Anorexia Nervosa Essay Introduction Example For Students

Anorexia Nervosa Essay Introduction Eating disorders are a cause for serious concern from both a psychological and anutritional point of view. They are often a complex expression of underlyingproblems with identity and self concept. These disorders often stem fromtraumatic experiences and are influenced by society`s attitudes toward beautyand worth (Eating Disorder Resource Center, 1997). Biological factors, familyissues, and psychological make-up may be what people who develop eatingdisorders are responding to. Anyone can be affected by eating disorders,regardless of their socioeconomic background (Eating Disorder Resource Center,1997). Anorexia nervosa is one such disorder characterized by extreme weightloss. It is the result of self imposed and severe restrictions of food and fluidintake, a distorted body image, an intense fear of becoming fat, and a poor selfesteem. Besides dieting to extremes, anorexics often over exercise to loseweight. Anorexics themselves are often the last to realize how undernourishedand unde rweight they are. Even after reaching a weight that is dangerously low,they feel good initially, about losing the weight. No matter how much is lost,anorexics continue to feel fat and desire to lose more weight. It is this denialthat makes it so hard to convince anorexics to seek help (Eating DisorderResource Center, 1997). This paper`s focus is to look in more detail at thepsychological and societal factors contributing to anorexia nervosa, as well asthe nutritional and physiological complications that arise for people on suchseverely restrictive diets. Psychological and Societal Contributions AnorexiaNervosa was first described by an English physician by the name of RichardMorton in 1689. Until 1914, it was considered a disease that arose from a morbidmental state and a disturbed nerve force. That year, Dr. Simmonds, apathologist, found one woman=s refusal to eat to be the direct result of ananterior pituitary lesion. This shifted the focus away from the emotionalaspects of the di sorder to more physiological and endocrinological terms. It wasnot until 1938 that anorexia nervosa was once again considered a largelyemotional disorder (Blackman, 1996). In fact, one of the criteria for thediagnosis of anorexia nervosa according to the manual of The American MedicalAssociation (DSM IV) is an intense fear of gaining weight or becoming fat, eventhough underweight. Another clearly psychological requirement for diagnosis, isa disturbance in the way in which one=s body weight or shape is experienced,undue influence of body weight or shape on self evaluation, or denial of theseriousness of the current low body weight (Blackman, 1996). Anorexia nervosamay be a primary disorder in which other psychiatric conditions are secondary,such as depression. It may also be secondary itself to a disorder such asschizophrenia or co-morbid with obsessive compulsive disorder. As well, it canalso be a component of a personality disorder (Blackman, 1996; Carlat, 1997). The anorexic sufferer is typically female. Ninety-percent of all cases occuramong adolescent girls or young women but the number of males with the disorderis on the rise (Blackman, 1996; Carlat, 1997; Kinzl, 1997). It is estimated that1% of girls ages 12-18 meet the criteria for full blown anorexia and as many as5-10% have milder forms of such eating disorders if the criteria is applied lessstringently (Blackman, 1996). Anorexics are usually high achieving youngsterswho may be heavily involved in sports (e.g. gymnastics, swimming, cheer leading,ballet, etc.). These people are often competitive, perfectionistic, withobsessive compulsive personality features. Fears of growing up or discomforttoward sexuality may also be precipitating factors (Blackman, 1996). Studieshave shown that 75% of American Women are dissatisfied with their appearance andas many as 50% are on a diet at any one time. Even more alarming is that 90% ofhigh school junior and senior women regularly diet, even though only between10%-15% are over the weight recommended by the standard height-weight charts(Council on Size and Weight Discrimination, 1996). The majority of these womendo not develop eating disorders; however, 1% of teenage girls and 5% ofcollege-age women do become anorexic or bulimic (Council on Size and WeightDiscrimination, 1996). Perhaps these figures represent the women who are lessable to cope with their bodily dissatisfaction and thus are the ones who takedieting to the extreme. The disordered eating behavior usually starts out with apattern of dieting or particular food choices, such as avoiding certain foodswhich are seen as fattening. As the disorder progresses, anorexics becomeresourceful in hiding their troublesome behavior and may start to avoid eatingwith their families. They may also attempt further weight loss by compulsiveexercising. The condition can become well advanced before parents even notice,as anorexics may wear many layers of clothes to conceal their thinnes s. Oftenthe diagnosis is not made until the person is brought to a clinic for problemssuch as physical weakness, lack of energy, excessive sleepiness, and recent poorperformance in school (Blackman, 1996). Actually, certain familial relationshipsseem to be more prevalent among anorexic sufferers. Studies have shown manyanorexic families are enmeshed, overprotective, conflict avoidant, and asco-opting the anorexic in destructive alliances with one parent or another. Theparents themselves tend to be more affectionate and neglectful than parents ofnon anorexic children. The father in particular is often controlling (Blackman,1996). Physical and/or sexual abuse are also not uncommon features in familieswith anorexics (Carlet, 1996; Kinzyl, 1997). Even though these trends are trendsoften seen, there are many anorexic families that do not fit this profile. Oneof the other major contributors to the disorder is society and its values. Anorexics are sensitive to society=s approval of what is an acceptable weight orbody size (Blackman, 1996). Self worth is equated with a desirable slimappearance. This creates a vulnerability to eating disorders for people who areespecially concerned with meeting this ideal. Western culture in particular hasan obsession with looks. Slim, attractive people are linked to beauty, success,and happiness. Our society teaches us to value such superficial standards andbombards us with images of the idealized female body through mediums such asmagazines, films, and television (Blackman, 1996). One only has to watchtelevision or read the latest magazines and take note of just how few overweightor average looking people there are appearing in advertisements to verify thisfact. Anorexia nervosa in fact predominates in industrialized developedcountries; yet is extremely rare in less industrialized and non westerncountries (Blackman, 1996). As well, immigrants who have migrated to awesternized cou ntry have been found to become more prone to develop eatingdisorders (Blackman, 1996). For the sufferer of anorexia, the onset of thedisease often begins with a chance remark by someone important to them, possiblya coach or a friend. They may suggest that they are getting fat, big, clumsy, orthat their performance (if they are athletes) is suffering (Blackman, 1996). The Greenhouse Effect Argumentative EssayThe nutritionist then must carefully plan nutrition education sessions to makethem as meaningful to the person as is possible. Refeeding is also not astraightforward process as anorexics often find it quite difficult to gainweight. This is due to an increased diet induced thermogenesis and a lowermetabolic efficiency. Anorexic patients can waste about 50% of the energy oftheir food due to this inefficient metabolism at the start of refeeding, makingthe maintenance of any gain in weight difficult (Moukadden, 1997). Another studyconcluded that even with weight gain after 3 months to a year, it was not enoughto maintain a desirable nutritional status. This was because patients did notreach an adequate body mass index and their immunological indexes were lowerthan in control subjects during an entire one year follow-up (Marcos, 1997). Conclusions From the information presented, one can only imagine just howcomplex the issues really are that the anorexic attempts to deal with viadieting. The anorexic may be dealing with substance abuse, depression, sexualabuse, confusion about their sexual orientation, or bodily dissatisfaction toname a few. The individual anorexic may be suffering from a combination of suchissues in varying degrees. To what extent, psychological, societal, andbiological factors affect the onset of the disorder is, as of yet, too complexto determine. It appears to vary from individual to individual, although thereare some features seen more commonly than others. The variability seen with thedisorder on an individual basis is why the anorexic sufferer can not becategorized into a particular stereotypical group. It is not just the whiteadolescent girl who is affected. The disorder affects various other groups aswell and is being seen more frequently in groups it did not typically affect. Ithas been m entioned how the disorder is becoming more prevalent among immigrantswho move to westernized cultures; yet, the disorder is rarely ever seen in lessdeveloped countries. Males also are being seen more frequently to be sufferersof this traditionally female disorder. This data seems not to point to aparticular group as being more prone to developing anorexia, but instead pointsto society=s unrealistic and unachievable ideals, as encouraging more sensitive,insecure, or emotionally disturbed individual members of society to lose weight. Weight loss often provides these people with short lived confidence, and for awhile they feel good about their weight loss and in control of something intheir life. They inevitably desire to feel like this again so they set out tolose more weight. This cycle continues until someone steps in and helps thesufferer by convincing them to seek help. This can be hard as the anorexic isusually so far in denial that they are the last to realize just what shape theyare in. The road to recovery is difficult and the body seems to resist anyweight gain during the initial refeeding period. Even after an entire year oftreatment, evidence suggests that recovery has not been achieved and manyanorexics still continue to suffer from their disorder. There are so manycomplications that anorexia can be attributed to that it would appear that thequicker a person complies with treatment and can be recovered, the better. It isquite obvious that anorexia is a complex disorder that partly involves how oneperc eives his or her self and what physical standard society dictates theyshould live up to. The topic has many areas that require further research associety has been shown not to be the entire causative factor for the developmentof the disorder. It has been shown to be one of them however; so until societybecomes more realistic in the ideals it endorses, it is responsible, at least inpart, for the prevalence of this disorder. BibliographyBlackman, M. A Anorexia Nervosa: Diagnosis and Management, @ Medical ScopeMonthly, July/August, 1996 (or see www.tminus10.com/children/health/anex.htm). Carlat, D. J. ; Camargo Jr. , C. A. ; and Herzog, D. B. AEating Disorders inMales: A Report on 135 Patients, A American Journal of Psychiatry, 154, August1997, 1127-1132. Council on Size and Weight Discrimination. Facts and Figures. New York: Council on Size and Weight Discrimination, Inc. , 1996. EatingDisorder Resource Centre of British Columbia. Do I Have an Eating Disorder? . Vancouver: Working Design, 1997. Kershenbaum, A. ; Jaffa, T. ; Zeman, A. ; andBoniface, S. A Bilateral Foot Drop in a Patient With Anorexia Nervosa, AInternational Journal of Eating Disorders, 22, November 1997, 335-337. Kinzl, J. F. ; Mangwelth, B. ; Traweger, C. 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