electrolyte imbalances, gastrointestinal problems, and oral and tooth-related problems (National Institute of Mental Health, 2009).
2) Statistics
Alarming rate and growing trend of sufferers
Estimates from the US National Institute of Mental Health put 5-10 million of females, and 1million males with eating disorders (Eating Disorder Statistics, 2007). They include anorexia and bulimia among others. 15 percent of young women take on unhealthy mindsets and behaviours about food.
In the UK, nearly 2 in every 100 secondary school girls suffer from anorexia and bulimia nervosa among other related disorders.
Eating disorders is the highest between teenage and early adulthood, but there is an increasing trend found in all age groups (Health Information Brought to Life, 2009). Disordered eating practices and concern about body image are happening at earlier ages. According to a survey, 70% of girls reported becoming concerned about their weight between 9-11 years old.
Interestingly, eating disorders are also becoming prevalent among elderly women. This is usually continued from their earlier years. Approximately 10-15% of eating disorders are fatal (Eating Disorder Statistics, 2007). However, owing to the guilt and secretiveness of eating disorders, many cases of such remain unknown.
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Increased Social Pressure to be thin
In relation to studies about diet, weight loss and body shape, many people feel discontented with their body shape, and subconsciously created the sub clinical/ borderline eating disorder attitudes and behaviours (Eating Disorder Statistics, 2007).
80% of American women were found to be dissatisfied with their appearance and shape. 1 in 2 American women are on a weight loss diet.
The rising standard of body weight and shape is complemented by overly thin models in advertisements, conveying the message of “thin is beautiful”, resulting in anorexia and bulimia.
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Social class affected by anorexia/bulimia
Studies show that social class plays a part in creating anorexic sufferers. For example, a study done by (Lee et al, 2005) showed that professionals in Singapore are at risk of getting eating related disorders such as anorexia and bulimia. Their study found out that of the 104 adults presented in the study, 12 were white-collared workers, indicating a 9.5% of adults which were suffering the 2 more prevalent disorders. Perhaps, an even higher number of white-collared professionals are still out there, struggling with problems unreported.
6) consequences
a)
ANOREXIA
Anorexics control their amount of calories too strictly and this can result in dreadful consequences. When the body fails to receive the fuel it requires to work in accordance due to the lack of food and very little body fat is left, it turns to itself for the necessary nutrients, thus causing more severe damage.
Effects:
- Loss of menstrual periods
- Lack of energy and weakness
- Feeling cold all the time
- Dry, yellowish skin
- Constipation and abdominal pain
- Restlessness and insomnia
- Dizziness, fainting, and headaches
- Growth of fine hair all over the body and face
Starvation:
Not eating can do threatening harm to major body systems and organs. When starving occurs, one’s body begins to use up its own tissue, including muscles and organs, for energy. The liver and intestines lose the most of their own weights when this occurs, followed by the heart and kidneys. Permanent damage is done, for instance of a reduced heart size, which will ultimately result in low blood pressure and a slowed pulse. In severe cases, death can occur.
Dehydration:
Kidney failure can happen if there is prolonged dehydration. Without having a necessary amount of water in one’s body, the functioning of cells and tissues is affected adversely. A lack of salt as well as water is a possible reason to dehydration.
Muscle and cartilage:
Over-exercise can create enormous stress on muscles and cartilage, especially if it is focused on one area extensively.
Bones:
Osteoporosis is the result of a loss of protein matrix tissue (bone density), making them frail and prone to fracture. Anorexics have a higher tendency to develop osteoporosis earlier than the general population does, due to hormonal changes. Bone growth may also be retarded in younger sufferers of anorexia.
Irregular or abnormally slow heart rate:
Heart muscles can be affected, causing an erratic heart rate. Low blood pressure is a consequence, which together with the irregular heart rate can lead to heart failure. Nutritional deficiency can contribute to damage of the heart muscle. An example of such can be the lack of calories and proteins.
Sexual function:
Due to the lack of fats, oestrogen is unable to be produced in females, which can result in the irregularity of periods and infertility, and testosterone in men, leading to low sex drive.
Lanugo growth:
The lack of fats can result in the body becoming cold easily. As compensation, lanugo (fine hair) grows all over to keep it warm.
Hyperactivity:
Instead of food, adrenaline, a hormone that is typically released during stress and fear experiences, is heavily depended on by the bodies of anorexics for energy. Thus, anorexics get excited and anxious easily.
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b)
BULIMIA
The greatest danger of bulimia is dehydration as caused purging. Vomiting, laxatives, and diuretics also distort the electrolyte balance in our body, commonly manifesting itself in low levels of potassium. This will trigger a wide range of symptoms, varying from lethargy and cloudy thinking to irregular heartbeat and death. Prolonged low levels of potassium causes kidney failure.
Effects:
- Weight gain
- Abdominal pain, bloating
- Swelling of the hands and feet
- Chronic sore throat, hoarseness
- Broken blood vessels in the eyes
- Swollen cheeks and salivary glands
- Weakness and dizziness
- Tooth decay and mouth sores
- Acid reflux or ulcers
- Ruptured stomach or esophagus
- Loss of menstrual periods
- Chronic constipation from laxative abuse
Self-induced vomiting:
- Damages the digestive system
Our stomach becomes eroded by a lack of stomach acid, laying the foundation for the growth of peptic ulcers. People may vomit blood and experience abdomen or chest pains. The pain is usually increased when food or drinks are consumed.
- Damages the oesophagus (throat)
When stomach acid touches the oesophagus, it can cause inflammation in raw areas, sometimes making swallowing painful. What is worse could be the rupture of the oesophagus, because this can be fatal. It is known as the Mallory-Weiss tear, caused by continuous vomiting, which leads to blood in it. It is when a doctor should be consulted.
- Brings stomach acids into the mouth
This causes the eroding of the tooth enamel and tooth decay, giving the teeth cavities and a ragged appearance, which may need to be extracted. It is recommended to NOT brush teeth following vomiting. Instead, drink water to replenish lost fluids.
- Swollen salivary glands
- Stomach cramps and difficulty in swallowing
Dehydration:
- Water is a pre-requisite for the healthy functioning of cells and tissues. For a dehydrated person may be suffering from a depletion of salt as well as water. Long term dehydration ultimately leads to kidney failure. Bulimics are usually dehydrated because the stomach’s gastric fluids are eliminated when they purge.
Abuse of laxatives and diuretics:
- Causes constipation since the body can no longer execute normal bowel movement on its own
- Bloating, water retention, and oedema (swelling) of the stomach
- Because the body is constantly denied nutrients and fluids essential for survival, the kidneys and heart will also be damaged. Also, deficiency in potassium will result in cardiac abnormalities and possibly kidney failure, which can be fatal.
(Understand, Prevent, & Life’s Challenges, 2009)
7) TREATMENT
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There are various treatment methods for eating disorders which are determined by the severity of the disorder as well as the specific issues face by the person. This includes talking the person out of the disorder and a few forms of therapies (Understand, Prevent, & Life’s Challenges, 2009).
When talking to the person with disorder, be sure to do it in a non-confrontational and tactful way in a private area to avoid defensiveness. On the other hand, focus on specific habits that worry you and explain why you care. Some advices for talking about an eating disorder:
Make your concerns known
Avoid debating
Avoid embarrassing, blaming or instilling guilt
Avoid suggesting simple “solutions”
Hang on
a)
ANOREXIA
Treating Anorexia involves three components:
- Restoring the normal body weight of the affected individual;
- Treating the psychological issues of the person; and
- Eliminating the thoughts leading to disordered eating, and preventing relapse of the individual
Some research suggests that the use of medications is modestly effective in treating patients with anorexia by helping to resolve mood and anxiety symptoms that often co-exist with anorexia (National Institute of Mental Health, 2009). Recent studies show that they may not be helpful by preventing relapse. In addition, no medication has shown to be effective during the critical first phase of restoring a patient to healthy weight.
Some forms of psychotherapy are useful for addressing the psychological aspects of the disorders, such as cognitive-behavioral therapy, and family-systems therapy. It has been suggested that the latter in which parents have the responsibility for feeding their adolescent is the most effective to help gain weight and improve eating habits, particularly in younger and first-time patients. However, it entirely depends on the patient involved, or just their medical situation. No method has been shown to be effective in all types of treatment, but research is showing some promising signs, with some new treatments being formulated.
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b)
BULIMIA
To reduce or eliminate binge and purge behaviour, a patient may undergo nutritional counselling and psychotherapy, especially cognitive behavioural therapy (CBT), or be prescribed medication (National Institute of Mental Health, 2009). Some antidepressants, such as fluoxetine (Prozac) may help patients who also have depression and/or anxiety. It also appears to help reduce binge-eating and purging behaviour, reduces the chance of relapse, and improves eating attitudes.
CBT that has been tailored to treat bulimia also has shown to be effective in changing binging and purging behaviour, and eating attitudes. Therapy may be individually oriented or group-based.
8) REFERENCES
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Bourbonnaise, R., Brisson, C., Moisan, J., & Vezina, M. (1996). Job strain and psychological
___distress in white-collar workers.
Scandinavian Journal of Work, Environment and Health,
___22, 139-145. Retrieved February 1, 2010, from http://www.earlylearning.ubc.ca
___/documents/developmenthealth/Bourbonnais%20R,%201996.pdf
Brooks, D.J. (2002). Job stress: A price of success.
Gallup. Retrieved February 1, 2010, from
___http://www.gallup.com/poll/6823/job-stress-price-success.aspx
Eating Disorder Statistics. (2007).
Statistics on Eating Disorders. Retrieved February 1, 2010, from
___http://www.annecollins.com/eating-disorders/statistics.htm
Health Information Brought to Life. (2009).
Eating Disorder Statistics. Retrieved February 1, 2010,
___from http://eating-disorders.emedtv.com/eating-disorders/eating-disorder-statistics.html
Health Topics A-Z. (2010).
Eating Disorders: Anorexia and Bulimia. Retrieved February 1, 2010, from
___http://adam.about.com/reports/000049_2.htm
Koo-Loeb, J.H., Costello, N., Light, K.C., & Gridler, S.S. (2000). Women with eating disorder
___tendencies display altered cardiovascular, neuroendocrine, and psychosocial profiles.
___
Psychosomatic Medicine, 62, 539-548. Retrieved February 1, 2010, from
___http://www.psychosomaticmedicine.org/cgi/reprint/62/4/539.pdf
Lee, H. Y., Lee, E. L., Pathy, P., & Chan Y. H. (2005). Anorexia Nervosa in Singapore: An eight-year
___retrospective study.
Singapore Medical Journal, 46(6), 275-282. Retrieved February 1, 2010,
___from http://www.sma.org.sg/smj/4606/4606a1.pdf
National Institute of Mental Health. (2009).
Eating Disorders. Retrieved February 1, 2010, from
___http://www.nimh.nih.gov/health/publications/eating-disorders/complete-index.shtml
Renault Moraes, L.F.D., Swan, J.A., & Cooper, C.L. (1992). A study of occupational stress among
___government white-collar workers in Brazil using the occupational stress indicator.
Wiley
___InterScience. Retrieved February 1, 2010, from
___http://www3.interscience.wiley.com/journal/112410102/abstract
Something Fishy. (2007).
Noticing the signs and symptoms. Retrieved February 1, 2010, from
___http://www.something-fishy.org/isf/signssymptoms.php
Soukup, V.M., Beiler, M.E., & Terrell, F. (1990). Stress, coping style, and problem solving ability
___among eating-disordered inpatients.
Journal of Clinical Psychology, 46(5), 592-601.
___Retrieved February 1, 2010, from EBSCOHost.
The Eating Problems Service. (n.d.).
Consequences of eating disorders. Retrieved February 1, 2010,
___from http://www.eatingproblems.org/epseffect.html
Understand, Prevent, & Life’s Challenges. (2009).
Anorexia Nervosa. Retrieved February 1, 2010, from
___http://www.helpguide.org/mental/anorexia_signs_symptoms_causes_treatment.htm
Understand, Prevent, & Life’s Challenges. (2009).
Bulimia Nervosa. Retrieved February 1, 2010, from
___http://www.helpguide.org/mental/bulimia_signs_symptoms_causes_treatment.htm
Understand, Prevent, & Life’s Challenges. (2009).
Eating Disorder Treatment and Recovery. Retrieved
___February 1, 2010, from http://www.helpguide.org/mental/eating_disorder_self_help.htm
3) Target group
It is found that stress is an important contributor to eating disorders such as bulimia nervosa and anorexia. (Koo-Loeb, Costello, Light, & Gridler, 2000). A study discovered that repeated exposure to stress will make some prone to developing eating disorder (Soukup, Beiler, & Terrell, 1990). Another study found that 37% of white–collared workers complained of stress in their jobs compared to 21% of the blue-collared workers. This may be because white-collared workers are more likely to see their workloads as a burden, compared to the hourly paying jobs of the blue-collared workers (Brooks, 2002). Exposure to high job strain in white-collared jobs is also associated with psychological stress (Bourbonnais, Brisson, Moisan, & Vezina, 1996). In addition, a study found that people who had degrees stated more sources of stress than those without (Renault, Moraes, Swan, & Cooper, 1992). Since more white-collared workers hold degrees, they are susceptible to greater sources of stress. Therefore, the stress that the white-collared workers face and the fact that stress has a large role underlying eating behaviours increases their risk of developing anorexia and bulimia nervosa.
4) Symptoms of eating disorders
ANOREXIA/ BULIMIA
Physical:
1. Drastic loss of weight in a short time
2. Wearing loose or in layer clothes to conceal body shape or weight loss
3. Hair loss
4. Pale skin
5. Giddiness and headaches
6. Prevalent sore throats and/or swollen glands.
7. Bruised or calluses knuckles; bloodshot eyes; light bruising under eyes and on cheeks.
8. Low blood pressure
9. Loss of menstrual cycle
10. Constipation
Psychological:
11. Obsession with weight and complaining of weight problems , calories and fat content of foods and continuous exercise.
12. Fear of eating around and with others
13. Low self-esteem. Often complaints of being "too stupid" or "too fat"
14. Mood swings
15. Depression
16. Fatigue
17. Poor sleeping habits
18. Perfectionist personality
Cognitional:
19. Pensive thoughts of food, weight and cooking
Behvioural:
20. Frequent trips to the bathroom immediately following meals (sometimes accompanied with water running in the bathroom for a long period of time to hide the sound of vomiting)
21. Visible food restriction, self-starvation, and binging and/or purging
22. Use or hiding use of diet pills, laxatives, ipecac syrup, or enemas
23. Unusual Food rituals for e.g.
- Shifting the food around on the plate to look eaten
- Cutting food into tiny pieces
- Lips avoid touching food (using teeth to scrap food off the fork or spoon)
- Chewing food and spitting it out
- Dropping food into napkin on lap to later throw away
24. Hiding food in strange places to avoid eating (Anorexia) or to eat at a later time (Bulimia
25. Flushing uneaten food down the toilet
26. Ambiguous or secretive eating patterns
27. Keeping a "food diary" or lists that consist of food and/or behaviours i.e.
purging, restricting, calories consumed, exercise
28. Going to websites that promote unhealthy ways to lose weight
29. Reading up on weight loss and eating disorders
30. Self-defeating statements after eating
31. Complaints of feeling cold
32. Loss of sexual desire
(Something Fishy, 2007)
5) Causes
There are many causes of Anorexia and Bulimia. More influential ones include negative family, cultural (environmental) influences, and genetic and hormonal influences.
Negative family influence is impactful to a growing child. It has been theorized that children of parents who have low attachment to their children may develop greater weight concern and low self-confidence; the behaviours and expectations of parents can also influence their child, such as a mother hoping her child will be prettier than others, may influence the child to desire to look pretty, and thus become slimmer especially if society defines slimness as beauty. Family history, such as abuse, addictions or emotional disorders, and also of obesity and the negative consequences of being fat, may also influence an individual to wish to look slimmer and maybe develop anorexia and bulimia as a result.
Another factor is cultural and societal influence. The influence of the media to both the cultural drive for thinness and overproduction of food play major roles in triggering obesity and eating disorders.
a)
ANOREXIA
Biological:
Relying on research we found, there is a biological base for anorexia. A girl with a sibling who suffers from anorexia is 10 to 20 times more likely than the general population, to develop it as well. Brain chemical is another major contributing factor. Anorexics are found to have a combination of high levels of cortisol, the brain hormone most interrelated to stress, and low levels of serotonin and norepinephrine, which are linked to feelings.
Psychological:
Perfectionists and overachievers are found to be correlated to anorexics. They have a mindset of being ideal, pleasing others and wanting the best in everything. Despite looking fine on the surface, they may be hiding their underlying low self-esteem due to the fact of being overly critical on themselves.
Social:
Family, social and cultural pressures can be attributed to anorexia. An example of such can come from involvement in activities which emphasizes slimness, such as ballet, gymnastics, or modelling. Having excessively dominant parents who have high expectations on looks, diets, or who often condemn on their children’s looks, can add on to the problem. Stressful events, such as puberty, a breakup, or leaving home to school, can also lead to anorexia.
(Understand, Prevent, & Life’s Challenges, 2009)
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b)
BULIMIA
Biological:
Eating disorders are heritable in families, indicating a genetic role involved. Research has also suggested that low levels of serotonin contribute to bulimia.
Psychological:
Those who find themselves worthless and unattractive are at high risk for bulimia. Characteristics related to low self-esteem include depression, perfectionism, childhood abuse, and a critical home environment. In addition, people who diet have a higher likelihood of developing an eating disorder as compared to those who do not. The extreme deprivation of food can trigger binge eating, leading to the binge-and-purge cycle of bulimia.
Social:
Our culture’s emphasis on “thin is beautiful” can lead to body dissatisfaction, particularly in young women who are vulnerable to the media’s messages of achieving an unrealistically thin physique. People who are compelled to achieve a certain body shape or stay thin are susceptible to eating disorders. Such people include ballet dancers, models, gymnasts, wrestlers, runners, and actors. Bulimia is often elicited by major changes or transitions, such as the physical effects of puberty, leaving for college, or break ups. Bingeing and purging may be an attempt to cope with the stress.
