Health Issues in Adolescence: Bulimia Nervosa - Term Paper Example

? Developmental Psychology Health Issues in Adolescence: Bulimia Nervosa Adolescence is a period of rapid change that connects childhood to adulthood. The adolescent body grows rapidly after puberty set in, and the development of secondary sex characteristics can be unnerving for the individual, particularly when the development is rapid. The adolescent brain also undergoes a number of significant changes that cause the adolescent to respond to stressful situations with irritation and distress. The physical and emotional changes make an adolescent very vulnerable to the influence of stress that can come from physical, social and cultural experiences (Kearney & Trull, 220). The high premium paid to how an individual looks is one such factor. Thin bodies are often believed (wrongly) to be synonymous with healthy, and a number of adolescents – both male and female feel the constant pressure to look thin to feel good about themselves. Without proper help and guidance, adolescents may adopt a number of unhealthy ways to achieve the body shape they desire (Kearney & Trull, 228), and these habits could lead to the development of eating disorders like Anorexia and bulimia. Bulimia Nervosa Bulimia nervosa is an eating disorder that involves eating large amounts of food in a short period of time and them attempting to expel that food using a number of methods (Kearney & Trull, 220). Although it is believed to be less dangerous as compared to Anorexia, a higher number of individuals are affected by bulimia and these individuals are often not detectable since they are of normal weight and usually do not exhibit as many visible symptoms (Barker, 323). It also affects women for more frequently as compared to men; and has been found to be shared by siblings, especially twins (Kearney & Trull, 222). Like other eating related disorders, symptoms of bulimia start between 14 – 18 years of age, and about 2-3% of the population tends to develop bulimia in their late teens and early adulthood (American Anorexia Bulimia Association). Most of the persons suffering from bulimia are women, and about 6 to 17% of girls in high school show some symptoms of bulimia although only a few develop the condition (Kearney & Trull, 222). A number of factors are associated with the onset of the binging periods including mood changes, negative emotions and stress (American Anorexia Bulimia Association). The person eats a large amount of food during the binging period, and may continue to eat till the fear of putting on weight makes them feel the need to get rid of the food consumed. While most persons suffering from Bulimia tend to purge the food either by vomiting it out, or by using laxatives to facilitate the rapid removal of the food, a few bulimics use non-purging methods like extreme exercise or fasting as primary methods of losing weight (Barker, 323). Causes Eating disorders find their origins in psychosocial variables and research into biological causes was yet to provide significant causes. A significant cause of bulimia is believed to be associated with the portrayal of the thin body as an ideal in the media (Kearney & Trull, 227). Becker, Burwell, Gilman, Herzog & Hamburg (509) have found evidence for this. Within three years after the introduction of television to a community in Fiji, purging behavior and reduced food consumption among young girls rose from close to zero to over 11%. This drastic change and the short time period within which it occurred provide a strong argument for how media and social norms can play a role in the development of eating disorders. Byrne & McLean, (17 – 31) have discussed the theoretical models that have attempted to explain the role of different causes in the development of Bulimia. They discuss the hypothesis proposed by Fairburn and others that being exposed to an idealized thin body as a role model can influence an individual’s choices and lead to reduction in food consumption. Each time the individual was unable to keep to the diet would be considered an infraction which would need to be offset. Cognitive distortions rising from these experiences may cause further stress which would feed back to the disordered behavior. Byrne & McLean, (17 – 31) also discuss their own findings which show that the purging behavior feeds back to the desire to binge rather than binging leading to purging behavior. It is important to note that the ‘thin ideal’ is perpetrated not only by media but also by family, friends and other significant social groups. Symptoms Bulimia is more difficult to find in its early stages since the individual looks and behaves normally under most circumstances. In most cases, they do not exhibit rapid and unexplained weight loss and are able to continue with day to day activities for a long period of time. Signs of bulimia become more apparent as the illness progresses, and includes a number of physical symptoms including dry skin, hair loss, degradation of tooth enamel and tooth decay (American Anorexia Bulimia Association). The process of purging can damage the digestive tract and thus leads to swollen glands in the neck, indigestion presence of blood in vomit and constipation. Persons suffering from bulimia often experience gastric reflux, ulcers and pain in the stomach after vomiting. Behavioral correlates include visiting the bathroom immediately after eating and isolating self or exercising excessively (Kearney & Trull, 228). Visible symptoms include dehydration and consequent flaky skin and nails, dull skin and fluctuating weight. These individuals may also show signs of cuts and wounds to the mouth and hands if they vomit often (American Anorexia Bulimia Association). A dental examination shows a reduction in tooth enamel due to constant exposure to gastric acid in the vomit. These individuals also manifest unexplained pains and women may experience erratic menses. Long term bulimia can lead to electrolyte imbalance which in a factor implicated in cardiac related issues. It can also cause the individual to have reduced energy and feel exhausted all the time (American Anorexia Bulimia Association). In some cases it has also been linked to reduced infertility. Emotional symptoms include mood swings and mood disorders including depression. Other emotional symptoms typically seen are anxiety related to body shape and the fear of being fat. Bulimics often eat in secret and hoard food, but feel shame and guilt about their bingeing. Depression and anxiety seem to be co-morbid disorders with bulimia and anorexia, as are dental problems (American Anorexia Bulimia Association). Some persons are also known to show substance dependency in a bid to reduce hunger and lose weight. Treatment Treatment of bulimia often includes the treatment of co-morbid disorders like depression and anxiety. Thus, treatment often includes antidepressants and other medication that is effective in the treatment of depression, seizures and anxiety and substance abuse. Besides medication, the use of psychotherapy and support groups have been found to help reduce bulimic tendencies. Cognitive Behavior therapy (CBT) has been found to help reduce bulimia by helping the individual learn new cognitions and behaviors and replace old, dysfunctional ones with these new functional behaviors (Kearney & Trull, 235-6). While CBT is very effective with adults, adolescents who are not as independent may benefit more from techniques like Family Based therapy and Cue therapy. Family Based therapy which includes the family and significant others in the adolescent’s life as part of the therapeutic process (Kearney & Trull, 235). This helps all stakeholders assess and revise their opinions about body image and healthy eating and provides the adolescent with a supportive environment not only in therapy but also at home so they are able to practice healthy eating and exercise habits. This process also educates and empowers families about health and eating disorders and helps them control some elements of the social experience of the recovering adolescent (235). Cue therapy involves helping the adolescent face and consume previously forbidden foods within limits and helps them overcome the anxiety associated with the foods that can trigger binge eating. Preventive measures Given that bulimia is significantly associated with perceptions and attitudes, it is important to address the development of attitudes that facilitate eating disorders if there is to be any hope for preventing adolescents from developing them. preventive psycho-education provides to large groups of adolescents may help increase awareness about the disorder and thus increase the chances that symptoms will be detected early (Kearney & Trull, 230). Parents should also be encouraged to place premium on health and achievements instead of body shape and weight so that adolescents are encouraged to indulge in sports and exercise in order to maintain health instead of weight. Adolescents draw on their attitudes from their families and peers; and introducing role models in the community and in the media who are healthy but not particularly thin will help adolescents feel less pressured about how they look. increasing exposure to the causes and symptoms of eating disorders with an emphasis on their treatability can also help reduce the stigma associated with bulimia and thus help people seek help faster (Kearney & Trull, 230). Works Cited Barker, P. Psychiatric and Mental Health Nursing: The Craft of Caring. Great Britain: Arnold. 2003. Print. American Anorexia Bulimia Association, Inc. Facts on Eating Disorders. New York, American Anorexia Bulimia Association. 1998. Becker, A.E., Burwell, R.A., Gilman, S.E., Herzog, D.B. & Hamburg, P. “Eating behaviours and attitudes following prolonged exposure to television among ethnic Fijian adolescent girls”. The British Journal of Psychiatry, 180.6. ( 2002): 509–14. Print. Kearney, C.A. & Trull, T.  Abnormal Psychology and Life: A Dimensional Approach. Belmont, CA: Wadsworth, Cengage Learning. 2011. Byrne, S. M., & McLean, N. J. “The cognitive-behavioral model of bulimia nervosa: A direct evaluation”. International Journal of Eating Disorders, 31. (2002): 17-31. Read More