The Causes, Implications and Solutions for Anorexia - Research Paper Example

Running Header: THE CAUSES, IMPLICATIONS AND SOLUTIONS FOR ANOREXIA The Causes, Implications and Solutions for Anorexia BY YOU YOUR SCHOOL INFO HERE DATE HERE ABSTRACT Anorexia Nervosa is a mental disorder in which the individual suffering from it becomes obsessed with food and food consumption and begins to restrict the volume of calories consumed on a daily basis. Common symptoms, both physical and behavioral, include thinning of the hair, extreme sensitivity to cold weather conditions, obsessiveness about food labeling and caloric value of food products, and even secrecy about eating habits such as hiding food and avoiding social dining activities. Anorexia is a complicated disease. Research has indicated that anorexia is caused by a variety of different factors, including biology, sociological considerations and psychological adjustment patterns that are often driven by youth historical experiences in society and with family members. It is also known to be caused by media representation of what constitutes an ideal form for men and women which alters a person’s self-esteem levels and sense of self-worth in a social context. Such causes of the disease are known to be attributed to body dysmorphia, an unreasonable and rather perverse sense of the self as it pertains to body image as well as youth caregiver attachment problem (to name only two potential causes). Treatment options include cognitive behavioral therapy, clinical interventions, family therapy, support groups, pharmaceuticals, and even more radical psychotherapy methodologies. Hence, there are potential solutions that can reduce prevalence of this mental disorder with many of the aforementioned treatment options sustaining credible and sometimes substantial recovery and success rates. The goal of treatment, as indicated by research, is to change the distorted sense of self that is common with anorexia and improve cognition patterns to develop healthier eating and coping strategies. The Causes, Implications and Solutions for Anorexia Introduction Anorexia Nervosa is a variety of eating disorder in which the individual radically curbs their food intake and maintains an unreasonable and rather groundless terror of weight gain. It is usually accomplished with a maladjusted viewpoint about their bodies. Anorexia is characterized by extreme weight loss. People who maintain this mental illness begin an extreme regulation of dietary consumption which leads to a variety of health problems. Anorexia is a common eating disorder that affects women and men, however its prevalence is most widespread in the female population. Those that have been diagnosed with anorexia often maintain an irrational obsession with maintaining a thin body figure and become preoccupied and often fanatical about ensuring the individual does not put on weight. Anorexia is most often caused by having a warped sense of self-image which leads to abnormal self evaluations regarding how the individual thinks about food, consumption of food, and their bodies. The most significant mental maladjustment with those who are diagnosed with anorexia is that they believe they are significantly fat even when it is apparent to others in their social and familial environments that they are drastically underweight (Attia, 2010). There is a common misconception that those with anorexia lose their appetites, however this is an unfounded fallacy. In fact, people who are diagnosed with anorexia actually maintain very healthy appetites, thus experiencing regular hunger, but refuse to allow themselves to eat anything but very insignificant volumes of food. In the domain of medicine and health, it is recommended that an individual consume between 2000 and 2500 calories per day depending on weight and height. However, people with anorexia only consume approximately 600 calories daily, which is absolutely insignificant for sustaining positive human health. Those sustaining the mental disorder of anorexia maintain a high volume of ghrelin, a hormone that regulates hunger signals. Abnormal levels of ghrelin indicates that the human body is frantic in an effort to indicate that the body is hungry, however people with anorexia become extremely adept in suppressing these sensations and refusing to ingest all but infinitesimal volumes of food. There are many in society that believe people with anorexia are simply trying to gain attention and are using this methodology of food consumption to gain social sympathy and social interest from others. However, anorexia is a legitimate type of mental disorder that often requires a variety of interventions and treatment methods in order to eliminate the complex attitudinal factors (such as maladjusted body self-perception) that lead to anorexia. People with anorexia often describe sustaining symptoms such as dizziness and headaches, which further complicates treatment as it often requires a blend of clinical and psychological procedures to heal the suffering individual. The enormity of potential physical symptoms that occur with anorexia are significantly dangerous to the human body and the mortality rate for those that do not receive adequate treatment and support is substantial enough to make this a considerable problem in today’s society and in the domains of medical and psychological sciences. Anorexia nervosa is a complicated type of mental disorder that is caused by unrealistic representations of human beauty in a variety of media sources, peer influence, and sociological stereotypes and established social norms related to masculinity and femininity expectations. Hence, anorexia is a multi-faceted and often pathological disease and, in order to determine an effective treatment option, psychologists and medical practitioners alike must determine whether it is psychological or sociological triggers that cause an individual to radically harm themselves through distorted eating behaviors and maladjusted self-evaluations pertaining to the body. Signs and Symptoms of Anorexia Development Individuals who are suffering with anorexia often display behaviors that indicate to others in their social and familial environments that the person sustains a dangerous mental disorder. Primarily, as the most common sign of the disease, the individual becomes preoccupied and obsessed with food labeling, reading a variety of diet books, and using scales and other instruments to accurately weigh and measure food portions (Smith & Segal, 2014). These behaviors become automatic over time and this preoccupation becomes abundantly apparent to others in their environment. What is interesting in understanding anorexia is that the individual often recognizes that their behaviors are abnormal and attempt to insulate themselves from social scrutiny by becoming highly secretive. Therefore, the sufferer will begin developing untruthful behaviors associated with their eating habits, such as making excuses to avoid eating, hiding their food portions, or suggesting physical problems such as stomachaches and indigestion. They will often refuse to have meals in places where public patrons dine or develop unusual and ritualistic eating patterns. It is also common for anorexic sufferers to become obsessive with exercise. In an effort to get their bodies to conform to expected ideals of physical attractiveness, they will become so preoccupied with exercise that they will be willing to run in dangerous and inclement weather conditions or avoiding other social or professional commitments in order to engage in exercise. In similar accord, the mentally disturbed individual will oftentimes demand to wear large, warm and inappropriate clothing, such as wearing a heavy winter jacket even when the weather conditions mandate shorts and light clothing. This is due to the belief that wearing these bulky clothes will hide their emaciated form and also serves as a form of psychological self-protection in an effort to hide their self-constructed perceptions of body defects. Physical signs that an individual maintains the disease of anorexia are brittle fingernails and hair, recurring lightheadedness complaints, a loss or drastic reduction in predictable menstrual cycles, and even a tendency to bruise much more easily than the average, fit human being. The individual may be regularly dehydrated and develop an extreme sensitivity to cold weather conditions. All of these physical symptoms are usually prevalent with individual who have sustained anorexia for an elongated period of time, which serves as a warning signal to family members and the social environment that the individual requires intervention and treatment assistance. Body Dysmorphia as a Cause of Anorexia Many individuals that are diagnosed with anorexia sustain what is referred to as body dysmorphia, a persistent type of mental disorder in which the suffering individual maintains a constant obsession with their body image. This mental disturbance manifests itself as extreme preoccupation about their physical appearance. People that are afflicted with body dysmorphia often find a perceived, minor defect in their physical appearance and greatly inflate negative emotional responses to the imperfection which causes impaired psychological and social functioning. What is most concerning about those sustaining the mental disorder known as body dysmorphia is that the individual becomes highly anxious and begins to withdraw socially (Bjornsson, Didie & Phillips, 2010). Body dysmorphia is accompanied with an obsessive desire to change a particular aspect of their appearance even when the individual suffering from this disorder is typically of nice-looking or average appearance. Over time, those with this disorder believe that their physical appearance is horrendous which leads to an inability to function socially for fear that they are being judged and ridiculed regarding their perceived appearance flaws. It becomes, therefore, a primary goal of the individual suffering from body dysmorphia to fix their perceived deformities which ultimately leads to obsessive-compulsive behaviors toward that end. Body dysmorphia, though often blamed on environmental and sociological factors, is also a product of genetics. Studies utilizing neuroimaging mechanisms have indicated that there is often an underdeveloped system of connections within the brain’s amygdale, the region of the brain that provides emotions, and areas of the frontal cortex that provides rational thought and serves to regulate the extent of emotional response. In the case of genetic factors contributing to development of anorexia, rational treatment options would involve surgical procedures or medicinal strategies as this type of irregularity or imbalance is independent of socio-psychological considerations as catalysts, thereby complicating offering assistance to the anorexia sufferer. Sociological Factors as Causes of Anorexia Anorexia is most prevalent in adolescents and young adults, a period in life stages in which the individual actively seeks social belonging and social approval from important reference groups in their environment (McAlister & Cornwell, 2010). In many developed, industrial nations such as the United States and the United Kingdom, culture often dictates what constitutes beauty. It is often promoted in society and media that being thin represents the ideological female figure and this norm is represented consistently in such magazines as Cosmopolitan, Teen Magazine and other relevant media publications. Such media often depicts thin and sometimes even emaciated celebrities who adorn the cover of these magazines which triggers a sociological belief and set of values that being of slight female form should be an aspirational body goal for the consuming audience. Youths between 12 and 18 are often very impressionable as they seek the establishment of self-identity in an important psychologically-driven effort to find their place and acceptance in society. Hence, in an environment where the social environment maintains similar values and attitudes about the importance of maintaining a slender figure, youths learn from their important reference group figures about how to consume low-calorie foods and consume a variety of diet pills. In an effort to properly fit in with their most desired in-group, the youth begins adopting these same unhealthy behaviors which often serves as a long-term trigger for development of anorexia. A university study that recruited 3,000 young females living in the United Kingdom discovered that the most significant contributor to the development of eating disorders was media representation of underweight female models (LSE, 2012). The secondary cause of anorexia development within this recruited sample was peer pressure, which supported the contention that reference groups and established social norms on female beauty were substantial influences in what drives individuals to develop distorted and maladjusted viewpoints about their physical appearance. Why is this, however? What legitimately causes such a strong need to succumb to reference group pressures and acceptance of established social norms related to majority social conceptions about what constitutes modern beauty? It is the phenomenon that is explained under social comparison theory, a contention that states individuals in society regularly compare themselves with others in the social environment as well as in media images that are deemed as being representative of ideal and attainable characteristics, known as aspirational reference groups. By making these comparisons to self and the reference groups, it creates a set of values and beliefs about what constitutes acceptable beauty and attractiveness. When upward comparisons are made, meaning comparisons against those who are perceived to have advantages in specific areas that are valued by the comparer, it creates envy and jealousy with many in society (Plante, 2013; Suls & Wheeler, 2011). Social comparison theory is relevant in understand both the role of media and social reference groups in contributing to development of anorexia. Upward social comparisons create the incentive to make radical body image changes when an individual making the comparisons believes that an aspirational figure maintains better and more appropriate physical characteristics than the self. Upward comparisons lead to reduced self-esteem, which is a fundamental and rather universal human need and motivation for positive psychological adjustment, and also creates diminished positive self-regard. Hence, in an effort to improve emotional well-being, the individual begins to identify potential methods to achieve the ideal characteristics of the figure by which they compared themselves, which can potentially lead to development of anorexia. Furthermore, a 2010 study indicated that sexism and chauvinism are still legitimate phenomenons that exist in developed societies even today. Sexism is defined as discriminatory attitudes and prejudices regarding a person’s gender. This is more relevant in understanding what might be potential causes of anorexia in the male population. Many cultures have distinct prejudices which indicate that legitimized and appropriate masculinity traits include a more in-shape figure, hence society often emphasizes that masculinity involves body development and fitness. Men in societies who feel pressured by these sexist values and norms experience diminished self-esteem if they have not achieved the ideological male build. In an effort to achieve more positive sentiment from other males who prescribe to predominant expectations for masculinity, men will begin concerning themselves with weight gain to avoid flabbiness which can ultimately lead to development of anorexia. Poor emotional functioning as a result of socio-environmental factors is directly correlated with the level of body fat dissatisfaction prevalent with men suffering from anorexia (Griffiths, Angus, Murray & Touyz, 2013). Hence, sexism and chauvinism could be direct catalysts for the development of anorexia in male populations due to the esteem problems that occur as a result of not attaining an idealized male body form. It is also recognized that the quality of early-age relationships and bonding with caregivers as a youth can be a predictor of anorexia development. The psychoanalytic perspective is that abnormal relationships between mother and daughter create psychological maladjustment that leads to eating disorders. Mothers, in order to develop fully functional and well-adjusted daughters, need to provide adequate emotional responses to the child’s needs. Failure to do this leads to confusion in relation to creating a positive self-identity. Mothers who do not maintain sufficient and satisfactory empathetic attitudes toward their daughter during childhood is a predictor of anorexia development (Canetti, Kanyas, Lerer, Latzer & Bachar, 2009). Furthermore, during the period of child development between infancy and two years of age, it is important for positive psychological adjustment for children to become attached to their parents as a means of achieving a sense of security. Most counselors and researchers have achieved consensus that caregiver attachment is fundamental and vital to the facilitation of positive emotional development. Failure to achieve this early-age attachment leads to social and psychological maladjustment. The extent to which a caregiver provides nurturing environments serves as a potential catalyst for negative self-esteem development later in life and the ability to function successfully in social environments. Under a respected model of psychology and motivation known as Maslow’s Hierarchy of Needs, the establishment of security is a fundamental need and, when unfulfilled, leads to an inability to achieve effective social belonging and self-esteem growth (Weiten & Lloyd, 2010). The lack of security provided by ineffective parenting systems can lead to an array of emotional problems that serve as potential catalysts for the development of eating disorders. A quantitative study utilizing a sample group of 43 participants who had been diagnosed with anorexia nervosa indicated that a higher volume of respondents had indicated historical experiences with less-caring mothers and fathers as compared to a non-clinical group of 33 individuals not experiencing anorexia (Canetti, et al., 2009). Hence, attachment and parenting capabilities are directly associated with development of anorexia. Treatment Solutions for Anorexia Because anorexia is clearly a multi-faceted and complicated mental disorder, there are a variety of potential treatment options available for curing this disease. One of the most respected and fundamental treatment options is a psychological counseling approach known as cognitive behavioral therapy. This is a psycho-therapeutic methodology designed to address maladjusted emotional capacity and attempts to alter dysfunctional cognitive thinking through a systematic approach that includes self-instruction, a process of promoting motivational self-talk in the patient to change negative self-evaluations. Cognitive behavioral therapy has the counselor develop a variety of coping strategies that can be adopted by the patient, such as reducing the frequency of self-defeating cognitions (Hoffman, Sawyer & Fang, 2010). CBT typically consists of a series of face-to-face interventions between counselor and patient, inclusive of approximately 15 different sessions with a gap of only one week between interventions. One strategy in cognitive behavioral therapy is known as cognitive rehearsal, in which the counselor asks the patient to recall a difficult or stressful situation that occurred historically. The purpose of this strategy is to have both the patient and counselor work on potential solutions to the problem whilst also rehearsing a series of positive thoughts that ultimately leads to a change from negative thinking to more appropriate, positive thought processes. Role playing is also effective in CBT, in which the counselor takes on the persona of individuals (such as historical caregivers or social reference groups), a methodology that ensures the patient understands more effective social responses and how best to respond in situations that cause stress and anxiety. How the counselor responds using effective strategies serves as a role model for the patient by which they are theoretically going to mold their own behaviors more effectively. Role playing is often supplemented with positive reinforcement strategies whereby the individual is given a series of rewards for illustrating more productive attitudes and behaviors. This not only reinforces the desired behavior, but serves to build a sense of self-esteem that is necessary for those suffering from anorexia who maintain significantly negative perceptions about the self and the body. Yet another treatment option for anorexia is implementing clinical interventions. In a controlled environment, patients are offered nutritional counseling services that emphasize the importance of sustaining a well-balanced diet, providing knowledge about the risks of sustaining such a complex eating disorder, and performing a rigorous physical examination to illustrate how the body sustainability is being eroded by malnutrition. This has fear-inducing implications that are beneficial in changing attitudes about food consumption. In a medical environment, the patient is given an initial 1200 calorie diet regimen to accustom the patient to consuming higher volumes of food and adjust the body to a more sufficient daily consumption level. Though often effective, this type of intervention costs between $7,000 and $9,400, hence making it unaffordable to many individuals in society. This type of intervention in a controlled hospital environment is known to have an effectiveness rate between 50 and 85 percent, making it one of the most viable treatment strategies for the disease. A further treatment option for anorexia offers the sufferer a regimen of the pharmaceutical Olanzapine, which is known to contribute to increases in a patient’s body mass index and change obsessive thoughts about food consumption. This is an anti-psychotic medication. Though the most common effect of this drug is rapid weight gain, there are drawbacks to this treatment option. Recurrent use of this pharmaceutical often leads to higher levels of blood cholesterol and increases the volume of natural insulin in the body that could lead to moderate diabetic development. Development of insomnia, erectile dysfunction in males, and swelling of extremities as a result of fluid build-ups represent three common side effects of Olanzapine. However, this particular drug has been illustrated to be highly effective in improving the body mass index of patients and has become highly affordable in recent years as a result of the availability of a generic version on the pharmaceutical market. Hence, many individuals seek this treatment option to restore the body to a more healthy physical condition. Family-based treatments from a counseling perspective have also been effective in treating anorexia. In this strategy, family members in the household are considered to be effective and productive resources for controlling eating behaviors of the patient. They are also viewed as support resources to assist in coping and through provision of empathic training provided by the counselor. Group counseling occurs in this treatment option, allowing the patient and family members to discuss conflicts that occur in the family dynamic and even historical relationship problems that have led to emotional problems whereby family members are directed by the counselor to evolve and improve their parenting skills and emotional intelligence. This approach to treatment, based on a follow-up study of individuals undergoing family therapy, illustrated a full recovery rate of 90 percent (Le Grange & Eisler, 2009). The difficulty, however, with this therapy approach is that it involves active commitment and involvement by important familial figures that is not always achievable in all household dynamics. Despite this reality, it does tend to support the literature that family relationships can serve as realistic predictors of anorexia development as proposed by Canetti, et al. (2009) illustrating that parental attachment and competency in parenting skills are directly correlated with being catalysts for development of anorexia. Participation in support groups are also known to be rather effective as treatment options for this mental disorder. It was established by McAlister & Cornwell (2010) that reference groups and social peers are fundamental influences in what drives development of anorexia, especially in female adolescents. Support groups are established with other individuals in the same demographic category that are suffering from anorexia who can discuss their concerns, fears and aggravations of the disease. Support groups illustrate to the sufferer that they are not alone in sustaining similar feelings and anxieties, which provides a sense of security that might not have been established with caregivers during their childhood. Individuals that become socially intimate with the participants become important reference groups and they have the ability to mold their behaviors against the achievements and perceptions of other participants in the support group. The organization known as Recoveries Anonymous specializes in support groups for individuals suffering from anorexia and is a free, 12-step program designed to foster social support and cognitive changes in the sufferer. For those who are suffering severe psychological problems that have led to anorexia, there is another, more radical treatment option known as hypnotherapy. As a branch of psychotherapy, hypnotherapy induces hypnosis and the trained professional begins altering behavioral patterns and thought patterns related to anxiety reduction, stress reduction, and removal of dysfunctional behaviors that contribute to psychological maladjustment. Under hypnosis, patients are known to sustain higher levels of suggestibility that assists in essentially implanting more productive thoughts into the mind of the patient. However, hypnotherapy and its productive implications are often contested by many in the research and medical communities regarding its viability and reliability in improving behavioral and emotional outcomes of the patient. However, if effective, hypnotherapy provides the foundation for substantial behavioral conditioning and removing distorted thoughts from the cognitive processes of the patient. Conclusion As illustrated, anorexia is a complicated and rather convoluted mental disorder that is caused, theoretically, by a series of genetic irregularities in the brain, sociological factors, maladjustment at the psychological level, and even as a result of obsessive compulsive disorder. It has been proposed that anorexia is caused by peer reference groups, social norms of beauty that reside in industrial and developed nations, the influence of media representation in contemporary society, and even prejudice as well as stereotypes about the appropriateness of certain masculine traits. There are clearly a plethora of potential drivers that lead to anorexia development, thus complicating the process of identifying the most appropriate treatment option for each individual case of anorexia. Whether driven by emotional or social maladjustment and abnormality or whether biological factors are constructing anorexia development, there are a variety of treatment options available, some with high success rates, which would provide a theoretical foundation for recovery of this difficult disorder. Ranging from more in-depth counseling to more radical procedures such as psychotherapy, it appears that there is some form of valid and reliable option for addressing recovery that would be available to a diverse group of sufferers of this disease, regardless of its severity or the causes that drove its development. Whether biologically-driven, psychologically-constructed, or sociologically-influenced, anorexia is a multi-faceted and complicated mental disorder that requires a system of self-reevaluation, support networks, clinical and familial interventions, and counseling in order to adjust the behaviors and maladjusted attitudes that have led to its development. References Attia, E. (2010). Anorexia nervosa: Current Status and Future Directions, Annual Review of Medicine, 61(1), pp.425-434. Bjornsson, A., Didie, E. & Phillips, K. (2010). Body Dysmorphic Disorder, Dialogues in Clinical Neurosciences, 12(2), pp.221-232. Canetti, L., Kanyas, K., Lerer, B., Latzer, Y. & Bachar, E. (2009). Anorexia Nervosa and Parental Bonding: The Contribution of Parent-Grandparent Relationships to Eating Disorder Psychopathology, Journal of Clinical Psychology, 64(6), pp.703-716. Griffiths, S., Angus, D., Murray, S.B. & Touyz, S. (2013). Unique Associations between Young Adult Men’s Emotional Functioning and their Body Dissatisfaction and Disordered Eating, Body Image, January 10. Retrieved February 14, 2014 from http://www.academia.edu/5331902/Unique_Associations_Between_Young_Adult_Mens _Emotional_Functioning_and_their_Body_Dissatisfaction_and_Disordered_Eating_2013 Hoffman, S.G., Sawyer, A.T. & Fang, A. (2010). The Empirical Status of the New Wave of Cognitive Behavioral Therapy, Psychiatry Clinic North America, 33(3), pp.701-710. Le Grange, D. & Eisler, I. (2009). Family Interventions in Adolescent Anorexia Nervosa, Child and Adolescent Psychiatry Clinics of North America, 18(1), pp.159-173. LSE. (2012). Anorexia Study backs Government Ban on Underweight Models, The London School of Economics and Political Science. Retrieved February 12, 2014 from http://www.lse.ac.uk/newsAndMedia/news/archives/2012/03/anorexia.aspx McAlister, A.R. & Cornwell, T.B. (2010). Children’s Brand Symbolism Understanding: Links to Theory of Mind and Executive Functioning, Psychology & Marketing, 27, pp.203-228. Plante, T. (2013). Understanding Envy with Social Comparison Theory, Psychology Today. Retrieved February 11, 2014 from http://www.psychologytoday.com/blog/do-the-right- thing/201307/understanding-envy-social-comparison-theory Smith, M. & Segal, J. (2014). Anorexia Nervosa: Signs, Symptoms, Causes and Treatment. Retrieved February 14, 2014 from http://helpguide.org/mental/anorexia_signs_symptoms_causes_treatment.htm Suls, J.M. & Wheeler, L. (2011). Handbook of Social Comparison: Theory and Research. Kluwer Academic Publishers. Weiten, W. & Lloyd, M.A. (2010). Psychology Applied to Modern Life: Adjustment in the 21st Century (8th ed.). Wadsworth Publishing. Read More