GRSJ224/TheMedicalizationofEatingDisorders

Medicalization

Individual taking a pill depicts that there is drug therapy available for every illness that our body can potentially experience

Medicalization is a contemporary sociocultural process that medically treats previously undefined medical problems into medical problems. Such medical problems are then identified as illnesses or disorders, some examples are eating disorders, obesity, menopause, alcoholism. Medicalization has substantially introduced a number of medical conditions, which also resulted in an increase of medicalized patients for these medical problems. The process of medicalization has been controversial in its core intentions and manifestations. One of the principal concerns regarding medicalization has been targeting the potentiality of “overmedicalization” and investigating the commercial and market interests of pharmaceutical market sales. As a result of medicalization, there is now more demand for medical attention. This ultimately overstrains the health care system and forces an upsurge in health care expenses.

Common Types

Anorexia nervosa

Anorexia nervosa patients perceive themselves as excessively overweight when they are severely underweight. Common symptoms of anorexia nervosa include extreme eating restrictions, distorted body image and extreme fear of weight gain. Anorexia nervosa is associated with high mortality rates, especially with anorexic women who choose to end their life.

Binge-eating disorder

Binge-eating disorder patients are not able to regulate their food consumption. Common symptoms of binge-eating disorder include excessive eating even when full, eating fast, and eating in private to prevent shame. Therefore, as a result of excessive eating, patients with binge-eating disorder are often overweight.

Individual taking a pill depicts that there is drug therapy available for every illness that our body can potentially experience

Bulimia nervosa

Bulimia nervosa patients have trouble regulating their food consumption as they experience frequent excessive eating episodes. Unlike binge-eating disorder, patients with bulimia nervosa engage in behaviors such as self-induced vomiting, use of laxatives, extreme exercising after excessive eating. Therefore, people with bulimia nervosa may maintain a relatively healthy weight. Common symptoms include chronic inflamed throat, swollen salivary glands, tooth sensitivity, and acid reflux disorder.

Others

Other types of eating disorders include Avoidant/Restrictive Food Intake Disorder (ARFID), Rumination Disorder, Pica, Other Specified Feeding or Eating Disorder (OSFED) and Unspecified Feeding or Eating Disorder.

Prevalence

As eating disorders are more stigmatized and commonly associated with females, accurate prevalence rates of eating disorders for males are difficult to obtain.

Misconception that previously thought that males only account for 10% of eating disorder cases.

Males tend to adapt to a masculine socialization perspective in which they believe that by admitting to a need for medical attention, relying on others and acknowledging their disorder as signs of vulnerability that pose threat to their masculinity. For these reasons, men are more reluctant to discuss about their eating disorder and therefore less likely to get medical treatment. The lack of data of eating disorders for males and societal emphasis on women with eating disorders reinforces us to believe that eating disorders are less common in males.

From medical history and studies, it was previously accepted that men only occupy about 10% of cases of eating disorders. However, more recent research has indicated this percentage to be around 25%, and with binge eating disorders, males can account for as high as 40% of all cases. Another study found that lifetime incidence rates for males with anorexia (0.3%) and bulimia (0.5%) were slightly lowered than female rates, 0.9% and 1.5% respectfully. However, it is important to acknowledge that these numbers may not be entirely accurate as eating disorders for men are highly underreported due to their lack of willingness to seek for medical attention.

Diagnosis and Manifestation

Although men and women experience similar medical problems when experiencing eating disorders , it has been identified that males tend to have other mental health issues (e.g. depression and anxiety) associated with the eating disorder. Other common male comorbidities associated with eating disorders include substance abuse and personality disorders. Compared to women, men are not as likely to initiate vomiting after eating and using pills as a method of weight management. The reason for this can be attributed to the fact that males have higher metabolic rates that help regulate weight loss, therefore they resort to other measures to help lose weight such as excessive exercising or starvation. In terms of diagnosing, one of the key indicator for eating disorders for amenorrhea, a condition in which regular menstruation does not occur. Given this gender-specific symptom, clear diagnosis would favor females rather than males. Eating disorder symptoms for men are less defined, of which include decrease in sexual interest and testosterone levels. Therefore, factors such as feelings of shame and less defined symptoms contribute to undetected and underreporting cases of potential eating disorders.

Causes

Eating disorders can be caused by an interaction of multiple factors such as genetic, biological, behavioral, psychological, and social factors. However, in terms of gender differences, the causes for eating disorder for females and males are similar in the sense that individuals are exhibiting emotional problems onto their own physical body. Additionally, individuals have the autonomy to control over their food consumption to regulate a positive body image. However, for women, the fundamental principles underlying their eating disorders can be commonly sourced from their resistance to appear unattractive by being fat. Women with eating disorders are frequently concerned about their physique, and especially regarding the lower part of their body (e.g. thighs, hip, buttocks). Additionally, women perceive weight, as measured on scales, clothing size or their body shape. For men, the primary cause that underlies their eating disorders can be due their own desirability to physically appear less fat and more muscular. This could be due to the fact that as in Western culture, we are socialized to perceive that the standard of attractiveness for masculine men are individuals who are bulky and muscular.

Treatment and Outcomes

Treatment for eating disorders for females and males are quite similar. Common types of treatment include cognitive behavioral, family, nutritional and medication therapy. However, it has been observed that physicians are more inclined to suggest treatment for women with eating disorders. This is especially crucial for positive prognosis, as the earlier the medical intervention occurs, the better the outcomes. Therefore, it is assumed that because men tend to seek treatment only in severe conditions and they can be subjected to less positive outcomes. Most medical outcome studies regarding eating disorders have studied small samples of women, future studies are needed to investigate the actual outcomes for male patients. However, a study on remission rates, as measured by body weight restoration and absence of binge or purgative behaviors, can provide some insights on gender differences on treatment outcomes. It was observed that males actually experienced better body weight restoration outcomes than females. The median time from onset to remission for males were significantly shorter (3 years) when compared to females (7 years).