Essay on Biological Causes of Anorexia Nervosa and Bulimia Nervosa
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Biological Causes of Anorexia Nervosa and Bulimia Nervosa
Anorexia nervosa and bulimia nervosa affect millions of people each year in the United States (1). Popular thought holds that these disorders are caused by women trying to fulfill a culturally imposed ideal body image which stresses thinness. As anorexia and bulimia have proven difficult to treat solely with a psychological-based treatment plan it is likely that there are many factors contributing to these disorders. Research has shown, however, that there is a significant biological component which leads to a manifestation of these disorders (2). Current ideas on the biological origins of anorexia and bulimia will be explored in this paper. These include areas ranging from…show more content…
There is a tremendous discord between actual weight and perceived body weight. While the woman may feel fat she is actually excessively underweight. "When she came in for consultation she looked like a walking skeleton. Alma insisted that she looked fine and that there was nothing wrong with her being so skinny. 'I enjoy having this disease and I want it. I cannot convince myself that I am sick and that there is anything from which I have to recover." (3)
Bulimia nervosa is a related disorder which affects two to three percent of young American women (1). This disease is most commonly described as the cycle of eating huge quantities of food, thousands of calories in one sitting, then ridding the body of this food through some form of self purging. Purging is accomplished through excessive exercise, abuse of laxatives or diuretics, enemas, or vomiting. Many of these methods are often incorporated simultaneously. The bulimic frequently thinks this practice of bingeing and purging is disgusting and does so in private, making it hard to detect and treat.
"Lisa would eat pounds of candy and cake at a time, and often not stop until she was exhausted or in severe pain. Then, overwhelmed with guilt and disgust, she would make herself vomit." (1)
Studies have shown genetic predisposition for developing an eating disorder. Females in a family which has a member with an eating disorders are more likely then average women to develop
Types of Eating Disorders
Individuals are diagnosed as anorexic (according to the DSM-IV-TR) if they refuse to maintain the appropriate body weight (according to age and height), and have an intense fear of gaining any more weight - even though they are already underweight (Keel & Klump, 2003). Concisely, if patient "X" is significantly underweight, yet does not want to do anything to correct this then patient "X" is anorexic.
Bulimia nervosa, as defined by the DSM-IV-TR, is just as terrifying as anorexia nervosa. The criteria is as follows: Recurrent episodes of binge-eating--consuming an amount of food which is much larger than most would eat during a similar period of time--at least once a week for three months. A lack of control over binge eating. Recurrent and inappropriate behavior aimed at compensating for the weight gain, self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. The subject�s self-evaluation is based on and influenced mainly by body shape and weight. (Keel & Klump, 2003) In short, a diagnosis of bulimia nervosa is if subject "X" eats more then he or she should, and then inappropriately extinguishes the weight because the subject is not the weight he or she fantasizes to be.
These two disorders, anorexia nervosa and bulimia nervosa, are alarming. Do they have particular risk factors? Can culture, socioculture or genetics cause them? What is their prevalence? These are questions which this paper addresses.
Causes of Eating Disorders
To determine if an eating disorder is culture bound data must be collected and sorted from various cultures along a timeline of many years. Are Eating Disorders Culture-Bound Syndromes? Implications for Conceptualizing Their Etiology, by Pamela Keel and Kelly Klump did just that. They attained statistics from an assortment of cultures and along a timeline of sixty years. The experiment was done for anorexia nervosa and duplicated for bulimia nervosa. The results were surprising. Anorexia nervosa does not seem to be a culture-bound syndrome. Bulimia nervosa on the other hand does seem to be culture-bound. There has been a significant increase in bulimia nervosa during the later half of the twentieth century. One striking fact is that every non-western nation that had evidence of bulimia nervosa also had evidence of western influence. The authors do not take this to be a coincidence (Keel & Klump, 2003).
Cashel, Cunningham, Cokley, and Muhammad, in Sociocultural Attitudes and Symptoms of Bulimia: Evaluating the SATAQ with Diverse College Groups, tested the affect of sociocultural attitudes on eating disorders. The method was to question an array of students from a Midwestern University in the United States. The participants consisted of both men and women. The procedure consisted of having the subjects fill out a structured questionnaire, the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ). After the questionnaire was finished a correlation between Caucasian women, all men, African American women, Hispanic American women, Caucasian sororities and Caucasian non-sororities to body dissatisfaction, drive for thinness, and bulimia was calculated.. SATAQ Internalization was significantly correlated with EDI-2 (a self-report measure developed to assess a variety of symptoms reflective of eating disorders), Body Dissatisfaction and Drive for Thinness. SATAQ Awareness scores were extensively correlated with the Body Dissatisfaction and Drive for Thinness scales for the Caucasian American and Hispanic American female groups. The SATAQ Awareness scores for African American women and men were not considerably related to scores from the EDI-2. The extent of the correlations with eating disorders was the strongest for Caucasian and Hispanic American women (Cashel, Cunningham, Cokley, & Muhammad, 2003). To get to the point, this study proves that there is an affect of sociocultural attitudes on eating disorders.
A third possible cause for eating disorders is substance abuse by the parents. Von Ranson, McGue, and Lacono (2003) tested 674 females and their parents. Daughters underwent assessment of eating disorders while their parents underwent assessment of substance abuse. The results of this study show no correlation between parents with past substance abuse problems and their daughters� eating disorders.
Another possible cause for eating disorders is heredity. If a mother has an eating disorder does it mean her child will as well? Von Ranson et al. (2003) tested this possibility. The findings were chilling. The results show a high correlation between mothers that have eating disorders and daughters that have eating disorders. This strengthens the theory that eating disorders can be passed down from generation to generation.
Genetic relationships could be a cause of eating disorders. The most accurate way to study this hypothesis is by examining monozygotic and dizygotic twins. Monozygotic twins have identical genes, while dizygotic twins do not. The higher the correlation between monozygotic twins points to greater genetic causes and less environmental causes. A study by Klump, K., McGue, M. & Lacono, W titled: Genetic Relationships between Personality and Eating Attitudes and Behaviors was undertaken. The study showed an extremely high correlation between genetic influence and eating disorders for the monozygotic twins and a low correlation for the dizygotic twins. Data can be viewed in Chart G in Appendix I. This strengthens the idea that there is a significant genetic influence in eating disorders.
As presumed, there are many things that can cause an eating disorder. Sociocultural attitudes, heredity, and genetics are much stronger influences then substance abuse and culture causes. This is not enough. Factors such as parent-child bonds, economic status, and intelligence must be studied. Unfortunately they have not. In light of this, we seem to know very little about what actually causes eating disorders.
Prevalence of Eating Disorders
Table 1 shows the point prevalence (1 year) of adolescent males and females. Table A-2 shows the lifetime prevalence of the same adolescents (Andrews, Hops, Roberts, Seeley & Lewinsohn, 1993).
The data in tables A-1 & A-2 was collected by interviewing 10,200 adolescents (under the age of 18) and their parents that lived in a population of 200,000. They were interviewed two times by clinical psychologists or certified social workers. The second interview was about one year (13.3 month mean) after the first. The results of the experiment are divided into anorexia nervosa and bulimia nervosa and further broken down by gender.
Focusing on the point prevalence (Table A-1), neither the adolescent males nor females were diagnosed with anorexia. With regards to bulimia nervosa, a significant number of females in interview one were diagnosed (Andrews, Hops, Roberts, Seeley & Lewinsohn, 1993). During the second interview, just one year later, the amount of females with bulimia nervosa rose.
The results of the lifetime prevalence show that during the one-year gap between the interviews the number of adolescent females diagnosed with anorexia nervosa almost doubled. The adolescent males show no signs of anorexia nervosa. Bulimia nervosa, just as anorexia nervosa, nearly doubles for the female subjects. For males, a small portion were diagnosed with bulimia nervosa; and had a small rise in one year (Andrews, Hops, Roberts, Seeley & Lewinsohn, 1993).
Assessing these results shows the researcher that adolescents are at risk of developing an eating disorder. Females are obviously more at risk (Table A-1 & A-2), but males cannot be omitted. This also shows that adolescents were diagnosed with bulimia nervosa two times more then with anorexia nervosa.
Table B-1 shows the lifetime prevalence of adults with anorexia nervosa (Zhang, & Snowden, 1999). The full chart can be viewed in Appendix I Chart J. The results come from a study of 18,151 American adults (18 years and older). They are broken down into four groups of white, black, Hispanic, and Asian. The results show that white Americans are more vulnerable to be diagnosed with anorexia nervosa then minority groups.
Table C-1 shows the lifetime prevalence of adults with bulimia nervosa divided by sexual orientation. (Siever, 1994) 250 adults participated in the study. The full chart can be viewed in Appendix I Chart K. The results of these findings show that homosexuals, both male and female are at a higher risk of being diagnosed with bulimia nervosa.
In contrast of these prevalence findings you can conclude that anyone is at risk for becoming diagnosed with an eating disorder. In all cases women are at more risk then men. However, men should not be overlooked as victims, as they usually are. The "Eating Disorder Information Board" says that one out of six people with an eating disorder is a man (http://www.eatingdisorderinfo.org/men_eating_disorders.htm). Therefore, eating disorders should be taken very seriously by men, women, and parents of adolescents.Conclusion Do you know someone that has ever had an eating disorder? You answer is more then likely yes. This paper has proved that no sets of people are immune, and that there is a wide variety of ways to contract this disease. There are many causes of eating disorders � genetics, and sociocultural factors are the most relevant. Anyone is at risk for being diagnosed with an eating disorder, however adult women face the highest risk. In contrast, be aware. Learn if you are at high risk for catching this disease. Study the symptoms. If you are experiencing any of them, seek professional help. "Knowing is not enough; we must apply. Willing is not enough we must do" (Johann Wolfgang von Goethe).
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