Adolescent anorexia nervosa: clinical features and treatment approaches

Adolescent Anorexia

Anorexia Nervosa is a psychological eating disorder that is characterized by a distorted body image and obsessive fear of gaining weight -- resulting in starving oneself or eating and then regurgitating food. The condition typically affects younger women, between 15 and 19 years old. Most anorexia sufferers are female, and the majority of cases go either undiagnosed or untreated until other medical issues intervene. In contemporary culture:

Over ae of adolescent girls feel negatively about their body

Almost 1/2 teenage girls know someone with an eating disorder

Almost 60% of girls want to lose weight

Girls are three times more likely to think they are too heavy

percent of young women worry "a lot" about how they look (Croll 536-7).

Anorexia sufferers typically experience weight loss about 15% below the level of normal body weight for their age group. People suffering from the disorder are typically quite thin, but convinced they are overweight. They will often refuse to eat, take massive doses of laxatives, or indulge in excessive exercise -- all from the fear of being perceived as fat. The disorder itself is thought to be more common among members of higher socioeconomic sectors, and even more so within groups that are involved in activities in which being thin is considered a positive attribute (dancing, theater, long-distance running, modeling, etc.). Health professionals have attributed some of the psychological pressures of becoming thin to the way in which the media portrays beauty, and certainly noticed an increase in anorexic cases within the last 2-3 decades.

Certainly, it is quite possible that anorexia may have been a malady which certain psychological types were predisposed throughout history, but in the contemporary world, the 1983 death of pop star Karen Carpenter brought attention to the term, and even the propensity to label thin individuals as "anorexic." However, on a positive note, recognition of the disease beginning in the late 1980s cause a number of specialized clinics to open that focus specifically dealing with eating disorders. Still, it is tough to change certain eating behaviors while one's peers, and sometimes even parents or caregivers, are of similar mindsets to anorexia sufferers. As the "ideal body shape" becomes even more entrenched in advertising, most young women face similar psycho-social issues. The simple fact is that in contemporary society -- appearance matters. Even mega-stars consent to surgery, expensive treatments, and massive retouching in photo shoots simply to be "beautiful." However, this translates down into adolescents, particularly girls, that something is always lacking -- that they can never be perfect, that they can never be ideal, unless they spend x dollars on certain products to make themselves beautiful. Indeed, the idea of inadequate body image leads to psychological and social problems that now transcend race, making body-image one of the most critical "problems" faced by American youth (Croll 539).

Since the 1980s, hyper-slimness embodied the supposed "ideal" of feminine beauty. This ideal resulted in a number of women who constantly diet in order to keep up with their perception of the contemporary idea of a perfect body, and to wear the fashion produced for the ultra-thin. Glamour magazine, in fact, carried out a survey in 1983 of thousands of women between 18-25; over three-quarters believed they were fat, although less than a quarter were actually clinically obese. Interestingly, the higher the socio-economic profile, the more women believed they were overweight, and the more this subgroup defined themselves by media messages (Croll 539).

Anorexia is almost common enough to call it an epidemic among certain portions of the population. It is a painful, life-long syndrome that punctuates through layers of society, ethnicity, and gender issues. The only effective prevention is early individual intervention -- whether that is from parents, from teachers, or from leaders in social settings. There is ample evidence that the cultural influences in our society set a high premium on thinness. Superficial beauty is valued above substance. These messages affect even young elementary schoolchildren and have a powerful impact on adolescents. They come to believe that they will be judged by how thin they are and how they compare to their idols -- popular singers, models, and actresses. In fact, even executives in fashion and beauty magazines see an alarming trend of "too thin" to the point of looking emaciated and unhealthy -- certainly not a look that "sells" (Wilson 542).

What is happening is a continual push to be something different, not because there is actually anything wrong with us -- at all. It is because advertising tells us that something is wrong. Advertising is part of the marketing mix that is designed to persuade a consumer to purchase something. Of course, there are many ways of doing this, and the "science" of this media has certainly evolved in the last century. Advertising is subliminal, sophisticated, pervasive, covert, overt, and a seminal part of the contemporary world. However, advertising has become so sophisticated that it sends messages both overt and covert that even if we are not paying attention to the exact product, the images we see become part of our cultural identity. The "power" of advertising in undeniable -- so powerful, it can even get the public upset over something as "earth-shattering" as the taste of a soft drink. Is there hope, or even a partial solution to this issue of changing so much of ourselves that we are continually unhappy because we can never be perfect?

Research also shows that familiar messages, concerns, and pressures have a strong effect on the way adolescent's perceive their body image. First, they are bombarded by advertising telling them they are "too fat," they have "the wrong hair color," their body shape "just isn't right," and a litany of other complaints that are simply, and usually, either genetic or just part of the maturation process. Parents, though, tend to be hyper critical to the extreme. If they perceive their child is too thin they will push food, sweets, and constantly nag; if they perceive their child is too pudgy, they will likely withhold food, change the way meals are served, or even lambast the child in front of siblings (Croll 539).

However, to the other extreme, many poorer families do not monitor meals because of economic or time reasons, and often push fast-food and other unhealthy choices. This is so endemic of a problem that even children as young as 8 -- elementary school, believe that their weight is strongly correlated with self-worth and are so concerned that the worry about dieting when they should be concerned about proper nutrition (Croll 540).