{"id":7516,"date":"2023-01-23T03:58:59","date_gmt":"2023-01-23T03:58:59","guid":{"rendered":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/anorexia-and-bulimia-risk-factors\/"},"modified":"2023-01-23T03:58:59","modified_gmt":"2023-01-23T03:58:59","slug":"anorexia-and-bulimia-risk-factors","status":"publish","type":"post","link":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/anorexia-and-bulimia-risk-factors\/","title":{"rendered":"Anorexia and Bulimia Risk Factors"},"content":{"rendered":"
\n

Exploring Eating Disorders<\/h2>\n

It is nearly impossible to walk past the aisles in stores without seeing headlines promising secrets to weight loss. Our cell phones are full of advertisements and videos of exercise routines. In the United States being thin has become a national obsession and places unrealistic expectations on what makes a female beautiful. To keep up with these expectations, females become dissatisfied with their bodies. With body dissatisfaction being the single most powerful contributor to the development of eating disorders, it is not surprising that these disorders continue to rise (Comer, 2015). The common eating disorders recognized by the Diagnostic and Statistical Manual are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) (APA, 2013). The focus of this paper is on the formally recognized eating disorders, anorexia and bulimia. \u00a0Briefly, these disorders are characterized by disturbances in body image and abnormal eating patterns. While the cause is elusive, today\u2019s theorists and researchers believe eating disorders arise from the interaction of multiple risk factors<\/a>. The more of these factors that are present, the likelier they will develop an eating disorder. Among these factors include biological, psychological, and sociocultural (Rikani, 2013).<\/p>\n

Etiology<\/h2>\n

Biological Factors<\/h3>\n

Studies have shown a genetic
\ncontribution to developing eating disorders (Fairburn & Harrison,
\n2003). Certain
\ngenes may leave some people more susceptible to the development of eating
\ndisorders and researchers suggest that these diseases are biologically based
\nforms of severe mental illnesses. This has been further supported by twin and
\nfamily studies. For each disorder the estimated heritability ranges between 50%
\nand 83%, therefore there is a possibility of genetic contribution to eating
\ndisorders (Treasure et al, 2003). <\/p>\n

Studies have also suggested role
\nof serotonin levels since this specific neurotransmitter is important in the
\nregulation of eating and mood (Fairburn & Harrison, 2003). Several studies have confirmed those suffering
\nfrom anorexia nervosa measured lower serotonin levels and may be an indirect
\neffect of eating disorders (Rikani, 2013). <\/p>\n

Psychological factors<\/h3>\n

<\/strong>Around 73% of girls and females have a negative body image, compared with 56% of boys and men (Comer, 2013). Body dissatisfaction has been defined as \u201cdiscontent with some aspect of one\u2019s physical appearance\u201d (Cash, 2012) and is a risk factor for developing an eating disorder (Stice, 2001). Furthermore, it \u201cencompasses one\u2019s body-related self-perceptions and self-attitudes, including thoughts, beliefs, feelings, and behaviors\u201d (Cash, 2012). Research has measured as far back to adolescent years and how the onset of puberty could set the stage for their body image perceptions (Rikani, 2013). According to Treasure, Claudina, and Zucker (2003), most eating disorders occur during adolescence.\u00a0 While females are more concerned about losing weight, their male counterparts are focused on the body image of needing to gain muscle. Additionally, female perceptions have been linked to negative body image and adolescent boys are likelier to have positive feelings about their bodies (Ata et al, 2007). Females ultimately feel discontent with the shape and size of their body at such an early age when they are forming their identities. Specifically, females are trying to fit into the image society has described as the ideal beauty of a woman, thus they become increasingly obsessed with disordered eating (Dittmar et al, 2009). In turn, they can suffer psychologically from low self-esteem, feelings of helplessness, and intense dissatisfaction with the way they look\u201d (APA, 2013). <\/p>\n

Body image and body dissatisfaction
\nhave been measured by examining cognitive components, such as negative
\nattitudes about the body or unrealistic expectations for appearance and behavioral
\ncomponents, such as avoiding perceived body scrutiny from others (e.g., avoiding
\nswimming) (Thompson et al., 1999b).<\/strong> Ata,
\nLudden, and Lally (2007) also found strong links between eating disorders and feelings
\nof depression and low self-esteem. \u00a0<\/p>\n

Sociocultural factors<\/h3>\n

Many
\nsociocultural factors like friends and family can influence the development of
\neating disorders. \u201cResearch focusing on the particular effects of teasing on female
\nadolescents found that those who are teased about their weight, body shape, and
\nappearance tend to exhibit poorer body image and are more likely to diet\u201d (Ata et al.,
\n2007). Furthermore, adolescents who have a relationship with their parents that
\nare less supportive and filled with conflict are more likely to choose
\ndisordered eating behaviors and have poor body image. In a survey of
\nindividuals with eating disorders, they included family factors such as, poor
\nparental control, controlling parents, poor relationship with parent, critical
\nfamily environment as causal factors with eating disorders (Salafia et al.,
\n2015). Swarr and Richards (1996) found that adolescents who have a healthy
\nrelationship with both parents are less likely to have concerns about their
\nweight. During this vulnerable stage of development, adolescents place a high
\nregard to the approval of their peers. Supported evidence shows that those with
\nlower peer acceptance and social support may be linked to negative body image \u00a0(Ata et al., 2007).<\/p>\n

It is not surprising that body image has been an obsession in
\nWestern society for decades. The media has portrayed the continually changing
\nconcept of beauty through advertisements, social media, magazines, and
\ntelevision, in turn shaping society\u2019s standard of beauty. Mulvey (1998) looked
\nat the history of female beauty and the major changes in the female image over
\nthe years. The cinched waist was popular in the 1900\u2019s, while being flat
\nchested without curves were emphasized in the 1920\u2019s. Throughout the 1930\u2019s
\nwomen were encouraged by societal standards to have curves and this emphasis
\ncontinued through the 1950\u2019s. Images of full figured women like Marilyn Monroe,
\nAudrey Hepburn and Elizabeth Taylor influenced the way women wanted to look
\n(Mulvey, 1998). It was not until the end of this decade that the thin ideal
\nbegan to decrease in shape (Rumsey). Women began to alter their bodies through
\nplastic surgery in the 1960\u2019s to reach society\u2019s standards. It was during this
\ntime that the body type drastically changed into the depiction of being
\nextremely thin and \u201cboyish.\u201d The immense pressure to be thin carried throughout
\nthe 1970\u2019s and the rail thin image resulted in an increase in eating disorders,
\nespecially anorexia (Mulvey, 1998<\/strong>). Fortunately,
\nthat image did not last long and women were advertised as being fit and sporty throughout
\nthe early 90s, yet thin models and anorexia became rampant again at the end of
\nthis decade. Sadly, this image of thinness has continued throughout the 21st<\/sup>
\ncentury. <\/p>\n

Prevalence <\/h3>\n

Measuring the prevalence of eating disorders is complex since countless numbers of people with the disorders do not seek treatment (Treasure et al., 2010). Research suggests that the stigma society has placed on eating disorders as being self-inflictive may factor in to why they do not seek help (Salafia et al., 2015). While eating disorders affect both genders<\/a>, the prevalence among women and girls are 2 \u00bd times greater for females (NIMH, 2013). Additionally, Wade, Keski-Rahkonen, and Hudson (2011) found that 20 million women and 10 million men suffer from an eating disorder at some point in their life. \u00a0According to the National Institute of Mental Health (NIMH), the lifetime prevalence among adults with eating disorders have measured to be 0.6% for both anorexia nervosa and bulimia nervosa for the adult population. <\/p>\n

The
\nmain risk factors that have been linked to anorexia nervosa and bulimia nervosa
\nare general factors such as, being female, adolescent\/young adult, and living
\nin Western society (NIMH, ).<\/strong> The National
\nInstitute of Mental Health reports of suicide being very common in women who
\nsuffer from anorexia nervosa and has the highest mortality rate around 10% among
\nall mental disorders.<\/p>\n

As mentioned earlier,
\nadolescent females are at a higher risk of developing eating disorders, which were
\nrelated to low self-esteem, social support, and negative attitudes of their
\nbody image. While the age of onset frequently appears during teen years and
\nyoung adulthood for both disorders, bulimia nervosa has a slightly later age of
\nonset, however can begin the same way as anorexia nervosa (Fairburn & Harrison, 2003). A study found one-third of
\npatients who had an initial diagnosis of anorexia nervosa crossed over to
\nbulimia nervosa during 7 years of follow up (Eddy et al., 2008). Between
\n.3 and .9% of this population are diagnosed with anorexia nervosa and .5 and 5%
\nwith bulimia nervosa (Salafia et al., 2015). Furthermore, the NIMH reported the
\nlifetime prevalence of 13-18 year olds to be 2.7% for both eating disorders. <\/p>\n

Certain professions and subcultures have a higher prevalence of developing eating disorders. These include professions where bodyweight is highly valued, such as athletes, models, performers, and dancers. In studies with female athletes the prevalence rate of eating disorders ranged from 0% and 8%, which is higher than that of the general population. Among these athletes, 33% engage in eating behaviors that put them at risk for such disorders, such as vomiting and using laxatives. Additional factors that increase the risk for this population have been shown to be the transition into the college setting and moving away from home.<\/p>\n

Cultural Factors\/Issues \u00a0<\/h3>\n

Historically, there has been a stereotype of eating disorders to effect young, female Caucasians, who are educated and from an upper socio-economic class. However, research increasingly shows that this disorder does not discriminate and is being reported in other race\/ethnicities of both upper and lower classes. The prevalence of eating disorders is similar among Non-Hispanic Whites, Hispanics, African-Americans, and Asians in the United States, with the exception that anorexia nervosa is more common among Non-Hispanic Whites (Hudson et al., 2007; Wade et al., 2011).<\/p>\n

One report found that views
\nabout body image and eating disorders varies among cultures and Caucasian women
\nhave the lowest body satisfaction and self esteem while Latina women score in
\nthe middle in terms of self-esteem and body satisfaction (Eating Disorder Hope,
\n2013). The literature among African American women is scarce, however Lee &
\nLock (2007)<\/strong> found that this group had
\nthe highest level of self-esteem and body satisfaction. <\/p>\n

With more and more studies comcluding
\nthat eating disorders are occurring in other ethnic groups, it becomes imperative
\nto note different cultural views and beliefs may influence this disorder. Common
\nbarriers among minority groups regarding treatment resistance, include language
\ndifficulties, lack of health insurance or transportation and lack of resources.
\nBarriers can be present in all ethnicities with eating disorders, but
\nultimately their cultural beliefs tends to be the greatest influence \u00a0in their decision to whether they seek
\ntreatment (McCaslin, 2014). <\/p>\n

Clinical picture <\/h3>\n

Mental disorders have been portrayed throughout movies and literature. While most do not portray a clear clinical picture of those disorders, a compelling illustration is of actress, Portia de Rossi, is able to show what it looks like and a raw mage of the eating disorder in her book, Unbearable Lightness: A Story of Loss and Gain<\/em>. She writes about her personal struggle with body image and testimony of her eating disorder. Her struggle with anorexia and bulimia began when she was modeling at the age of 12 after her agents informed her she needed to go on a diet. She was influenced by her older colleagues to vomit to maintain the rail-thin figure directors favored. The actress discussed her disordered eating behaviors, such as taking 20 laxatives a day and restricting her caloric intake to 300 calories a day. She explained the overwhelming desire for perfectionism. Her personal account of her struggle with an eating disorder and illustrates the clinical picture of what it looks like to live through anorexia. From the competitiveness, obsessions, and distorted thoughts, she reveals a life of trying to measure up to the relentless pursuit to measure up to society\u2019s standards of beauty. <\/p>\n

Ronald Comer\u2019s text, Abnormal Psychology, also gives a clinical
\ninsight into the nature of eating disorders. Sufferers have dysfunctional
\neating attitudes towards food. The main goal for people who suffer from
\nanorexia nervosa is to become thin. They are fearful of gaining weight and the
\nloss of control over the size and shape of their body. People with this
\ndisorder are so preoccupied with food that it results in food deprivation.
\nTheir thinking becomes distorted and are likely to have negative perceptions
\nand poor body image. Distorted thinking can lead to psychological problems,
\nsuch as depression, anxiety low self-esteem, and insomnia in those who suffer
\nfrom anorexia nervosa. Comer (2015) provides research that suggests sufferers
\nmay also display symptoms of obsessive-compulsive patterns. The American
\nPsychiatric Association (APA) confirms this finding of eating disorders being linked
\nto other mental health issues. The APA reported 50-70% suffer from depression,
\n42-75% have a present personality disorder, 30-37% of bulimic sufferers engage
\nin substance abuse as well as 12-18% of anorexic sufferers. Approximately 25%
\nhave OCD and 4-6% suffer from bipolar disorder.<\/p>\n

\u00a0It is common for sufferers
\nto engage in over exercising, misusage of laxatives and diuretics, and a
\ndecreased interest in the outside world (Fairburn & Harrison, 2003). Research
\nhas considered the main physical features of anorexia nervosa. The physical
\nsymptoms have included, heightened sensitivity to cold, gastrointestinal
\nproblems, dizziness, amenorrhea, and insomnia. The physical signs of a sufferer
\nof this disorder may show signs of emaciation, dry skin, erosion of teeth, and
\ncardiac arrhythmias (Fairburn & Harrison, 2003).<\/p>\n

Bulimia Nervosa is defined by the DSM-V as eating behaviors that
\ninvolve binging and purging to avoid weight gain (APA, 2013). Similar to
\nanorexia nervosa, symptoms of depression and anxiety are often seen and
\nsufferers may also engage in substance misuse or self-injury, or both (Fairburn
\n& Harrison, 2003). Mitchell et al. (1983) found physiological electrolyte abnormalities
\nin patients with bulimia nervosa, which can lead to irregular heartbeat and
\nseizures. Other health complications of this eating disorder may include
\nedema\/swelling, dehydration, vitamin\/mineral deficiencies, gastrointestinal
\nproblems, inflammation or possible rupture of the esophagus, tooth decay, and even
\nchronic kidney problems\/failure (Alliance for Eating Disorders Awareness,
\n2013). <\/p>\n

Evaluating the prevelance of having eating disorders is fairly new for researchers and health care providers, however, continues to be challenging with the major gap in literature. Eating disorders are severe conditions and often associated with comorbidity and adverse medical conditions, as described earlier. Therefore, a large part of research only focuses on the psychiatric comorbidity in eating disorders, including depression, personality disorder, substance abuse, and obsessive compulsive disorder.<\/p>\n

The stigma society has placed
\non eating disorders also influences the accuracy regarding the costs of these
\ndisorders, whether they are impacted directly or indirectly. The lack of
\nreporting within the health care sector continues to make it difficult to estimate
\ncosts and prevalence. It is very common for sufferers to seek treatment for the
\nphysical problems than the eating disorder itself and one in four individuals actually
\nseek treatment specifically directed at improving their eating disorder
\nsymptoms (Striegel-Moore et al., 2003). In past
\nresearch that reviewed insurance claims regarding eating disorders, it was found
\nthat many insurance companies did not cover treatment for these disorders, which
\noften resulted in the treatment providers to use different diagnostic codes
\nwhen submitting the claims (Striegel-Moore et al., 2003). \u00a0One clinical trial that reviewed health
\nrecords and insurance codes found that 42% of the claims related to weight or
\neating disorders, however, only 4% had an actual eating disorder diagnosis
\n(Rosselli, 2016).<\/p>\n

Samnaliev et al. (2015) measured the
\nimpact of eating disorders on health care costs, employment status, and income
\nin the United States. Their evaluation indicated that individuals with eating
\ndisorders had more health care costs than those who did not have an eating
\ndisorder. In addition, if one had a comorbid then they saw an increase in
\nannual costs, compared to those with no comorbidities. Another impact of the
\ndisease that they found during their analysis was lower rates of employment for
\nthose with eating disorders. The study also found a link
\nbetween higher hospitalization costs for sufferers of anorexia nervosa compared
\nto those with bulimia nervosa. Another study (Agras, 2001) found the average
\ncost for inpatient treatment for female anorexics was $17,384 compared to the
\ncost of $9088 for bulimic patients. The same study found treatment for
\noutpatient settings for treatment of anorexia and bulimia to average around
\n$2344. The costs of treating eating disorders were compared to schizophrenia
\nand OCD and indicated costs for anorexia were not significantly different from schizophrenia,
\nhowever much more expensive than treatment for OCD (Agras, 2001).<\/p>\n

Research<\/h2>\n

While there has been a significant amount
\nof research speculating the factors that influence the development to eating
\ndisorders, it continues to remain challenging. Questions remain unanswered regarding
\nthe etiology, prevelance cross-culturally, and effective treatment approaches. The
\nonly promising finding in current research has been the evidence that heritable
\nfactors make a significant contribution to the etiology of these disorders.
\n(Walsh, 2004).<\/p>\n

Another issue regarding the
\nresearch is that a considerable amount is focuses on the eating disorders of Caucasian
\nfemales in Western society in part due to the stigma placed on eating
\ndisorders. Past studies found that eating behaviors of young African American
\nwomen were more positive than those of young white American women. However,
\nover the past decade research has suggested that body image
\nconcerns\/dissatisfaction, and disordered eating behaviors have increased for
\nyoung African American women, as well as women of other minority groups.
\nDespite these trends, society continues to believe that it is likelier for a
\nwhite American female to develop an eating disorder, rather than a woman of a
\nminority group (Comer, 2015).
\n\u00a0It is clear that eating disorders are
\nhappening within other cultures, however, the prevelance continues to be an
\nissue to measure. There are also issues regarding treatment. There is ongoing
\nresearch on the efficacy of treatment for bulimia nervosa, but not for
\nsufferers of anorexia nervosa, which suggests that future research should focus
\non interventions and treatments for this type of eating disorder. Furthermore,
\nwith culture being a risk factor in eating disorders, the development of
\nculturally specific interventions and their efficacy could be beneficial
\nfor\u00a0 future research (Walsh, 2004).<\/p>\n

Prevention<\/h2>\n

It would be helpful for
\nclinicians to hold a multidemensial risk perspective regarding eating disorders
\nuntil findings point to the exact etiology of the disorder. With new research
\nand data strongly suggesting genetic influence, it is promising that the
\netiology may eventually be explained. It is importance to understand that all
\neating disorders occur in all races and ethnicities. Sala et al. (2014) made
\nsuggestions for prevention of the disorders, such as public health campaigns to
\nincrease awareness and peer recognition since adolescents place a higher value
\nto what their peers think of them. If awareness is brought about in schools
\nthan earlier detection may prevent eating disorders among adolescents. Also,
\nsince studies suggest that the family has an influence on the younger
\npopulation, they could be used to inform prevention approaches at the family
\nlevel (Langdon-Daly & Serpell, 2017).<\/p>\n

Treatment<\/h2>\n

Being
\nfamiliar with the factors invluencing the development of the eating disorder is
\nimperative in order to understand and adequately help the person suffering from
\nanorexia or bulimia. With that being said, the lack of empirical research regarding
\nthe treatment of anorexia nervosa is scarce, thus making it difficult to treat.
\nStudies have shown a strong emphasis on a multidisciplinary approach for
\nsufferers of anorexia is helpful. This approach involves a team of medical,
\nnutritional, social, and psycholological professionals. Therpists typically use
\na combination of psychotherapy and family therapyto overcome the underlying
\nissue of anorexia nervosa sufferers ( Comer, 2015). <\/p>\n

Treatment
\nfor bulimia nervosa is often in clinic settings with the goals of eliminating
\nthe binge-purge patterns, developing healthier eating behaviors, and removing
\nthe underlying influence (Comer, 2015)
\nA large amount of research concerning the treatment of bulimia nervosa suggests
\nthat Cognitive Behavioral Therapy is the treatment of choice, while other data
\nsuggests CBT being unsuccessful for anorexia. This proves of the need for new
\ninterventions and treatment models for eating disorders, specifically anorexia.
\nStrong evidence from pharmacological trials have found that Pharmacotherapy is
\neffective in treatment for bulimia in the short term. Other models of treatment
\nregarding bulimia focus on emotional regulation, such as dialectical behavior
\ntherapy (Treasure et al., 2010). <\/p>\n

A new approach that has
\ngained preliminary support is Acceptance and Commitment Therapy (ACT). ACT
\nfocuses on accepting unwanted feelings\/thoughts and seeing them as part of
\nbeing human. One study suggested that ACT could be neneficial with patients of
\neating disorders. Treatment interventions that target negative body image may
\nbe beneficial when developing newer interventions and approaches towards
\ntreatment since both eating disorders have a strong desire to control their
\nurges, thoughts, and feelings (Butryn et al., 2013).<\/p>\n

Conclusion <\/h2>\n

Eating
\ndisorders are complex and various factors can influence the development of an
\neating disorder. These disorders cross all cultural and social backgrounds.
\nWhile the exact etiology is unknown the overlapping theories help in
\nunderstanding the combination of factors that influence the causes of eating
\ndisorders, It is important to understand they are severe mental disorders and
\nhave serious medical consequences. \u00a0The
\nadvancement in today\u2019s research is encouraging and may eventually offer better
\ntreatment options and specific links to the development of an eating disorders.
\n<\/strong><\/p>\n

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