Anorexia Nervosa in Today's Society - Essay Example

ANOREXIA NERVOSA IN TODAY'S SOCIETY Liza Duran Sociology 301 Supervisor: Jack Levinson May 22, 2008 ANOREXIA NERVOSA IN TODAY'S SOCIETY To lose confidence in one's body is to lose confidence in oneself Simone De Beauvoir INTRODUCTION Anorexia Nervosa is an eating disorder that affects approximately 1 percent of female population in the U.K. This disorder turns people neurotically anxious to reduce body weight or maintain it at abnormally low level. Strict control of calorie intake coupled with distorted perception of physical appearance is the most common characteristic of Anorexia, while the most disturbing tendency about it is the frightening increase in incidence of this disorder over the last decades (Eagles et al, 1995). Officially, anorexia is estimated to be the third most common chronic condition among adolescent girls, but many scholars believe that official statistics does not reflect all incidents of this disorder. The true occurrence of anorexia may be times higher if one takes into consideration unreported or undiagnosed cases (Misra et al, 2004). Although Anorexia Nervosa mostly affects female population aged 15 - 30, girls under 15 and women above 30 can suffer from this disorder as well. Thus, the oldest patient reported was a woman of 68 without any prior history of eating disorders (Dally, 1984). Anorexia affects certain share of male population: estimated 10 to 15 percent of people with anorexia are men. The highest occurrence of anorexia among males is reported in the age group of young adolescents from 7 to 14 years: nearly 25 percent of anorexia cases in this age group are boys (Herman-Giddens et al, 1997). Experts identify two types of Anorexia Nervosa: food restricting type, and binge eating (purging). The most common characteristic of the restricting type is substantial reduction in calories intake (normally to 300 to 700 kcal per day) and intensive physical over-exercising. By contrast, in the binging type intake of calories may be either small or as high as several thousand followed by purging - self-induced or pharmacologically conditioned vomiting (Yager & Andersen, 2005: 1481). Health complications resulting from either type of this eating disorder affect practically all biological systems of human organism. Anorexia Nervosa poses a number of threats in terms of mental and physiological health. Similarly to other eating disorders Anorexia Nervosa frequently co-occur with depression, substance abuse and anxiety disorders (APAWGED, 2000). Physiologically Anorexia Nervosa causes a wide range of health complications some of which - cardiovascular conditions and kidney failure - are life threatening. However, despite the awareness of the risks associated with anorexia, it is on the rise these days, and a number of laymen and experts even believe that anorexia has already become a norm in modern society. A brief inquiry into the etiology of this eating disorder reveals the reasons for such seemingly strange point of view. MAIN DISCUSSION The cause of Anorexia Nervosa isn't fully understood at present. Possible causes of this eating disorder are: destructive influence of family and society, genetic (inherited) factors, brain dysfunction, neurotransmitter levels imbalances, etc. Yet, none of these factors has been proved to be the key determinant of developing Anorexia as well as no specific life experiences are linked to onset of this eating disorder. Several recent twin studies suggest that Anorexia Nervosa is more than other eating disorders associated with a genetic predisposition (Paris, 1999). Many recent studies associate the risk of developing Anorexia Nervosa with media influence. Evidences and arguments provided by these studies deserve particular attention: media influence may be one of the central factors in extremely high incidence of Anorexia Nervosa among female adolescents. Absolute majority of anorexia nervosa incidents occur in female population: according to estimations of American Psychiatric Association approximately 90-95% of anorexia nervosa patients are girls and young women (DSM-IV-TR, 2000). Most frequent occurrence of Anorexia is reported during the adolescence, while the highest occurrence is reported at age of 14.5 and 18 years (Halmi et al, 1979). Negative body image developed by adolescents at this period of their psychosocial development is one of the most probable causes for high occurrence of Anorexia Nervosa among representatives of this age/gender group. Adolescence is the time when boys and girls become extremely preoccupied with their body image. The period of adolescence is the time of sexual maturation, and the possibility of developing a negative physical self-image is very high. Adolescents have to cope with physiological changes within their bodies and adjust themselves to the growing level of social and educational demands. Their conformance to the accepted standards of physical beauty plays a very important role in their achievement of personhood. Unfortunately, no comprehensive study is available to deal with the question of how body image promoted in mass media correlates with incidence of Anorexia Nervosa. Yet, abundant data captured independently by sociologists and physicians may be employed to find an answer to the question whether mass media influence on body image does contribute seriously to development of Anorexia Nervosa or not. One of the most peculiar characteristics of adolescence is the need to have someone to look up to. If consider than reading magazines and watching television is the most popular pastime of British adolescents nowadays it is easy to predict who is supposed to be their cult-figure, and whom they will try to follow in real life. Often the desire to walk, talk and look like some celebrity results in bitter and lasting frustration together with unreasonably low self-esteem (Jovanovic, Lerner, & Lerner, 1989). Most researchers of the issue consider that mass media, and especially television, is the main factor that creates the contemporary ideal of physical beauty. Even cursory analysis of TV films and popular shows demonstrates that they provide the audience with a distorted ideal of physical appearance. In absolute majority of television programs the woman's body is popularized as very thin. Famous actresses or onscreen moderators have always been thin, as shown in a study by Silverstein, Perdue, Peterson, and Kelly who studied thousands of photographs and hundreds of movies from the early twentieth century to the modern times (Botta, 1990). But contemporary situation is really unique. A lot of today's personalities are thin, and with the fresh shows and movies coming out, it is extremely difficult, nearly impossible to find an actress with 'average' body. The message perceived by female adolescents watching these stereotypical female characters is that all heroines are thin and their thinness is an important determinant of their beauty. In the popular show Friends, the 3 female leads, Jennifer Aniston, Courtney Cox, and Lisa Kudrow, all have thin builds. Also, the more popular movie actresses, such as Catherine Zeta Jones, Cameron Diaz, and Gwyneth Paltrow, are very thin. Therefore it is natural and psychologically reasoned that adolescents want to have the same physical appearance. Another thing that has to be mentioned with regard to the hypothesis is the fact that many studies report boys are usually less dissatisfied with their appearance in adolescence than girls. One possible explanation may be that as boys grow up they gradually approach the masculine ideal even without any conscious effort: they become taller, stronger, broader in shoulders, and so on (Fox, 1997). Yet, in any case this is another argument in support of strong correlation between negative body image promoted by mass media and incidence of anorexia nervosa: anorexia is the disease of female adolescents. Pro-Anorexia Websites (PAW) is another media phenomenon that contributes substantially to the promotion of anorectic body image. These sites enable anorexics and individuals suffering from other eating disorder to establish and maintain communication with each other, outside of a treatment environment thus redefining the concept of anorexia as a lifestyle rather than a serious disorder (Davies & Lipsey, 2003). A spokeswoman for the National Eating Disorders Association stated: "[visiting PAWs] is like putting a loaded gun into the hands of someone who is suicidal" (Brase, 2006, cited in Tennen, 2006). Thus, the most recent Stanford study conducted only several months ago in 2006 found that "users of [pro-eating disorder] sites were sick longer...96 percent of [patients] reported learning new tips for weight loss or purging, and 69 percent said they had used them" (Wilson et. al., 2006). The US Academy for Eating Disorders statement on PAWs reflects a similarly negative opinion stating that "websites that glorify anorexia as a lifestyle choice play directly to the psychology of its victims ... provide support and encouragement to engage in health threatening behaviours, and neglect the serious consequences of starvation" (Lask et. al., 2005, p.50). Girls normally have to take serious efforts to be satisfied with their appearance and achieve ideal promoted in the media. This promotion has been so intensive that many started to reasonably believe that "in our current cultural context 'thin' has come to represent much more then physical beauty. A thin body has become synonymous with self-discipline, success, and control" (Dworkin, 1999). It made females, especially adolescents, extremely vulnerable to TV influence. The recent research shows that majority of girls consider absolutely normal physiological changes, like increase in weight on the hips for instance, a real tragedy that makes them charmless and ugly (Fox, 1997). A study carried out at Harvard University discovered that approximately two thirds of twelve-year girls considered themselves fat while the real state of thing was just the opposite: their weight was even less than it had to be upon the condition of normal physiological development. As a result about fifty percent of girls at the age of thirteen felt unhappy about their physical condition and at the age of fourteen that feeling intensified. So at the age of seventeen only three girls out of ten were not on a diet and eighty percent of them were dissatisfied with their appearance based only upon their understanding of the physical ideal (Fox, 1997). Another study at Harvard Medical School attempted to reveal the linkage between watching television and eating disorders before and after exposure to television. The researchers found out that "Prior to access to television, no girls used vomiting to induce weight loss. Three years after the introduction of television 11% of girls were using self-induced vomiting for weight control, dieting had become commonplace with 69% of girls having gone on diets and 74% stating that they were too fat" (BBC, 2002). The reason for such a drastic change in eating behavior was precisely the girls' desire to look like the television characters. The study estimated the risk of developing eating disorder in girls exposed to television to be three times higher than in girls having no TV set in home. Given these trends in formation and development of adolescents' body image under the influence of mass media it would be reasonable to assume that adolescents take some measures to loose weight trying to put their actual physical appearance in compliance with media promoted one. However, the desire to loose a couple of pounds does not mean that a person will necessarily develop Anorexia Nervosa or other eating disorder. This desire is harmless if a person sticks to healthy medical diet, but unfortunately it seldom happens. Usually girls simply hunger themselves regardless of possible consequences for their health (Weinshenker, 2002). And most often all their endeavors go for nothing because only five percent of women can physically achieve the absolute compliance with the TV ideal of beauty while other ninety five percent can only approach it (Fox, 1997). Statistics shows that during the past twenty years " the majority of individuals with eating disorders have been young, female, white, and from middle to upper-class families in Western countries and Japan. Girls with anorexia have traditionally been academically successful, first or second-born children and often work as dancers or athletes" (Halmi, 1997: 507). Assumption that indigence is the source of numerous eating disorders in girls from comfortably situated middle-class families is senseless. Clearly, it is media promoted body image that makes girls from families with above average income voluntarily damage their health. Although mass media influence is definitely one of the factors in development of Anorexia Nervosa, no evidence is available to consider it the major cause. Therefore, the dominant opinion is that this eating disorder develops due to a combination of various causes: "The causes [of Anorexia Nervosa] appear to be multifactorial, with determinants including genetic influences, personality traits of perfectionism and compulsiveness, anxiety disorders, family history of depression and obesity, and peer, familial, and cultural pressures with respect to appearance" (Steiner et al, 2003: 40). For the sake of objectivity, it must be admitted, however, that the precise combination of causes for developing anorexia is different for each individual. CONCLUSION Even brief analysis of various media reveals the key reason for the belief that anorexia is already perceived as a norm rather than a disease in modern society: the media tend to unreasonably idealize thinness as the main attribute of physical beauty and success. Positive mood and self-esteem of adolescents who belong to the highest-risk group directly depend upon the compliance between their actual bodies and the media-inspired physical ideal. However, the truth is that anorexia nervosa is a dangerous life-threatening eating disorder that has to be in the focus of professional attention due to its high incidence among adolescents. This disorder is the reason for serious physiological and psychological complications such as cardiovascular conditions, impaired menstrual function, hypothermia, low self-esteem, anxiety disorder, and depression. Some possible actions to address this problem with the traditional media might be shifting the priorities toward plus sized models images of whom reportedly "...could reduce perceived pressure to be thin and lead to more positive self-evaluations in women" (Irving, 1990: 239). Some major players in the media market have already undertaken first steps in this direction. Thus, Nike and Dove have begun using plus-size models increasingly in their advertisements. A recent Nike advertisement featured a woman who claimed to have 'thunder thighs' and was cheered in marathons. And the popular Dove campaign last year featured six 'real women' who were not professional models, and showed them in their 'real curves'. Though such tendencies are still rare, the very fact that they appear demonstrates that continuous appeals of the scholarly community to stop turning anorexia into the social norm did not remain unheard. WORKS CITED American Psychiatric Association Work Group on Eating Disorders (2000). Practice guideline for the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 157(1 Suppl): 1-39. Botta, R. (1999) "Television Images and Adolescent Girls' Body Image Disturbance", in Journal of Communication Davies, P. & Lipsey, Z. (2003). Ana's gone surfing. The Psychologist, 16(8), 424-425. Dworkin, N. (1999). Food Fight: Understanding and Recovering from Eating Disorders. Retrieved May 22, 2008 from http://www.consciouschoice.com/features/fooddisorders1205.html Eagles J, Johnston M, Hunter D, Lobban M, Millar H. (1995). Increasing incidence of anorexia nervosa in the female population of northeast Scotland. American Journal of Psychiatry, 152, 1266-1271 Fox, K. (2003). Mirror, mirror. Retrieved May 22, 2008 from, from http://www.sirc.org/publik/mirror.html Halmi, KA (1997). Models to conceptualize risk factors for bulimia nervosa. Archives of General Psychiatry, 54, 507-508. Halmi K, Casper R, Eckert E, Goldberg S, Davis J. (1979). Unique features associated with age of onset of anorexia nervosa. Psychiatry Research, 1, 209-215 Herman-Giddens M, Slora E, Wasserman R, et al (1997). Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. Pediatrics, 99:505-512 Irving, L. M. (1990). Mirror images: Effects of the standard of beauty on the self and body-esteem of women exhibiting varying levels of bulimic symptoms. Journal of Social and Clinical Psychology, 9, 230-242. Jovanovic J., Lerner, R. & Lerner, J. (1989). Objective and subjective attractiveness and early adolescent adjustment. Journal of Adolescence, 12, 225-229. Lask, B., Gordon, I., Christie, D., Frampton, I., Chowdhury, U. & Watkins, B. (2005). Functional neuroimaging in early-onset anorexia nervosa. International Journal of Eating Disorders, 37, 49-51. Misra, Madhusmita et al (2004). Effects of Anorexia Nervosa on Clinical, Hematologic, Biochemical, and Bone Density Parameters in Community-Dwelling Adolescent Girls" Pediatrics, 114, 1574-1583 Paris, J. (1999). Nature and Nurture in Psychiatry. Oxford Press Steiner H, Kwan W, Shaffer TG, et al. (2003). Risk and protective factors for juvenile eating disorders. European Child and Adolescent Psychiatry, 12, Suppl. 1, 38-46. Tennen, M. (2006). Children May Learn Eating Disorders. Health A to Z. Retrieved May 22, 2008, from http://vww.healthatoz.com/healthatoz/Atoz/common/standard/transform.isprequestURI=/healthatoz/Atoz/dc/cen/ment/eatd/alert08282002.isp Weinshenker, N. (2002). Adolescents and Body Image: What's Typical and What's Not. Child Study Center Letter, Vol. 6, No. 24 Wilson, J., Peebles, R., Hardy, K. & Litt, I. (2006). Surfing for Thinness: A Pilot Study of Pro-Eating Disorder Web Site Usage in Adolescents With Eating Disorders. Pediatrics, 118(6), e1635-e1643 Yager, J, and Arnold E. Andersen, M.D. (2005). Anorexia Nervosa" The New England Journal of Medicine, 353, 1481-8. Read More