Eating Disorders Anorexia Nervosa: American Society Seems

Eating Disorders

Anorexia nervosa: American society seems to have an obsession with thinness, particularly for women. Over the last two decades, the United States has seen two eating disorders become more and more common: anorexia nervosa and bulimia nervosa. In both disorders, the person takes extreme measures to lose weight. The young women who develop these conditions tend to tend toward perfectionism and be high achievers who try to meet all demands placed on them.

The clinical picture: the person, usually a girl, has a distorted sense of her own self-image and an exaggerated fear of becoming overweight. It often starts with a more moderate diet, but gradually they start rejecting more and more food until they are eating very little and become emaciated, but believe that they look fat. As they eat less and less, they may talk and think about food a lot, carefully planning their miniscule meals. Some people say they like the feeling they get of increased control over their lives.

Medical problems: As weight loss increased, monthly period stop, body temperature lowers, bones can become less dense and heart rate may drop. If the nutritional deficiencies become severe enough, they may die of cardiac arrest, as the singer Karen Carpenter did.

Bulimia nervosa: in this form of the problem, the person cannot resist not only eating, but overeating, or binging on, favored foods. The person then forces herself to regurgitate the food so she will not absorb the calories. They may also overuse laxatives or enemas, take diuretics to shed water weight, or use extreme exercising to burn calories.

Both anorexia and bulimia tend to develop in the ages from young adolescence to young adulthood, and may be triggered by one offhand comment: supposedly Karen Carpenter started on the path to anorexia when one reviewer described her as "pudgy."

Binging can be extreme; some people binge up to 40 times in a week -- more than five times a day, and usually in secret. They may consume more than 3,000 calories in a short period of time without chewing the food much or even tasting it. The binge is followed by feelings of guilt. Compensatory actions follow to get rid of the food, but that leaves the person feeling hungry, and the cycle can repeat itself fairly quickly.

Bulimia nervosa vs. anorexia nervosa: the two are similar in some ways. Both are often triggered by a period of more sensible dieting, by people who fear becoming overweight. Both can involve substance abuse, often drugs intended to support weight loss. Both involve distorted senses of self-appearance. However, those with anorexia show more obsessive tendencies, while bulimics are more interested in pleasing others. Those with bulimia tend toward mood swings and emotionality. Anorexia is more likely to lead to menstrual irregularities, but bulimia can damage the throat, teeth, lungs, and gums.

What causes eating disorders? Experts believe that multiple factors lead to the development of anorexia and bulimia.

Societal pressures: Western society's fascination with thinness is believed to be a strong factor in the development of these disorders. Researchers note a steady trend toward "Miss Americas" and even Playboy centerfolds who have become thinner and thinner over the years. Weight has been emphasized, perhaps too much, among athletes, resulting in an estimated 9% female college athletes who show signs of eating disorders and another 50% at risk of developing them. It is especially prevalent among gymnasts. In addition, overweight people are often the butt of jokes in movies and on television, further emphasizing the desirability of being thin.

Family environment: may play an important role. 50% of girls with anorexia come from families where physical appearance, including dieting, is emphasized. Some feel that the problem tends to appear in dysfunctional families with the anorexia just another symptom of that, especially families that allow little room for individuality. They argue that when someone becomes sick with anorexia, it holds the family together as they support her in her battle with food.

Mood disorders: are particularly common among those with bulimia, including major depressive disorder, low levels of certain neurotransmitters, and benefiting from taking antidepressants. Often they have close relatives who have mood disorders. However, it isn't clear whether the depression comes first, or the eating disorder.

Biological factors: genetic research suggests a genetic predisposition, and once again neurotransmitters are implicated.