The Medicalization of Eating Disorders

Medicalization

Medicalization is a process where human conditions come to be defined as pathological and treated as medical problems. For example, obesity, alcoholism, childhood hyperactivity and sexual abuse have all been defined as medical problems that are, as a result, increasingly referred to and treated by physicians. Though, there has been certain controversy as younger parents are calling energetic children "attention deficit" and getting doctors to prescribe them prescription pills to help them calm down and focus, or the sudden trend where everyone being intolerant of gluten and needing to eat gluten free.

Types

The three most common types of eating disorders are:

Anorexia Nervosa

Anorexia Nervosa In The Eyes Of A Sufferer

Classified as a disorder where there is insufficient food intake leading to a loss of weight which is much too low and dangerous for health. Many people with anorexia will see themselves as overweight when they are in fact underweight. Includes an obsession fear to gain weight gain. Anorexia often leads to bone loss and greatly stresses the heart increasing risk of heart attacks and heart related problems . Some will exercise excessively, force themselves to vomit, or use laxatives to lose weight. Complications will include osteoporosis, infertility and heart damage. Women will often stop having menstrual periods.

Binge Eating Disorder

Defined by recurrent binge eating without the regular use of inappropriate compensatory weight control methods that are a defining feature of bulimia nervosa. The research diagnostic criteria for binge-eating disorder include several behavioural indicators to help determine loss of control in addition to the overeating of large quantities of food, and require that the binge eating be associated with emotional distress, occur regularly (at least two days per week), and be persistent (at least six months).

Bulimia Nervosa

The Bulimia Nervosa Cycle

Characterized by recurrent binge eating (uncontrolled consumption of a large amount of food); regular compensatory behaviour designed to influence body shape and weight (e.g., self-induced vomiting, laxative misuse, or excessive exercise); and negative self-evaluation that is unduly determined by body shape and weight. Individuals with bulimia nervosa diet in a rigid and dysfunctional manner. Their body weight is typically normal or low normal, although bulimia nervosa does occur in some overweight individuals. Associated general psychopathology (e.g., depression and personality disorders) and psychosocial impairment are common. The disorder primarily occurs in young females, and prevalence is roughly 1% to 2% in community samples. Bulimia nervosa has a chronic course and tends to be self-perpetuating. Estimates of remission over time range from 31% to 74%, Remission is often fleeting, and relapse is common, As with other eating disorders, bulimia nervosa appears to be unstable and often morphs into eating disorder not otherwise specified.

Others

Muscle dysmorphia, Other Specified Feeding or Eating Disorder Compulsive Overeating (CEO), Prader-Willi syndrome, Diabulimia, Food maintenance, Orthorexia Nervosa, Selective Eating Disorder, Drunkorexia, Pregorexia, Gourmand Syndrome

Causes

Ultimately, the specific cause for eating disorders are unknown. However, it is believed that a combination of biological and environmental factors aid in the development in these disorders.

Biological

Genetics

Genetic research has always known that eating disorders run in families but not in a way recently discovered. Recent studies have identified two genes that increase a person’s risk for developing anorexia or bulimia nervosa. In one study found that people with mutations in two genes known as ESSRA and HDAC4 increase an individual’s chances of developing an ED by 85% to 90%. A simplified explanation to the process of the mechanisms is that the normal type genes of ESSRA and HDAC4 increases a person’s craving for food. However, when both those genes are mutated, they limit an individual’s desire for food. In another study they investigated between the TPH2 gene, anorexia nervosa (AN), bulimia nervosa (BN) and EDs characterized by self-induced vomiting (SV). Where they hypothesized, and found that THP2 rs1473473 is associated with a lower activity of the TPH2 gene. Where less serotonin will be synthesized in the brain leading to a lower serotonin neurotransmission. Lower serotonin activity is associated with higher impulsivity which makes people more prone to SV and EDs.

Where The Eating Disorders Originates

Psychological

EDs are classified as mental disorders. There are many psychological issues that aid in the development of EDs. Individuals who suffer from EDs suffer from other psychological disorders that co-exist with one another. For example, body dysmorphic disorder is a co-existing disorder with EDs where an individual is obsessed with a flaw in their appearance. Men and women who experience EDs struggle internally with low levels of self-esteem, experience anxiety, depression and high levels of stress. There is a strong correlation present between BED and depression. Where one feels guilty after eating a great amount of food in a short period of time. EDs may co-exist with Attention Deficit Disorder (ADD) and Attention Deficit and Hyperactivity Disorder (ADHD). Researchers have found that women with ADD are likely to develop an ED. Individuals with ADHD or ADD act impulsively and hold onto negative thoughts and/or anger which are symptoms that individuals with ED also experience. Individuals with other emotional or psychological disorders, substance addiction, personality disorders are at higher risks of developing and ED.

Environmental

Media Influence

Unrealistic Standard Set By The Media

The media has increased the risk of EDs globally by painting a certain image considered to be ideal for men and women. Although, the ideal body image varies depending on culture, it is often portrayed that a women with a petite body and a small waist are viewed as more favorable in terms of sexual responses from males as well as job acceptances. The media displays unrealistic body images for both men and women, which in turn allows individuals to believe that they have lower societal status if they do not look like actors/singers on the television or magazines. People neglect the fact that each body is unique as the media can be blinding of reality. These unrealistic standards of body imaging for both men and women continues to increase the risk for EDs as well as other disorders like depression, anxiety, personality disorder, and body dysmorphic.

Familial Influence

Parent Pressure

Parental and family influence, including dietary, cultural and physical acceptance, have a role in how individuals perceive themselves, and their body image. Negative comments about a person's body image, especially when it comes from close family members, can be detrimental to self-esteem and can play a factor in a person resorting to extremes. These extremes include self-vomiting, restricting food intake or obsessively exercising. Similar to the media, familial influence can vary depending on culture as some cultures consider harsh verbal language as a method to toughen children. A common thought-process is that if close family members view an individual's body in a negative way, there is no doubt that others around them will as well.

Peer Influence

Peer Pressure

Peer influence can impact both males and females negatively, where they feel the need to compete with their peers in terms of their body image. It is often the case that young teenagers feel unworthy or unattractive when their peers have the "ideal" image that is portrayed in the media. This can lead to all forms of bullying, as individuals that claim to have the body image represented in the media hold themselves higher than those that do not. Sometimes, it becomes the case that individual's self-vomit or begin to restrict their eating habits in attempt to stop the bullying and try to fit in. Thus, peer influence can be lead to EDs, and associated anxiety and depression.

Treatment

There is no single cure for EDs for but are highly effective treatments available. The treatment of EDs vary from medical prescription pills to counselling. It all depends on the severity and the duration of the disorder. Many individuals keep their EDs to themselves and find it tough to get help. Though the first step is to reach out for help, early treatment is the most effective treatment which increases the speed of the recovery immensely. The most effective treatment is psychotherapy or psychological counselling combined with supervised weight gain or food intake.

Types of Therapy

Art Therapy

Art Therapy

A form of psychotherapy involving self-expression through painting and drawing.

Cognitive Behaviour Therapy

This therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder. It takes on the practical approach and focuses on a different way of thinking so individuals can change the way they feel.

Family Therapy

Family Therapy

Best when individual is a child to a young adult and are suffering an ED. Target is to focus on strengthening family relationships and being supportive of the individual who is suffering for the ED. It is the most extensively researched for anorexia nervosa, contributing at least one cell more than half of all randomized controlled trials. In general, the results have been encouraging; unfortunately they are widely misunderstood.

Nutritional Therapy

Nutritional Therapy

Approach is planned by a dietician or nutritionist during treatment. They provide meal plan and ensure the individual suffering is provided with all the right levels of vitamins and minerals to get healthy eating habits.

Medication Therapy

Is often an approach when an individual is suffering for multiple disorders such as depression, anxiety, or insomnia. The medication prescribed is by doctors and psychiatrists.

Self-Help Therapy

The includes support groups and self-help groups, often involve forms of cognitive behavioural therapy. They are most effective when combined with approaches provided by professionals.

Others

Dance therapy, dialectical behavioural therapy, interpersonal psychotherapy, cognitive emotional behaviour therapy, music therapy, recreation therapy, inpatient care, psychoanalysis.

Prevention

Prevention Of Eating Disorders

Prevention starts with minimizing pressure from family and emphasizing support on the individual. Parents need to teach themselves about EDs so they understand the symptoms. Parents need to let their child be not being over-controlling, deciding everything for them. Providing a healthy, comforting, happy environment at home reduced the risk for chances of EDs greatly. Which also lets the child know they are comfortable to talk to someone. A healthy diet and adequate exercise plays a vital role where the individual can feel good about themselves which is important. Educating children about their body and making them understand the different forms of body shapes. Teaching children not focus much on appearance but more on personality. . Parent’s need to teach their children to learn their body, the way it feels after you are finished eating, for example if they are satisfied or not. Talk about effective ways of coping with stress, such as talking to a friend instead of keeping it bottled inside.

References

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6. “Statistics.” Statistics National Eating Disorder Information Centre (NEDIC). N.p, n.d. Web. 11 Aug 2017
7. Woodside, D. Blake, Paul E. Garfinkel Elizabeth Lin, Paula Georing, Allan S. Kaplan, David S. Godbloom and Sidney H. Kennedy. “Comparisons of Men With Full or Partial Eating Disorders, Men Without Eating Disorders, and Women With Eating Disorders in the Community.” American Journal of Psychiatry 158.4 (2001): 570-74. Web