Dissertation on Eating Disorders
Eating plays a very important role in our lives. Not only is eating necessary to survival, but it is also a recreational activity, associated with most holidays, bringing joy to many people. However, for nearly 10 million people in the U.S. alone, eating is an enemy.(Bell, 65) These 10 million people suffer from some sort eating disorder, most commonly Anorexia nervosa or Bulimia nervosa. The first and most common eating disorder, affecting nearly seven million women and one million men each year, is Anorexia nervosa .(Kolodny, 40) Anorexia means the loss of apatite, however, this is often misleading because anorexics do not loose their apatite, they merely learn to suppress it. A more appropriate definition of anorexia is; a mental illness in which a person has an intense fear of gaining weight and a distorted perception of their weight and body shape (Encarta 1). Anorexia generally affects the same type of person, regardless of sex. The typical anorexic tends to be controlling, a great overachiever, and a perfectionist, who strives to please other people. Anorexia normally begins with a diet. A person will begin not only to lose weight but to receive complements on how good they look.
An anorexic will take these complements as cues to continue their dieting. They believe that the more weight they loose the better they will look. At this point an anorexic will begin to invent many different ways to loose weight. The person will start to become obsessed with food. They will constantly cook wonderful meals and deserts for friends but never eat what they cook. When placed in a setting, such as a family mealtime, where they are expected to eat they will often cut their food into small pieces and move it around their plate to make it look as if they have eaten, or they will hide food in their napkin.
They will also commonly tell people that they do not know as well that they cannot eat sugar, because they are diabetic or they cannot drink milk, because they are lactose intolerant. Eventually they will begin to make excuses to avoid mealtime all together. They will say they have already eaten, or they are in a hurry to be somewhere, or they aren't feeling well. Since they are so determined to avoid meals they are forced to become very withdrawn from friends and family.
They avoid social situations as much as possible. Anorexics are very good at disguising their disease, one way that they will do this is by wearing very baggy clothes. However, there are many warning signs to look for. These signs include; a skeletal look with sunken eyes, yellow or grey, pale dry skin, thinning hair on their head but fuzzy hair growth on the rest of the body, inability to sleep yet they appear to be exhausted, menstruation stops, frequent urge to urinate, and depression. Anorexia is extremely harmful both a person's mental and physical health. As people with anorexia decrease the amount of food they eat, the body begins to burn up fatty tissue.
As the condition worsens the body burns up nearly all of this tissue. The body also burns up muscle tissue in order to receive the nutrients which it lacks. Malnutrition is an obvious danger of anorexia that can be seen just by looking at the anorexic person. Yet there are many more unseen dangers. Anorexics often suffer from a shrunken heart with an irregular beat, a loss of bone marrow, brittle bones, and a low pulse and blood pressure.
Experts estimate that between 10-20% of those with anorexia die from it.(Bode, 12) Aside from the physical harms people with anorexia become extremely nervous, depressed, and often suicidal. The second type of major eating disorder is Bulimia nervosa. Bulimia is an eating disorder in which persistent over concern for body weight and shape leads to repeated episodes of binging, associated with induced vomiting, use of laxatives, fasting and or excessive exercise to control weight.(Encarta 1) Bulimia is less common than anorexia, however 50% of anorexics at some point in their illness also suffer from bulimia and 20% of bulimics go through anorexic periods. (Bode,19) Unlike anorexics, bulimics are unable to suppress their hunger. Therefore their dieting consists of a cycle of fasting, binging, and purging.
Fasting is to restrain from eating for a period of time. A binge is to eat an unusually large quantity of food "most often food that is high in calorie and very fattening" at one time. Binges can last up to several hours or even on and off for several days. In some cases though, a bulimic will binge on shopping, shoplifting, alcohol, drugs, or sex with multiple partners. Purging most commonly is the voluntary act of vomiting, however laxatives, extreme vigorous exercise, and diuretics are also used.
Many bulimics are desperate to quit binging and they will try almost anything, with the exception of seeking help, to stop. Many bulimics will hide food from themselves or even pour detergent on their food. None of this seems to work though, when a bulimic feels the urge to binge they will. Bulimia is not quite as easy to detect as anorexia is because bulimics often maintain a normal body weight. There are although, warning signs to look for.
Some examples include; broken blood vessels in the face, bite marks on the middle or index finger, dry, flaky skin, tooth decay, indigestion, and constipation. Bulimia, like anorexia has many harmful side effects, most of which go unseen. Some of the dangers include; electrolyte imbalance "which is when the body's fluid and mineral balance is upset" dehydration, damage to bowls, kidney, and liver, and in many cases heart attack or failure. Emotionally, bulimics suffer from guilt, loneliness, and depression all which contribute to the extremely high suicide rate of bulimics. The third classified eating disorder is called Compulsive Overeating or Binge Eating. For years experts have been debating the issue of whether or not to include Compulsive Overeating as an eating disorder.
Finally in the 1970s it was recognized as an eating disorder and people began to receive treatment. Compulsive overeating is a continuous cycle between extreme binging and dieting. Compulsive overeaters have dramatic weight decrease and increase within a matter of months. A typical Compulsive overeater will binge at least twice a week for several months. The amount of food consumed during their binges is tremendous. A typical binge could consist of an entire cake, a gallon of ice cream and some cookies.
Some binge eaters report consuming as much as twenty thousand calories in a single sitting, the amount an average person eats in 8 days.(Nardo, 28) Compulsive overeaters will binge for a few months and then they will stop for a few weeks to begin dieting. The diet is an attempt to loose whatever weight they gained during their months of binging. This however, is useless, because as soon as the weight is lost they will begin to binge again gaining all of the weight back. Compulsive overeating is harmful to a persons body. The continuous weight gain and weight loss interferes with the bodies metabolism.
The more the person transitions between binging and dieting the slower their metabolism becomes, therefore making it much harder for them to loose weight. Aside from being physically harmful compulsive overeating is also harmful to a person mentally and emotionally. Since almost all compulsive overeaters binge in secrecy it becomes a dominant part of their life which forces them to withdraw themselves socially. Most compulsive overeaters are aware that they do have a problem, but they are unable to control it and are too ashamed to ask for help. Like compulsive overeating, doctors have debated for years about whether or not obesity is an eating disorder.
At this point a majority of the doctors say that an obese person does have disordered eating, although they will not classify it as an official eating disorder. However, several people who suffer from obesity are compulsive overeaters. Twenty-five percent of people with eating disorders, no matter which type, will experience periods of time where they will go into a trance.(Claude-Pierre, 100) When a person goes into one of these trances it is an indication that they are at the most serious psychological state of the illness. The persons negative mind consumes them are they are oblivious to reality.
Warning signs to an approaching trance may include; the voice of the person becoming a whisper, the body beginning to immobilize(curl into the fetal person out of fear), and the person does not make eye contact and seems to be lost in the battle that is going on within their mind. One thing most scientists, doctors, and other specialists disagree on, is the cause of eating disorders. A humanist would say that a person develops and eating disorder after several failed attempts of becoming self actualized.
Therefore the person will fall all of the way down to the bottom of the hierarchy of needs and feel they are not worthy enough to even fulfill the basic needs, including food. A behaviorist would feel that a person with an eating disorder developed it as a reaction to a certain stimuli in their life. Some of the common stimuli which trigger eating disorders are; family or other relationship problems, a persons casual remarks about weight, the feeling of inadequacy, and pop culture. Most people agree with the behaviorist point of view, and feel that there are triggers, usually more than one, which trigger eating disorders.
Another common view about the cause of eating disorders is the constant battle between the person and their negative mind, and the person feels obligated to obey the commands of the negative mind, for example, "you are FAT, you may not eat today unless you run 5 miles!" Treating eating disorders is usually a very long and difficult process. There are many different forms of treatment a patient can receive, but the type of treatment along with the effectiveness of the treatment generally depends on the individual personality and background of the patient. The two basic types of treatment are physical and psychological.
For some patients the psychological treatment alone will help cure them, but in many cases both psychological and physical treatment are required. The most common form of physical treatment is hospitalization. The length of stay in the hospital varies for each individual patient depending on how severe their condition is. The most important part of this type of treatment is to make the patient gain weight. This initial weight gain is always the most difficult part of the physical treatment because the patient continues to deny they have a problem.
The major downfall of strictly hospital treatment is that 38% of anorexics will relapse within 2 years after being released from the hospital and have to be hospitalized again.(Bode,10) Another physical treatment is drug therapy. In the 1960s and 1970s doctors began experimenting with different types of drugs, hoping that they would eliminate the patients fear of food and being fat. One substance that was commonly used is called chlorpromazine.
Chlorpromazine was reported to have been helpful in several cases, but because of its many side effects including, lowering blood pressure, and reducing body temperature, it is rarely used today. Another form of drugs that are often used to help cure eating disorders are antidepressants, since this is a leading cause of eating disorders in many cases. Psychotherapy, is the most common type of psychological therapy. The main goal in psychotherapy is to help the patient realize and understand not only that they have a problem, but what has caused it and how they can deal with it. Psychotherapy begins with the doctor giving the patient strait facts about their problem. The doctor will tell them about their disorder and why it is harmful.
From there the patient and doctor will discuss the patients life-style, concerns, fears, and stresses hoping to find what things contributed to the development of their eating disorder. The patient will have several counseling sessions and throughout these the patient learns how to cope with improve their body image, cope with stress, and establish and maintain a normal eating pattern. A second type of psychological therapy is general counseling. The counseling begins as initial one-to-one sessions between doctor and patient. As the patient begins to recover, they normally begin group therapy.
In group therapy around 5 people with the same disorder will come together to share their stories, and experience with eating disorders with each other. There is always a doctor present during group therapy, who normally will lead the discussions, and offer emotional support along with facts about the disorders. Counseling has been found to be most helpful for both compulsive overeaters and bulimics. It forces them to realize that their problems really are common, which makes them feel less alone and more worthwhile. A third type of psychological approach to treating eating disorders is called behavior modification.
Behavior modification which is generally used by humanists or behaviorists is a step-by-step process which is used as an attempt to modify a person's eating habits. Together a patient and their doctor will create a list of goals to be accomplished. An example of the goals a bulimic may have may be to refrain from vomiting after eating or to substitute a healthy meal, for an unhealthy binge. An example of the goals an anorexic may have would be to eat all the food on their plate, or to gain a certain amount of weight within a certain amount of time. If these goals are reached the patient is positively reinforced and possibly even given a reward.
However behavior modification is often criticized. People who object to this type of treatment feel that once the patient is on their own, and the rewards stop they will fall back into their old eating habits. Despite the amount of therapy are person goes through, it is believed that a person can never be cured of an eating disorder. People who have had eating disorders at one time in their life will continue to struggle with it, either consciously, or unconsciously for the rest of their lives. Eating disorder are a very serious mental and physical illness which people need to be more educated about.
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