Anorexia Nervosa is a serious eating disorder that affects millions of people all over the globe. The purpose of this discussion is to examine this disorder. We will begin by defining and characterizing anorexia nervosa. We will then discuss the factors that contribute to the development of the disorder. Finally, our discourse will investigate the treatments associated with anorexia nervosa.
Definition of Anorexia Nervosa
The Gale Encyclopedia of Alternative Medicine defines Anorexia nervosa as, "an eating disorder characterized by unrealistic fear of weight gain, self-starvation, and conspicuous distortion of body image." (Tran) The disorder is a combination of two Latin words that literally mean "a nervous inability to eat."
The Encyclopedia explains that there are to different types of anorexia. The first type is described as restrictive, in which the person suffering with the disorder has a strict diet and exercises compulsively. The second type is described as a binge type in which the individual suffering with the disorder eats compulsively and purges by vomiting or through the use of laxatives. (Tran)
Anorexia Nervosa was classified as a psychiatric disorder in 1980 and has become a serious health problem. It is estimated that over 5 million individuals have some type of eating disorder. ("Position of the American Dietetic Association...") Most of the individuals that suffer with anorexia are females between the ages of 14 and 18 but a high percentage college women also suffer from the disorder. (Johnson and Petrie) The disorder can cause serious damage to the body including; kidney failure, anemia, osteoporosis, heart failure, stomach rupture and stunted growth. (Tran)
Characterizations of Anorexia
According to Anorexia Nervosa and Related Eating Disorders Incorporated, there are several factors that characterize Anorexia nervosa including:
Unusual eating habits, withdrawal, depression
Separation of food into good and bad categories.
An individuals' refusal to maintain normal body weight for their specific height and age.
Weighs 85% or less than what is expected for age and height.
Menstrual periods cease in females that suffer from the disorder.
Sex hormone levels decrease in men that suffer from the disorder.
Young girls do not begin to menstruate at the appropriate age
The individual does not accept the serious consequences of low weight.
Individual is frightened of becoming overweight even when they are drastically underweight.
Individual may also feel fat even though they are thin. ("The Better Known eating disorders")
Factors that contribute to the development of Anorexia Nervosa
There are no clear cut answers for why some people develop anorexia. The theories about the factors that contribute to the development of the disorder range from societal pressures to family relationships. (Pryor Wiederman)
The Societal pressures facing young women definitely contribute to the development of the disorder the most; these pressures come from the media and peer groups. Quite often the magazines and television shows define a woman's worth by the amount that she weighs. Young women are constantly bombarded with these images and begin to believe that this is how they should look.(Candy and Fee) The constant emphasis on looks and weight lead some individuals' diet and eventually begin starve themselves so that they look like the images that they see in the media. (Myers and Biocca)
Many young women are unaware of the fact that the women that appear in magazines have been airbrushed and that these women are not "perfect." They are also unaware of the fact that many of the models and actresses that they see are suffering from eating disorders. These falsehoods give young women a distorted view of how their bodies should look -- leading to the development of anorexia nervosa.
In addition to the media's portrayal of women, family relationships can also contribute to the development of anorexia. Young women that have an unstable family life are at a greater risk of developing the disorder. Many professionals believe that this has to with the fact that anorexia gives the individual something that they have control over. (Mintz) family's attitude towards weight can also contribute to the development of the disorder. Many families view fat as a negative attribute for an individual to possess. This attitude often leads individuals to adhere to extremely restrictive diets and large amounts of exercise so that they will not develop this negative attribute.
Many individuals that suffer from anorexia come from families that expect a certain level of achievement and worship education. These young women tend to be very goal oriented and strive to impress their families. They also have profectionistic tendencies. (Tran)
Women that have been sexually assaulted are also at a higher risk of developing anorexia. (Tran) Psychologists believe that the trauma of rape or molestation can contribute to the development of anorexia. (Barlow) Because sexual assault can make a woman feel helpless, the development of an eating disorder gives a woman a sense of control.
There are also genetic factors that contribute to an increased risk of developing the disorder. For instance a young woman whose mother or sister has the disorder is at a greater risk for developing the disorder. Often times the young woman will simply copy the behavior of the mother or sister that has the disorder. (Tran)
Treatments for Anorexia
According to the Journal of the American Dietetic Association there are several outpatient and inpatient treatments for the disorder.
Two important aspects of inpatient and outpatient treatment are making certain that the weight of the patient is taken and understanding the patients' mental condition. Knowing these factors aids the practitioner in deciding how aggressive the therapy should be.
These treatments must involve both psychiatric and nutritional care; neither one of these therapies alone can treat anorexia nervosa.
The purpose of outpatient treatment is to "focus on nutritional rehabilitation, weight restoration, cessation of weight reduction behaviors, improvement in eating behaviors, and improvement in psychological and emotional state." ("Position of the American Dietetic Association...") During outpatient treatment the physical condition of the patient is assessed and recommendations are made concerning dietary supplements. A dietician may also reduce or eliminate the patients' exercise regiment to promote weight gain. Patients are taught that food and exercise should be used to get the appropriate amount of nutrition and to promote physical fitness and not as means to control weight.
Individuals are monitored for problems associated with refeeding. These problems can include "severe hypophosphatemia, sudden drops in potassium and magnesium, glucose intolerance, hypokalemia, gastrointestinal dysfunction, and cardiac arrhythmias, and water retention." ("Position of the American Dietetic Association...") Patients are also taught that certain food choices can lead to adverse effects such as abnormal bowel function. The weight gain goal for this particular stage of treatment is 1 to 2 pounds per week.
If the individual that is receiving outpatient care responds well to this treatment there is no need for inpatient treatment. ("Position of the American Dietetic Association...")
Inpatient treatment generally occurs when the individual is grossly underweight and suffering from malnutrition. According to the Journal of American Dietetics Association, the other factors that contribute to impatient admission include but are not limited to;
Physiological volatility hypotension hypothermia stunted growth and development
Failure in outpatient treatment
Severe food refusal
Unmanageable binging and purging. ("Position of the American Dietetic Association...")
Inpatient treatment is usually more intense than outpatient treatment because the condition of the patient is usually more severe. The first step that is taken in inpatient treatment is to stabilize the condition of the patient. ("Position of the American Dietetic Association...") This is done by feeding the patient intravenously and administering the appropriate medication for any psychiatric issues that the patient may have.
After the patient is medically and psychologically stable many of the same tactics are used to treat their conditions as in outpatient treatment. The patient is referred to a dietician who presents the patient with a meal plan. In inpatient the administering and the adherence to the meal plan is carefully monitored so that weight gain can occur as soon as possible. ("Position of the American Dietetic Association...")
Recently inpatient facilities have began to utilize partial hospitalization as a means of treatment. Partial hospitalization allows the patient with a less severe form of anorexia to go to the hospital for 7 to 10 hours a day. ("Position of the American Dietetic Association...")
During their stay in the hospital patients must eat 2 meals and 2 snacks. The patient is then responsible for eating one meals and one snack on their own.
The patients that participate in partial hospitalization are also given group and individual therapy concerning nutrition and psychological issues. ("Position of the American Dietetic Association...")
In addition to the treatments that we have already discussed there are some less practiced treatments for anorexia that offer hope. The first of which is herbal treatments. It is believed that certain herbs such as linden, lemon balm, and chamomile aid in the reduction of depression and anxiety that can result in an eating disorder. It is also believed that relaxation techniques such as tai chi and yoga can aid…