Thursday, April 4, 2019
Anorexia and Bulimia Risk Factors
Anorexia and Bulimia Risk FactorsExploring ingest DisordersIt is nearly impossible to walk past the aisles in stores without seeing headlines brilliant secrets to weight loss. Our cell phones ar full of advertisements and videos of exercise routines. In the United States universe thin has become a national obsession and places unrealistic expectations on what makes a distaff beautiful. To keep up with these expectations, womanishs become dissatisfied with their bodies. With personate dissatisfaction being the single most powerful contributor to the breeding of take disorders, it is non surprising that these disorders continue to jumpstart (Comer, 2015). The rough-cutplace ingest disorders recognized by the Diagnostic and Statistical Manual argon anorexia nervosa (AN), bulimia nervosa (BN), and block require disorder (BED) (APA, 2013). The revolve about of this paper is on the formally recognized ingest disorders, anorexia and bulimia. Briefly, these disorders argo n characterized by disturbances in carcass im geezerhood and abnormal take in patterns. While the cause is elusive, todays theorists and look intoers view eat disorders arise from the interaction of multiple risk factors. The more of these factors that are present, the likelier they will develop an alimentation disorder. Among these factors accept biological, psychological, and sociocultural (Rikani, 2013).EtiologyBiological FactorsStudies occupy shown a genetic percentage to developing take disorders (Fairburn & Harrison,2003). Certaingenes may leave some people more susceptible to the development of consumedisorders and interrogationers evoke that these diseases are biologically basedforms of severe mental illnesses. This has been further supported by twin andfamily studies. For all(prenominal) disorder the estimated heritability ranges between 50%and 83%, therefore there is a possibility of genetic share to obligatedisorders (Treasure et al, 2003). Studies pee a lso suggested roleof serotonin levels since this representativeicular proposition neurotransmitter is important in theregulation of eat and mood (Fairburn & Harrison, 2003). Several studies makeer confirmed those houseingfrom anorexia nervosa mensural set down serotonin levels and may be an indirecteffect of feeding disorders (Rikani, 2013). Psychological factors Around 73% of girls and females sop up a negative embody image, compared with 56% of boys and men (Comer, 2013). Body dissatisfaction has been defined as discontent with some aspect of ones sensible style (Cash, 2012) and is a risk factor for developing an ingest disorder (Stice, 2001). Furthermore, it encompasses ones body-related self-perceptions and self-attitudes, including thoughts, beliefs, feelings, and behaviors (Cash, 2012). Research has measured as far back to juvenile years and how the on circle of puberty could set the stage for their body image perceptions (Rikani, 2013). According to Treasure, Cl audina, and Zucker (2003), most eating disorders occur during adolescence. While females are more concerned somewhat losing weight, their male counterparts are focused on the body image of needing to gain muscle. surplusly, female perceptions flummox been linked to negative body image and adolescent boys are likelier to have positive feelings about(predicate) their bodies (Ata et al, 2007). Females ultimately feel discontent with the pattern and size of their body at such an early age when they are forming their identities. Specifically, females are toilsome to fit into the image society has described as the ideal peach of a woman, thus they become increasingly obsessed with disordered eating (Dittmar et al, 2009). In turn, they end bruise psychologically from low self-esteem, feelings of help slightness, and intense dissatisfaction with the dash they look (APA, 2013). Body image and body dissatisfactionhave been measured by examining cognitive components, such as negative attitudes about the body or unrealistic expectations for appearance and behavioralcomponents, such as suspending perceived body scrutiny from former(a)s (e.g., avoidingswimming) (Thompson et al., 1999b). Ata,Ludden, and Lally (2007) also found salutary links between eating disorders and feelingsof depression and low self-esteem. Sociocultural factorsManysociocultural factors like friends and family can process the development ofeating disorders. Research focusing on the particular effects of teasing on femaleadolescents found that those who are teased about their weight, body shape, andappearance tend to exhibit poorer body image and are more likely to diet (Ata et al.,2007). Furthermore, adolescents who have a family relationship with their parents thatare less supportive and filled with conflict are more likely to choosedisordered eating behaviors and have poor body image. In a survey ofindividuals with eating disorders, they included family factors such as, poor maternal(p) visit, controlling parents, poor relationship with parent, criticalfamily environment as causal factors with eating disorders (Salafia et al.,2015). Swarr and Richards (1996) found that adolescents who have a wellnessyrelationship with two parents are less likely to have concerns about theirweight. During this insecure stage of development, adolescents place a highregard to the approval of their friends. Supported evidence shows that those withlower peer acceptance and friendly support may be linked to negative body image (Ata et al., 2007).It is not surprising that body image has been an obsession inWestern society for decades. The media has portrayed the continually changingconcept of beauty through advertisements, social media, magazines, andtelevision, in turn shaping societys modular of beauty. Mulvey (1998) lookedat the history of female beauty and the major changes in the female image everyplacethe years. The cinched shank was popular in the 1900s, while being flatche sted without curves were emphasized in the 1920s. Throughout the 1930swomen were boost by societal standards to have curves and this emphasiscontinued through the 1950s. Images of full figured women like Marilyn Monroe,Audrey Hepburn and Elizabeth Taylor influenced the way women wanted to look(Mulvey, 1998). It was not until the end of this decade that the thin idealbegan to decrease in shape (Rumsey). Women began to alter their bodies throughplastic surgery in the 1960s to reach societys standards. It was during this time that the body type drastically changed into the depiction of beingextremely thin and boyish. The immense pressure to be thin carried throughoutthe 1970s and the rail thin image resulted in an plus in eating disorders,especially anorexia (Mulvey, 1998). Fortunately,that image did not last long and women were advertised as being fit and glossy throughoutthe early 90s, yet thin models and anorexia became rampant again at the end ofthis decade. Sadly, this image of sparsity has continued throughout the 21stcentury. Prevalence Measuring the prevalence of eating disorders is complex since countless metrical composition of people with the disorders do not set about word (Treasure et al., 2010). Research suggests that the stigma society has placed on eating disorders as being self-inflictive may factor in to why they do not seek help (Salafia et al., 2015). While eating disorders affect both genders, the prevalence among women and girls are 2 times greater for females (NIMH, 2013). Additionally, Wade, Keski-Rahkonen, and Hudson (2011) found that 20 million women and 10 million men suffer from an eating disorder at some point in their life. According to the internal Institute of Mental Health (NIMH), the lifetime prevalence among adults with eating disorders have measured to be 0.6% for both anorexia nervosa and bulimia nervosa for the adult population. Themain risk factors that have been linked to anorexia nervosa and bulimia nervosaare ge neral factors such as, being female, adolescent/young adult, and livingin Western society (NIMH, ). The NationalInstitute of Mental Health reports of suicide being very common in women whosuffer from anorexia nervosa and has the highest mortality rate around 10% amongall mental disorders.As mentioned earlier,adolescent females are at a high risk of developing eating disorders, which wererelated to low self-esteem, social support, and negative attitudes of theirbody image. While the age of onset frequently appears during teen years andyoung maturity for both disorders, bulimia nervosa has a slightly later age ofonset, however can begin the kindred way as anorexia nervosa (Fairburn & Harrison, 2003). A study found one-third ofpatients who had an initial diagnosis of anorexia nervosa crossed everywhere tobulimia nervosa during 7 years of follow up ( braid et al., 2008). Between.3 and .9% of this population are diagnosed with anorexia nervosa and .5 and 5%with bulimia nervosa (Salaf ia et al., 2015). Furthermore, the NIMH reported thelifetime prevalence of 13-18 year olds to be 2.7% for both eating disorders. Certain professions and subcultures have a higher prevalence of developing eating disorders. These include professions where bodyweight is highly valued, such as athletes, models, performers, and dancers. In studies with female athletes the prevalence rate of eating disorders ranged from 0% and 8%, which is higher than that of the general population. Among these athletes, 33% absorb in eating behaviors that put them at risk for such disorders, such as vomiting and using laxatives. Additional factors that increase the risk for this population have been shown to be the transition into the college setting and moving away from home. ethnic Factors/Issues Historically, there has been a stereotype of eating disorders to effect young, female gabardines, who are educated and from an upper socio-economic class. However, interrogation increasingly shows that this disorder does not discriminate and is being reported in other race/ethnicities of both upper and lower classes. The prevalence of eating disorders is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, with the exception that anorexia nervosa is more common among Non-Hispanic Whites (Hudson et al., 2007 Wade et al., 2011).One report found that viewsabout body image and eating disorders varies among cultures and Caucasian womenhave the lowest body satisfaction and self esteem while Latina women score inthe middle in terms of self-esteem and body satisfaction ( consume Disorder Hope,2013). The literature among African American women is scarce, however lee side &Lock (2007) found that this group hadthe highest level of self-esteem and body satisfaction. With more and more studies comcludingthat eating disorders are occurring in other ethnic groups, it becomes imperativeto note different cultural views and beliefs may influence this disord er. crudebarriers among minority groups regarding treatment resistance, include languagedifficulties, neediness of health insurance or transportation and lack of resources.Barriers can be present in all ethnicities with eating disorders, butultimately their cultural beliefs tends to be the greatest influence in their decision to whether they seektreatment (McCaslin, 2014). Clinical picture Mental disorders have been portrayed throughout movies and literature. While most do not portray a clear clinical picture of those disorders, a compelling illustration is of actress, Portia de Rossi, is able to show what it looks like and a raw mage of the eating disorder in her book, Unbearable Lightness A Story of Loss and Gain. She writes about her personal seek with body image and testimony of her eating disorder. Her struggle with anorexia and bulimia began when she was modeling at the age of 12 after her agents informed her she needed to go on a diet. She was influenced by her older collea gues to vomit to confine the rail-thin figure directors favored. The actress discussed her disordered eating behaviors, such as taking 20 laxatives a day and constricting her caloric intake to 300 calories a day. She explained the overwhelming desire for perfectionism. Her personal account of her struggle with an eating disorder and illustrates the clinical picture of what it looks like to live through anorexia. From the competitiveness, obsessions, and distorted thoughts, she reveals a life of trying to measure up to the relentless pursuit to measure up to societys standards of beauty. Ronald Comers text, Abnormal Psychology, also gives a clinicalinsight into the nature of eating disorders. Sufferers have dysfunctionaleating attitudes towards food. The main goal for people who suffer fromanorexia nervosa is to become thin. They are fearful of gaining weight and theloss of control over the size and shape of their body. People with thisdisorder are so preoccupied with food that it results in food deprivation.Their thinking becomes distorted and are likely to have negative perceptionsand poor body image. falsify thinking can lead to psychological problems,such as depression, anxiety low self-esteem, and insomnia in those who sufferfrom anorexia nervosa. Comer (2015) provides seek that suggests sufferersmay also display symptoms of obsessive-compulsive patterns. The AmericanPsychiatric Association (APA) confirms this decision of eating disorders being linkedto other mental health issues. The APA reported 50-70% suffer from depression,42-75% have a present personality disorder, 30-37% of bulimic sufferers engagein import abuse as well as 12-18% of anorexic sufferers. Approximately 25%have OCD and 4-6% suffer from bipolar disorder.It is common for sufferersto engage in over exercising, misusage of laxatives and diuretics, and adecreased interest in the outside world (Fairburn & Harrison, 2003). Researchhas considered the main physical features of anorexia nerv osa. The physicalsymptoms have included, heightened sensitivity to cold, gastrointestinalproblems, dizziness, amenorrhea, and insomnia. The physical signs of a suffererof this disorder may show signs of emaciation, ironical skin, erosion of teeth, andcardiac arrhythmias (Fairburn & Harrison, 2003).Bulimia Nervosa is defined by the DSM-V as eating behaviors thatinvolve binging and purging to avoid weight gain (APA, 2013). Similar toanorexia nervosa, symptoms of depression and anxiety are oft seen andsufferers may also engage in substance misuse or self-injury, or both (Fairburn& Harrison, 2003). Mitchell et al. (1983) found physiological electrolyte abnormalitiesin patients with bulimia nervosa, which can lead to irregular heartbeat andseizures. Other health complications of this eating disorder may includeedema/swelling, dehydration, vitamin/mineral deficiencies, gastrointestinalproblems, inflammation or possible rupture of the esophagus, tooth decay, and evenchronic kidney proble ms/ nonstarter (Alliance for ingest Disorders Awareness,2013). Evaluating the prevelance of having eating disorders is fairly new for researchers and health care providers, however, continues to be challenging with the major breakage in literature. eating disorders are severe conditions and often associated with comorbidity and adverse medical conditions, as described earlier. Therefore, a large part of research only focuses on the psychiatric comorbidity in eating disorders, including depression, personality disorder, substance abuse, and obsessive compulsive disorder.The stigma society has placedon eating disorders also influences the accuracy regarding the be of thesedisorders, whether they are impacted directly or indirectly. The lack ofreporting within the health care sphere of influence continues to make it difficult to estimatecosts and prevalence. It is very common for sufferers to seek treatment for thephysical problems than the eating disorder itself and one in four i ndividuals actuallyseek treatment specifically directed at improving their eating disordersymptoms (Striegel-Moore et al., 2003). In pastresearch that reviewed insurance claims regarding eating disorders, it was foundthat some insurance companies did not cover treatment for these disorders, whichoften resulted in the treatment providers to use different symptomatic codeswhen submitting the claims (Striegel-Moore et al., 2003). One clinical trial that reviewed healthrecords and insurance codes found that 42% of the claims related to weight oreating disorders, however, only 4% had an actual eating disorder diagnosis(Rosselli, 2016).Samnaliev et al. (2015) measured theimpact of eating disorders on health care costs, employment status, and incomein the United States. Their evaluation indicated that individuals with eatingdisorders had more health care costs than those who did not have an eatingdisorder. In addition, if one had a comorbid then they axiom an increase inannual costs, com pared to those with no comorbidities. Another impact of thedisease that they found during their compend was lower rates of employment forthose with eating disorders. The study also found a linkbetween higher hospitalization costs for sufferers of anorexia nervosa comparedto those with bulimia nervosa. Another study (Agras, 2001) found the averagecost for inpatient treatment for female anorexics was $17,384 compared to thecost of $9088 for bulimic patients. The same study found treatment foroutpatient settings for treatment of anorexia and bulimia to average around$2344. The costs of treating eating disorders were compared to schizophreniaand OCD and indicated costs for anorexia were not significantly different from schizophrenia,however more than more expensive than treatment for OCD (Agras, 2001).ResearchWhile there has been a significant amountof research speculating the factors that influence the development to eatingdisorders, it continues to remain challenging. Questions rema in unanswered regardingthe aetiology, prevelance cross-culturally, and effective treatment approaches. Theonly promising finding in current research has been the evidence that heritablefactors make a significant contribution to the etiology of these disorders.(Walsh, 2004).Another issue regarding theresearch is that a considerable amount is focuses on the eating disorders of Caucasianfemales in Western society in part due to the stigma placed on eatingdisorders. Past studies found that eating behaviors of young African Americanwomen were more positive than those of young flannel American women. However,over the past decade research has suggested that body imageconcerns/dissatisfaction, and disordered eating behaviors have increased foryoung African American women, as well as women of other minority groups. condescension these trends, society continues to believe that it is likelier for awhite American female to develop an eating disorder, rather than a woman of aminority group (Co mer, 2015).It is clear that eating disorders arehappening within other cultures, however, the prevelance continues to be anissue to measure. There are also issues regarding treatment. There is ongoingresearch on the capability of treatment for bulimia nervosa, but not forsufferers of anorexia nervosa, which suggests that rising research should focuson interventions and treatments for this type of eating disorder. Furthermore,with culture being a risk factor in eating disorders, the development ofculturally specific interventions and their efficacy could be beneficialfor future research (Walsh, 2004).PreventionIt would be helpful forclinicians to hold a multidemensial risk perspective regarding eating disordersuntil findings point to the exact etiology of the disorder. With new researchand data powerfully suggesting genetic influence, it is promising that theetiology may eventually be explained. It is importance to understand that alleating disorders occur in all races and ethnicit ies. Sala et al. (2014) madesuggestions for prevention of the disorders, such as public health campaigns toincrease awareness and peer recognition since adolescents place a higher valueto what their peers think of them. If awareness is brought about in schoolsthan earlier detection may prevent eating disorders among adolescents. Also,since studies suggest that the family has an influence on the youngpopulation, they could be used to inform prevention approaches at the familylevel (Langdon-Daly & Serpell, 2017).TreatmentBeingfamiliar with the factors invluencing the development of the eating disorder isimperative in order to understand and adequately help the person distress fromanorexia or bulimia. With that being said, the lack of empirical research regardingthe treatment of anorexia nervosa is scarce, thus making it difficult to treat.Studies have shown a strong emphasis on a multidisciplinary approach forsufferers of anorexia is helpful. This approach involves a team of medical ,nutritional, social, and psycholological professionals. Therpists typically usea combination of psychotherapy and family therapyto overcome the underlyingissue of anorexia nervosa sufferers ( Comer, 2015). Treatmentfor bulimia nervosa is often in clinic settings with the goals of eliminatingthe riot-purge patterns, developing healthier eating behaviors, and removingthe underlying influence (Comer, 2015)A large amount of research concerning the treatment of bulimia nervosa suggeststhat Cognitive Behavioral Therapy is the treatment of choice, while other datasuggests CBT being stillborn for anorexia. This proves of the need for newinterventions and treatment models for eating disorders, specifically anorexia.Strong evidence from pharmacological trials have found that Pharmacotherapy iseffective in treatment for bulimia in the short term. Other models of treatmentregarding bulimia focus on emotional regulation, such as dialectical behaviortherapy (Treasure et al., 2010). A new appro ach that hasgained overture support is Acceptance and Commitment Therapy (ACT). ACTfocuses on accepting unwanted feelings/thoughts and seeing them as part ofbeing human. One study suggested that ACT could be neneficial with patients ofeating disorders. Treatment interventions that target negative body image maybe beneficial when developing newer interventions and approaches towardstreatment since both eating disorders have a strong desire to control theirurges, thoughts, and feelings (Butryn et al., 2013).Conclusion Eatingdisorders are complex and various factors can influence the development of aneating disorder. These disorders cross all cultural and social backgrounds.While the exact etiology is uncharted the overlapping theories help inunderstanding the combination of factors that influence the causes of eatingdisorders, It is important to understand they are severe mental disorders andhave serious medical consequences. Theadvancement in todays research is encouraging and may eventually offer bettertreatment options and specific links to the development of an eating disorders.ReferencesAgras, W. S. (2001). 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