EDs: Social Pressure & Mental Illness - Anorexia & Bulimia: Paper Example

Introduction

Eating Disorders (EDs) are a group of mental disorders characterized by pathological behaviors in the face of food intake and alteration in behaviors related to weight control. Two types of EDs are recognized, Anorexia nervosa (AN) and bulimia nervosa (BN), whose development of social pressure to achieve an ideal physique plays a fundamental role. These disorders are identified as emotional disorders of high severity and interference in many of the vital areas of the individual (Forrest et al., 2018). The data indicate that the confluence of biological, psychological, and social factors interact with the individual's personality, promoting the development of this eating pathology. The two share psychological factors typical of an eating disorder: low self-esteem, difficulty perceiving and accepting oneself, low ability to cope with problems, and frustration. People with this problem are overly critical of their bodies and have a strong desire for perfectionism that is never achievable (Erskine et al., 2016).

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Anorexia nervosa is characterized by voluntary restriction of food consumption and progressive weight loss until underweight (Mott et al., 2019). Likewise, there is a distortion of the body image; this means that people with anorexia look thicker. Anorexia has two subtypes: restrictive, in which weight is lost primarily through fasting and physical exercise, and compulsive/purgative, in which bingeing and purging occur.

In bulimia nervosa, the emotional discomfort or stress triggers binges, general food containing high caloric, followed by purging behavior (vomiting, using laxatives) or countervailing (fasting, intense exercise) that result from feelings of guilt or shame (Mott et al., 2019). During binge eating, a sense of loss of control over eating is experienced. Bulimia is also classified according to purgative and non-purgative, which corresponds more to compensatory behaviors such as fasting.

Unlike anorexia, bulimia is witnessed much less frequently (Galmiche et al., 2019). In this case, the weight loss is not so evident since the binge-compensation cycles keep it, more or less, at similar values. Bulimic people are characterized by expressing an exaggeratedly intense concern for their body image, although they manifest differently from anorexia. In this case, the ingestion becomes the method to cover their emotional needs, not satisfied by the appropriate channels.

Analogously to anorexia, alterations are also observed at a psychological and social level. Usually, these people show marked isolation, explaining why family and social interactions are often inadequate and unsatisfactory.

People More Likely to Suffer from Anorexia Nervosa and Bulimia Nervosa

EDs are disorders of multifactorial origin; that is, multiple factors affect their appearance and maintenance. Although both diseases usually appear at an early age, anorexia usually develops in people younger than bulimia, during adolescence, between 15 and 18 years, and bulimia later, in the youth stage, between 18 and 25 years (Galmiche et al., 2019). EDs have an approximate prevalence of between 6% and 8%, mostly affecting adolescents (Galmiche et al., 2019). However, in recent decades, there has been an increase in the incidence and prevalence of eating disorders, probably due to sociocultural factors of social pressure for image and prevailing standards of beauty. Because of this, eating behavior problems are much more prevalent in adolescent and young women than in the rest of the population, since, although not exclusively, a large part of these messages from society are focused on this population sector.

Causes Contributing to Anorexia Nervosa

According to DSM-5, anorexia nervosa is a psychological disorder characterized by restriction of intake that leads to significantly lower body weight than normal (Mott & Lumsden, 2019). In anorexia, there is a distortion of the perception of one's body and weight to which, also, exaggerated importance is given. Anorexia nervosa also features a disproportionate fear of gaining weight and behaviors to avoid it.

Three factors have been demonstrated in a majority by consensus by expert authors in this field of knowledge: predisposing, precipitating, and perpetuating (Galmiche et al., 2019; Mott et al., 2019). Thus, there seems to be an agreement in granting the causality of EDs a multicausal aspect where both physiological and evolutionary, psychological, and cultural elements are combined as intervening in the appearance of the pathology.

Among the predisposing aspects, reference is made to individual factors (overweight, perfectionism, level of self-esteem, etc.), genetic (higher prevalence in the subject whose relatives present said psychopathology) and sociocultural (fashionable ideals, eating habits, prejudices derived from body image, parental overprotection, etc.).

As precipitating factors are the subject's age (greater vulnerability in adolescence and early youth), inadequate assessment of the body, excessive physical exercise, stressful environment, interpersonal problems, presence of other psychopathologies, etc.

The perpetuating factors differ in terms of psychopathology. Although it is true that negative beliefs about body image, social pressure, and the experience of stressful experiences are common, in the case of anorexia, the most important factors are related to complications derived from malnutrition, social isolation, and development of fears and obsessive ideas about food or body shape.

Consequences of Eating Disorders

EDs have negative physical and mental consequences for the people who suffer from them, affecting social functioning (Mott et al., 2019). Unlike anorexia, bulimia is seen much less frequently. In this case, the weight loss is not so evident since the binge-compensation cycles keep it, more or less, at similar values. Bulimic people are characterized by expressing an exaggeratedly intense concern for their body image, although they manifest it differently than in anorexia. In this case, the ingestion becomes the method to cover their emotional needs not satisfied by the appropriate channels.

Comorbidity has also been observed between bulimia, anxiety, and depression, with depression usually presented as a bulimia derivative. Regarding the level of anxiety, a parallel is usually shown between the disorder and the frequency of bingeing carried out by the subject. Later, feelings of guilt and impulsivity motivate the behavior of compensating the binge. For this reason, a particular relationship of bulimia with other impulsive disorders such as substance abuse, pathological gambling, or personality disorders where behavioral impulsivity predominates has also been indicated.

Diagnosing Eating Disorders

Eating disorders are the result of a long list of symptoms of different types. These symptoms, instead of being different between anorexia and bulimia, are rather shared by the two diseases to a greater or lesser extent and can be divided into three groups: psychological, behavioral, and emotional (Galmiche et al., 2019).

Psychological symptoms include an obsession with weight and excessive fear of gaining weight; negative thoughts about diet, body image, and weight; distortion in one's body image; decreased creative and concentration abilities, and abstraction in thoughts. From behavior, the symptoms include restrictive diets or binge eating, refusal of certain foods, the use of extreme methods to eliminate the food consumed such as ingesting laxatives or causing vomiting, obsessive-compulsive behaviors, and social isolation. On an emotional level, the symptoms are depression, anxiety, deep sadness, phobias, and suicidal ideas.

Treatment and Support Options for People with Eating Disorders

Given the complex nature of the psychopathology and the powerful maintenance factors that make a favorable evolution of EDs extremely difficult, early detection of the first manifestations seems essential as well as guaranteeing a multicomponent and multidisciplinary intervention that encompasses both all the components altered (physical, cognitive, emotional and behavioral) as the extensive set of vital areas affected (Galmiche et al., 2019; Mott et al., 2019).

The primary and initial goal of treatment for anorexia nervosa is to regain weight to a healthy weight, while that for bulimia is to reduce binge eating and subsequent compensatory behaviors. Intervention in anorexia in many cases requires hospitalization, while in bulimia is significantly much lower.

References

Erskine, H. E., Whiteford, H. A., & Pike, K. M. (2016). The global burden of eating disorders. Current Opinion in Psychiatry, 29(6), 346-353. DOI:10.1097/YCO.0000000000000276

Forrest, L. N., Jones, P. J., Ortiz, S. N., & Smith, A. R. (2018). Core psychopathology in anorexia nervosa and bulimia nervosa: A network analysis. International Journal of Eating Disorders, 51(7), 668-679. https://doi.org/10.1002/eat.22871

Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: a systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402-1413. https://doi.org/10.1093/ajcn/nqy342

Mott, L. A., & Lumsden, B. D. (2019). Understanding Eating Disorders: Anorexia Nervosa, Bulimia Nervosa And Obesity. Taylor & Francis.