Not just the media... (Eating disorders - how are they caused?)

Member Name: magpie

Product:	Eating disorders - how are they caused?
Date:	27/02/01 (153 review reads)
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There are two main eating disorders - anorexia nervosa and anorexia bulimia. These two disorders are quite different in their symptoms, and I shall first describe them.

Anorexia nervosa

Anorexia refers to loss of appetite and nervosa indicates for emotional reasons (Davison & Neale, 1998). However, patients while starving themselves may actually become preoccupied with food. The criterion for diagnosis are
* person refuses to maintain normal body weight (they usually weigh less than 85% of their recommended weight) and this weight loss is achieved thought dieting, purging (vomiting and use of laxatives and diuretics), and excessive exercise
* Person has an intense fear of gaining weight, which is not ameliorated by weight loss
* in females emaciation often causes amenorrhoea (ceasation of normal periods)
* distorted sense of body shape

Even when emaciated patients will perceive body parts as being grossly fat, and will spend hours weighing, measuring, and examining their bodies.

Bulemia nervosa

Bulimia is from a greek word meaining ‘ox hunger’. The disorder involves binge eating followed by purging behaviour. Binges happen in secret, are triggered by stress, being alone, social eating situations and concerns about weight gain. The person eats for upwards of two hours solid, until they are uncomfortably full. During the binge the person feels that they cannot control the amount of food which is being consumed. A binge typically involves between 2000 and 4000 calories of food. Following the binge patients typically induce vomiting, or take laxitives. For diagnosis of bulimia binging and purging episodes must occur at least twice a week for three months.
Bulimia is similar to anorexia in that the patient is obsessed by their weight, and are overly concerned by their body shape. However, bulimia is only diagnosed without the extreme weightloss associated with anorexia - if an anor
exic is also binging and purging this is classified as anorexia - binging and purging sub type.

What then causes these eating disorders?

As with all psychopathologies, it is unlikely to be a single cause. I will now describe some of the possible causes of eating disorders

Genetics

Anorexia and Bulemia both run in families. First degree female relatives (parents, siblings, children) of young women with eating disorders are five times more likely to suffer from an eating disorder than someone in the normal population. Of identical twins with eating disorders, 47% of their twins will also have an eating disorder, as opposed to 10% of non identical twins. This sort of research shows that as identical twins share the same genes, at least some component of eating disorders are due to genetic susceptibility.

Biological factors

Eating is controlled by the hypothalamus in the brain. Lesions of the hypothalamus can induce a state similar to anorexia, and so it has been proposed that this part of the brain may be involved in anorexia. Some of the hormones in the hypothalamus are different in anorexics compared with normals, supporting this notion. However, this doesn’t explain all the facets of anorexia, but it may provide a clue for developing drug interventions.

Sociocultural factors

While genetics and biology contribute to anorexia, environment is also important. Afterall, 53% of identical twins don’t get an eating disorder when their twin does - showing that while genetics and biology (nature) are important - the environment (nurture) is also critical in producing the disorder.
The standards society has set for body image has varied throughout history, from the famous nudes of Rubens (who are now viewed as fat) to modern, androgynous models. Throughout the past 50 years playboy centre-fold women have been getting slimmer, as have beauty pageant queens. One third of teenage
rs feel they are overweight, although they are not. The number of dieters has increased from 14% of women in 1950 to 40% in 1993, and liposuction has become the most common procedure in plastic surgery.
Not only is slim regarded as the ideal, but fat is regarded as unsuccessful, with little self control. Fat people are viewed as being more stupid, lonely, shy, and greedy.

Given the cultural ideal, what then is the evidence that this contributes to eating disorders? The prevalence of eating disorders changes across cultures. Highly industrialised societies have many more cases of eating disorders than non industrialised nations, and the perception of ideal body weight also changes in the same way. Higher class groups, which have a of lower deal body weight also have more prevelance of eating disorders.

There are other sociocultural factors than simply the media however. Patients with eating disorders often come from families with high levels of conflict. Often the family is highly controlling, with high expectations of the patient. This is the ‘perfect little girl’ type of eating disorder - the patient is often highly intelligent, and a perfectionist.

Treatment of eating disorders is often not successful. Anorexia has the highest mortality rate of any psychopathology (6%). Patients often drop out, or treatment is unsuccessful.

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