Essays on Eating Disorders

Most individuals receive nutrients from eating food. Nutrients are important because it is required to sustain life. The hypothalamus, which is a part of the brain, contains the appetite regulation center. This part of the brain regulates the body’s ability to recognize when it is hungry and when it has been satisfied. There are studies that show how serotonin and norepinephrine dysfunction play a role in individuals with eating disorders. Society and culture also have a great deal of influence on eating behaviors. Eating is a social activity. It is very rare to have any event where food is not present.

There are three different types of eating disorders. They are anorexia nervosa, bulimia nervosa, and binge-eating disorder. Anorexia nervosa is defined as the prolonged loss of appetite. This disorder is characterized by a morbid fear of obesity. Some symptoms of anorexia include hypothermia, slowed heart rate, hypotension, a variety of metabolic changes, a gross distortion of body image, preoccupation with food, and refusal to eat. It was believed that individuals with this disorder did not experience sensations of hunger.

Research indicates that they do not suffer from the pain of hunger, and it is only with a food intake of fewer than 200 calories per day that the hunger stops. The distortion in body image is manifested by the individual’s perception of being “fat” when they are obviously underweight or excessively thin. People with this disorder usually accomplish weight loss by reducing food intake and participating in the extensive exercise. There are times where these people would purposely induce vomiting and abuse using laxatives or diuretics. Weight loss is excessive.

People who are diagnosed with anorexia are often obsessed with food. For example, they may hoard or conceal food, talk about food and different recipes, or prepare intricate meals for others, only to restrict themselves to a limited amount of low-calorie food intake. They may also have compulsive behaviors such as handwashing. Age at onset is early to late adolescence and psychosocial development is often delayed. Feelings of depression and anxiety often accompany this disorder.

The next eating disorder is bulimia nervosa. Bulimia nervosa is defined as excessive, insatiable appetite. Bulimia is an episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over a short period of time which is followed by inappropriate compensatory behaviors to get rid of the excessive calories in the body. Some examples of inappropriate compensatory behaviors are purging, fasting, or excessive exercise. When these people eat rapidly they tend to not chew. Food consumed during a binge often has a high caloric content, a sweet taste, and a soft or smooth texture that can be consumed fast. Binging episodes often occur in secret and are usually terminated by only abdominal discomfort, sleep, social interruption, or self-induced vomiting. People who are diagnosed with this disorder may feel self-degradation and have a depressed mood. Although the eating binges may bring pleasure while they are occurring, self-degradation and depressed mood commonly follow. Constant purging may lead to dental erosion. This is because the acid from the vomit causes enamel erosion of the tooth. There is a persistent overconcern with personal appearance particularly regarding how they believe others see them. Weight fluctuations are common because of the alternating binges and fasts. Most individuals with bulimia are within a normal weight range. Some are slightly underweight and some are slightly overweight.

Last is binge-eating disorder. Individuals who are diagnosed with binge-eating disorders or BED have episodes of binge eating that may be similar to those with bulimia nervosa. However, one different thing about BED and bulimia nervosa is the absence of compensatory purging. As a result, people with BED are at risk for substantial weight gain. Another difference between bulimia and BED is that the rates of improvement are consistently higher among individuals with BED than among those with bulimia nervosa. Episodes of eating are referred to as binges when they occur over a discrete period of time which is usually less than 2 hours. Food consumption is rapid and it continues until the point where the individual feels uncomfortable full. Some possible triggers for this disorder are interpersonal stressors, low self-esteem, and boredom. Individuals with this disorder describe their eating as out of control and is often accompanied by guilt and depression. As many as 50% of individuals with BED have a history of depression.

There are predisposing factors associated with these eating disorders. Biological influence is a predisposing factor. Under biological influences are genetics, neuroendocrine abnormalities, and neurochemical influences. A study concluded that genetic factors account for 56% of the risk for developing anorexia. It is more common among sisters and mothers of those with the disorder than among the general population. Social factors such as modeling and mimicking may influence these relationships. Speculation has occurred regarding a primary hypothalamic dysfunction in anorexia. Support for this hypothesis is gathered from the fact that many people with anorexia experience amenorrhea before the onset of starvation and significant weight loss. The diagnosis of bulimia may be associated with the neurotransmitters serotonin and norepinephrine. Some evidence also indicates that low levels of the neurotransmitter serotonin may play a role in compulsive eating. Psychodynamic influences is also a predisposing factor. When events occur that threaten the ego, feelings of lack of control over one’s body emerge. Behaviors associated with food and eating serve to provide feelings of control over one’s life. Family influences is also a predisposing factor. Historically, parents are often seen as over-controlling and perfectionistic. This theory has been problematic because not all siblings in the same family develop eating disorders. There is not enough evidence to support these claims. Conflicts arise in a family when a child is starving herself or himself but is has become clear that family members need to be involved in treatment rather than blamed.

The aim of treatment in eating disorders is to restore the individual’s nutritional status. Complications of emaciation, dehydration, and electrolyte imbalance can lead to death. There are four treatment modalities. The first is behavior modification. The importance of the behavior modification program with these individuals is to ensure that the program does not “control” them. Issues of control are central in these disorders. In order for the program to be successful, the individual must perceive that he or she is in control of the treatment.

The second type of treatment is individual therapy. Although individual psychotherapy is not the therapy of choice for eating disorders, it may be an addition to a comprehensive treatment approach when underlying psychological problems are contributing to the maladaptive behaviors. In this therapy, therapists encourage clients to explore unresolved conflicts and to recognize the maladaptive eating behaviors as defense mechanisms used to ease the emotional pain.

The third treatment is family treatment. A more specific type of family treatment is the Maudsley Approach. This approach actively involves the family in each step of the process. Ninety percent of individuals showed improvement compared to 36% of those in individual therapies. This is conducted in an intensive outpatient program. There are three phases to the Maudsley Approach. The first phase focuses on weight restoration. This is where parents are actively engaged in establishing the rules and guidelines around eating. The second phase is where the control of maintaining weight gain is returned to the individual. Once the individual demonstrates the ability to maintain above 95% of ideal weight then they would move on to phase 3. The third phase focuses on assisting the individual to develop a healthy self-identity. This phase includes incorporating cognitive behavior therapy and dialectical behavior therapy skills. The last treatment modality is psychopharmacology. The medication fluoxetine has been found to be useful in the treatment of bulimia. This medication may decrease the craving for carbohydrates which then decreases the incidence of binge eating. High doses of selective serotonin reuptake inhibitors have demonstrated some effectiveness in promoting weight loss for patients with BED, but weight loss was temporary and weight gain occurred after the medication was discontinued.

Eating disorders are defined in the DSM-5 as a “persistent disturbance of eating or eating-related behavior that results in altered consumption or absorptions of food and that significantly impairs physical health or psychosocial functioning”. These disorders can sometimes be overlooked by society, and called a “cry for attention” or a “fake disorder”. The truth of this disorder is that over thirty million people’s lives in the United States are impacted daily by these disorders, and every sixty-two minutes, at the minimum, one person dies as a result of a feeding or eating disorder. Although feeding and eating disorders come in many different forms and severities, every one of them has a possible cure when brought to attention in front of the right people. People with these disorders need the support of society to come forward and face their disorder head-on, and this all starts with awareness of how the disorders come about and overall how they can affect one’s life.