Implications of Socio-Cultural, Environmental and Biological Factors upon Eating Disorders - Case Study Example

An inquiry into the implications of Socio-Cultural, Environmental and Biological Factors upon Eating Disorders. This paper will review the negative mental, physical and psychological implications of eating disorders on patients. These disorders, which include anorexia (AN) and bulimia nervosa, are a result of abnormalities in eating behaviors and patterns which are a result of disturbing psychological fears of the patient based mainly on the fear of obesity and general dissatisfaction with the body image. The review explores the causes of eating disorders, particularly, anorexia nervosa. Anorexia nervosa is the self-induced starvation where the observed Body Mass Index (BMI) is in the 15th percentile for age and gender. (Williamson 2002) The victims have serious issues with their body image and they are mostly unhappy with their body shape (Williamson 2002) These include the socio-economic factors like cultural considerations of body image and media influence (the recent hype created by the sickly size zero models is a prominent example in this regard).These disorders are also caused by biological factors , in terms of genetics and hormonal problems which are generally aggravated by clinical depression and the traumatic time period of puberty especially for young teenage girls. Keywords: eating disorder, socio-cultural factor, biological factors, environmental factors and anorexia nervosa Introduction Eating disorders remain a hazard for the emotional and physical well being of a patient. The modern society with its complex nuclear family systems and increasingly disturbed teenagers are increasingly threatened by ha Socio-cultural factors are the most highlighted by the media. According to Simpson (2002), Anorexia Nervosa is becoming an increased threat emanating from the ideals presented by the Western Culture and the Media and damaging young teenagers and young women, coming from the so called “ ideals of slimness and beauty which have infiltrated these societies”.Even though Anorexia Nervosa(AN) is primarily classified as a “fat-phobia” but evidence suggests that it can exist as a medical condition apart from the cultural influences emanating from extraneous circumstances.(Simpson 2002). Eating disorders, such as anorexia nervosa and bulimia nervosa, are characterized by abnormal eating patterns and typical psychopathological features, a drive for starving thinness.(Uher et al 2005). Also at times these disorders may lead to a complete deliberate disregard for any sustenance at all.(Uher et al. 2005). Medical Science has yet to reach a coherent and unchallenged conclusion regarding the current evidence that suggests that biological, environmental and social factors are important .(Panfilis et al 2003).The reason for this is that the relative influence of these broad factors is not uniform across all patient histories. Although a fair amount of discussion is devoted to the etiologies of the other disorders, the review avoids any discussion of the psychological factors which have been comprehensively reviewed by other literature. (Williamson 2004) Studies show that young boys and girls are restricting themselves from good , nutritious food in order to look like celebrities they admire (Williamson 2004).Also recent statistics show that the age of onset of the AN disorder is 14–19 years (Fairburn 2003).Also it has been noted that most of the patients (almost 95%) are females (Van Hoeken 2003).Another interesting thing to note is that many anorexics will inevitably show patterns of bulimic behaviour and most bulimics will posses an anorexia problem in the past(Steinhausen 2002). Research on the connection between starvation and eating disorders (Crisp 1995) has pointed put how starvation and AN affect a human body in a similar way. In a recent Growing Up Today Study (GUTS) performed in the United States, it was found that 32% of girls and 20% of boys were trying to lose weight (Williamson 2004) Whereas some of participants of this study reported more severe weight-control behaviours such as self-induced vomiting and the use of laxatives and/or diuretics (Crisp 1995) Interviews with females aged 10-14 years to assist with eating disorder ED diagnoses, showed that 2.5% of girls presented at baseline met partial or full syndrome ED diagnostic criteria, and 2.9% of girls who were a symptomatic at baseline developed a partial or full syndrome ED over the course of the three-year follow-up period (Bulik et al. 2006).The etiology of eating disorders are complex, varied and of a long-term nature. In this review the three factors of environmental, biological and social are discussed in length supported by various findings and scientific reviews of scholars and researchers. In order to explore the socio-economic factors various cross-cultural examples are taken into consideration with a brief discussion of body image and media influence. Biological factors are considered in regard to the effect of genetics and hormones in developing eating disorders. However, the environmental factors are taken into consideration pertaining to the influence of patients and the time of the puberty. It is then discussed in brief about the influence of each factor in developing AN. Socio -Cultural Factors It is believed that the society or culture in which one resides has an influence on the ideals of beauty and appearance that are at times difficult to attain and this is particularly an intense trend amongst western societies (Simpson 2002) These causes have more to do with self perception of the patients and the messages they are getting from the outside world about their bodies.(Crisp 1995).The modern media promotes extremely thin dimensions of body size as the very epitome of a successful life and this causes a general sense of dissatisfaction amongst the young impressionable audiences.(Steinhausen 2002) .All this time the patients of anorexia are trying to live up to the high standards created by the glitzy models and their size zero dimensions. Academics have also stressed upon the likelihood of strained family relationships in this regard because studies show that they stir up negative self esteem issues with in the young patients which may ultimately contribute to the aggravation of the AN (Fairburn 2003) . Research has further shown that sufferers of anorexia nervosa suffer from a distorted body image syndrome wherein they are not happy with certain parts of their body or, at times, with their entire appearance. They then try to change their appearance by trying various means such as crash dieting, rigorous exercise, yo-yo dieting, fasting, bingeing and purging (De Panfilis et al. 2003). Barry & Grilo (2002) state these disordered behaviors are harmful for the physical, mental and spiritual state of the victim. Mental disturbances force the victim to alter their body shape to fit into the social and cultural criteria set by the surroundings (Simpson 2002).Media is another very important component of socio-cultural factor in promoting AN. Today’s youth are highly influenced by the beautiful bodies of their celebrities they see in magazines, television and movies (De Panfilis et al. 2003). People residing in a narrow image society have laid certain standards pressurising the individuals living in that community. It was believed that anorexia nervosa (AN) is mainly prevalent in the European women (Simpson 2002,Hepworth 1999)Yet, epidemiological data now indicates that eating disorders occur across ethnically and socio-economically diverse populations (Franko et al. 2007). Prevalence data for DSM-IV eating disorder diagnoses indicate that anorexia nervosa (AN) and bulimia nervosa (BN) is less prevalent in African American than Caucasian women and binge eating disorder was found to be marginally less prevalent among African American women (Striegel-Moore 2003). Earlier research confirmed that there is existence of a social class in anorexia , popularly known as the “disease of the rich”, however recent studies in the same field have confirmed that the disorder is now crossing the boundaries of social class even though the percentile of it may be more dominant in higher class. (Striegel-Moore 2003).Academics have pointed out several factors in this regard but are generally of the view that these disorders are spread amongst the patients of more affluent social backgrounds.Theander (1970, cited in Mclelland & Crisp 2001) stated a progressive augmentation in the proportion of patients from the lower social classes giving due credit to recognition and diagnosis of anorexia nervosa. Garfinkel & Garner (1982 in Mclelland and Crisp (2001)) reported a similar change when they compared their referral pattern pre- and post-1975. The study conducted by McClelland, & Crisp (2001) confirmed that presence of social class bias in patients seriously. The research confirmed that the majority of patients (67.5%) were from higher social classes, which were consistent with earlier research. Anorexics are sensitive to societal influence and they try and fit into the image set by the society in which they live by being thinner. Even though these are socio-cultural impacts having deep influence on victims these are not the only factors affecting it. Biological Factors Biological factors encompass the genetic and hereditary propensities, which are transferred through genes that pass on the disorder from one generation to another. Twin studies and family studies will be explored in this section to examine the biological factors. Several studies conducted all around the world support the familial aggregation of eating disorders and related traits and suggest that genetic factors play an important etiological role. In a subsequent bivariate analysis of anorexia nervosa and major depression, the inheritability of anorexia was estimated to be 58% and there was correlated genetic liability between anorexia and major depression (Bulik et al. 2000). Family studies have indicated that the prevalence of eating disorders is seven to twelve times higher in relatives of anorexic pro-bands compared with controls (Klump et al. 2001).Hormonal imbalance can be one of the biological causes of anorexia especially in the hypothalamus and the anterior pituitary gland (Klump et al 2001). AN has been shown to be associated with right temporal brain? Disturbances which are considered as secondary factors in the etiology of anorexia. As a result of such abnormal weight loss, extreme loss of fat tissue and the subsequent complications concerning pregnancy is evident (Bulik et al. 2006; Castro-Fornieles et al. 2007). Environmental Factors The surroundings in which a person grows up also has a deep influence on his or her mind set, attitude and behavior to various situations. Additive genetic effects accounted for approximately 74% of the variance in broadly defined AN, with non-shared environmental influences accounting for the remaining variance (Klump et al, 2001). If females who develop anorexia nervosa have unusual family compositions in terms of the size of their families, their birth order, or the gender of their siblings, then this would have intriguing implications for the much debated etiology of the disorder (Eagles 2005) .Research has thus shown that genetic predisposition to AN does affect the chances of the disorder repeating itself amongst the new generations (Klump et al 2001). Further more studies show that AN patients display higher serotonin levels than normal people .(Klump et al 2001).This chemical which actually controls the brain activity related to the digestive and appetite related behaviours might have something to do with the causes of AN amongst patients (Klump et al 2001).The fact whether these levels are however ,actually responsible for or a result of AN is still a matter of further research.(Klump et al 2001). Some of the experiences in childhood are too deeply rooted to leave their impacts all their life. Research shows that there are basically four types of eating disorder patients which includes Type A that refers to dismissing the importance of close relationships and negative feelings about them. However, Type C refers to a preoccupation with close relationships and negative feelings about them. Type B refers to a secure valuing of relationships whereas Type D refers to disorganization that is the inability to form a strategy for managing relationships. Type D women have not been fully explored. Research shows that Type B women, most of the time, do not have any eating disorder but it is unclear if the rest are type A or C (Ramacciotti et al. 2001; Ward et al. 2000; Folse 2007). These studies show that most women who suffer from an eating disorder have had problems with family relationships. Ward et al (2000) states that mothers of women with eating disorders had unresolved loss and eating disorder issues to which their daughters responded with compulsive care giving. Therefore it can be concluded that parental history and hidden issues in the parents spousal relationship might have a significant influence upon their daughters’ development of an eating disorder. Whereas the recent study conducted by Ringer & Crittenden (2007) revealed that, if the mother had certain trauma in her childhood or in her relationships, she tried to maintain closeness with her daughter(s) and tried to shelter her daughter by confining her of their traumas. But the unresolved issues kept changing the behaviors and making these type mothers unavailable to their daughter(s) when needed most. The eating disorder symptom functions to coerce the parents to acknowledge their importance to their daughter, as opposed to her function in their marriage (Ringer and Crittenden 2007) Another exploration into the research by Ringer & Crittenden (2007) shows that when the parents do not pay attention to the child and are more self absorbed, as a result, the child feels invisible and possibly the symptom of a refusal to eat simply announces that, without psychological recognition and emotional inclusion, there is no meaning to life. It is also suggested that there is a high degree of consistency between the former AN patients’ perceptions of their problems, as reflected in the self-report, and both the parents’ reports and the clinical diagnoses (Halvorsen et al, 2005).This may lead us to conclude that AN can be a result of negligent or less than perfect upbringing coming from emotionally disturbed parents.If this is conclusively proved this may lead to a modification in the family based therapeutic methods currently used nowadays to cure AN , to pay more attention to parental history of the child. Studies indicate that information from parents may be useful for investigating emotional and behavioral problems also in young adulthood especially important when the girls reach their puberty. Competencies, such as good relationships with friends and family and adjustments at work, may be just as important for quality of life as emotional and behavioral problems (Halvorsen et al, 2005; Folse, 2007) Discussion All the three factors discussed have important significance towards the development of anorexia nervosa. As a matter of fact all the three factors socio-economic, biological and environmental are interrelated.(Ward, 2000) .It has been seen that although biological, psychodynamic model, cognitive-behavioral factors influence the magnitude of the disorder itself ,the genetic factors are of primary importance aswell.1 The interaction of these genetic and environmental factors may be a good base for explaining the real causes of AN.2 This it can be concluded that unhealthy eating patterns in childhood as well as the parental influence upon the children’s eating habits may explain the cause of AN. However it has to be admitted in this regard that the literature is very limited and does not take into account the statistics from other ethnic parts of the population.3. The studies often focus too much on the Anglo-Saxon population. Furthermore the studies and theories need development to try and pinpoint specific causes for these disorders.4 It seems a major concern is the lack of care and attention to a child in its early stages of life. Starvation and/or severe overeating are the result as well as social class, the society in which one life and fads being main issues. Conclusion Biological, socio-cultural and environmental dynamics have deep significance in the causation of eating disorders. These are all complex factors, which interact and are inter-related. It is important to consider individual differences in the assessment of an individual with a possible eating disorder. Body image is a paramount point when reviewing one’s disorder as the media plays a significant influence, especially to pubescent females. In the light of the above it is possible to say ,at least on the basis of several academic works5 and social studies that the female gender is the most highly affected in the society AN. This not only includes young women but also very young teenage females.Genetics and hormones are other issues not to be ignored as to whether a person might experience an eating disorder. It would also serve this review to include psychological factors at a later time to continue such review in order to expand the knowledge obtained herein. Finally, it appears that there are no conclusive causes related to why a person suffers anorexia nervosa or other eating disorders. Reference list 1. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. AMA, Washington, DC. 2. 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