Genetic Factors That Associated with the Development of Anorexia - Research Paper Example

The prevalence of anorexia is high in women, with especially high rates in western countries. After extensive researchby a few physicians, the disorder was recognized in the late 19th century despite its existence for ages. Genetic factors has been associated with the development of anorexia, however, research is still underway to determine the relationship between genes and the development of anorexia. Treatment is mainly focused on weight gain and is achieved by monitoring a patient’s weight and food intake. Prevention is the best option for anorexia but is not guaranteed achieve satisfactory results. Introduction Anorexia nervosa, also called anorexia, is a serious eating disorder with a high prevalence rate in women. The disorder is a mental illness defined by low body weight, persistence in maintenance of thinness and emotional disturbances about weight and body shape. An analysis of anorexia shows different features from other mental or emotional disorders. This is because the symptoms displayed by the victim show that he or she has the disorder. The disorder is different from other ailments such as flue or STDs since these ailments are spread or caused by viruses while anorexia is caused by emotions and thought. In anorexic patients, the victim stops eating in a bid to avoid weight gain despite feeling hungry, and the resultant starvation causes a person to loss more weight, which sometimes leads to death. Anorexia is common in young women, begins at the age of twelve and can continue to adulthood. However, the prevalence of men suffering from the disorder is also increasing. DSM Classification for Anorexia Nervosa The classification of anorexia nervosa was first done in 1970 having been prepared with specific diagnostic classification criteria. The disorder was one of the first eating disorders to be classified followed by bulimia in 1980. Classification criterion that focused more on the signs and symptoms was developed after the first classification done in 1970. Gerald Russell proposed the first criteria in 1970 based on behaviour disturbance, characteristic psychopathology and endocrine disorders. The classifications for the disorder in DSM-IV and DSM-V have had changes made on them; changes mainly being on the focus on weight in accordance to sex, age, physical health and course of development. The following are requirements for diagnosis of anorexia to be made based on the current diagnostic classification (DSM- V) (Focker et al. 2013). A. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory and physical health. Significantly low weight is defined as weight that is less than minimally normal, or, for children and adolescents, less than that minimally expected. B. Intense fear of gaining weight or becoming fat or persistent behaviour that interferes with weight gain, even though at a significantly low weight. C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation or persistent lack of recognition of the seriousness of the current low body weight (Focker et al. 2013, p. 29). The last classification criterion that talks about amenorrhea on women on DSM-IV was omitted in the current DSM-V (Focker et al. 2013, p. 29). Historical Factors Anorexia nervosa has existed for ages even before it was highlighted in the media. However, the word anorexia currently used is new; it was termed as self-starvation and practiced mainly for religious purposes. Avoiding food and overeating was traditionally viewed as an ailment, for example, the occurrence of gastrointestinal disorder. Christians practiced extreme fasting in 19 centuries, which was not a pathological experience. However, extreme fasting with no symptoms of ailments such as tuberculosis or for any religious reason caused people to regard the victim as being in control of demons. Additionally, the persistence of such a habit led to the view that the person might be abnormal or having a mental disorder. Abstinence from food was common in individuals with disorders such as mania, chlorosis, hysteria and other psychotic disorders. The start of 17th century led to the description of the disorder by the renowned English physician, Richard Morton. The physician explained that the disorder is a nervous consumption and differs from tuberculosis because of emotional turmoil. However, the physician’s analysis of the disorder was not taken into consideration until three centuries later. However, the end of 19th century saw another physician, Withey Gull, develop a description of the disorder similar to the diagnosis used currently. According to Gull and another physician, anorexia is a common psychogenic disorder on young girls and women. The characteristics presented by the physician include significant weight loss, amenorrhea, restlessness, and constipation. Despite interest on the cause of the disorder by different physicians from Europe and the United States, anorexia did not receive much consideration until the 20th century (Fairburn and Brownell, 2005, p. 45). Cause of the Illness Research is underway on the causes of anorexia nervosa. However, psychological, emotional, personal, behavioural and social factors are some of the causes of the disorder. The main focus on the cause of the disorder is biochemical and genetic factors. Causes of anorexia have been associated to variation in levels of dopamine and serotonin. Serotonin and dopamine are neurotransmitters that determine the behaviour, cognition, mood regulation, appetite, sleep and other related features (Scherag et al. 2010, p. 211). Researchers have also focused on the physiology of the disorder. The centre of the study is the neurological abnormalities thought to be the cause of anorexia because of the effect on emotion and behaviour. Various neurotransmitters have been studied such as serotonin, leptin, dopamine and ghrelin. Researchers have targeted serotonin more in the research because of several factors thought to play a role in the development of anorexia or any other eating disorder. Abnormal serotonin levels are common in patients with anorexia; the abnormality depicted involves transporters and receptors. Deformity of 5-HT transmitters distresses some of the common symptoms of anorexia such as anxiety, depression and harm avoidance. Another factor that has seen the target of serotonin is the treatment that has led to improvement of 5-HT pathways. Control of appetite is done by 5-HT, as well as allocation and control which is done by 5-HT over postprandial satiety. This explains the level of satiety impairment that arises whenever there is an increase in carbohydrate intake caused by decrease of hypothalamic 5-HT (Scherag et al. 2010, p. 217). Research has also been done on dopamine, though not as much as the research on serotonin and its effect on anorexia. According to Scherag et al. (2010), PET scans conducted with the help of MRIs on patients with anorexia shows that there is a decreased level of inter-synaptic dopamine, which coordinates motor regulation, insulin regulation, emotions, thinking and short term memory. Therefore, in case there is an imbalance in dopamine, the issues stated above are affected. Genes also contribute to anorexia nervosa, since they have a big influence on the development of mental illness especially anorexia. This is because they act on each other and against each other. Research also shows that children in families with history of the disorder have high chances of developing the disorder (Scherag et al. 2010, p. 219). Treatment Weight gain is highlighted more in the treatment options available for anorexia. From the definition of anorexia, restriction of food intake and lack of physical activity are pointed out as the main cause of the disorder. However, despite the view that weight gain is the main target of treatment of the disorder, there is no clear guideline to be followed for achievement of better results. Guidelines available show that weight gain must be achieved by patients weighing 85% less than normal weight. Hospital treatment is recommended for patients with weight lower than 75% of normal weight. Paediatricians provide medical monitoring for patients with the disorder including laboratory test and weight monitoring, psychiatrists provide the psychological support to the patient with anorexia and counselling is also provided to the patient regarding nutrition. All the above are done under supervision of a medical clinician with experience on eating disorders (Attia and Walsh, 2007, p. 1805). Behavioural change and weight gain are terms use to assess the effectiveness of the treatments provided to the patient with anorexia. Based on the above analysis of various treatments for anorexic patients, the most benefit is obtained from therapies and counselling. A patient achieves good eating habits because of advice from the dietary counsellors. Physical health is also improved when anorexic patients get treatment (Attia and Walsh, 2007, p. 1806). Prevention Prevention of anorexia or any other eating disorder is not easy and there is no guarantee that any measure taken to curb the disorder will be effective. Anorexia nervosa appears as the most common disorder currently in the society. The prevalence rate is high in women with numbers showing a 90-95% rate. Chances of recovery from anorexia nervosa are 50% after a period of 10 years and the mortality rate ranges from 0% to 25%. However, Greenblatt (2010) argues that preventable measures based on nutrition can be effective in curbing anorexia in individuals that are genetically exposed to disorder (p. 76). Prevention is done by first identifying some risks that can increase the occurrence of the disorder. For example, a female teen aged between 13 and 25 with family background of eating disorders, low birth weight and other complications during birth is more prone to the development of anorexic behaviours. Additionally, depression, anxiety, low self esteem and dieting habits are some features that have to be identified so as to prevent anorexia from developing. In case a child in a family has more than three of the mentioned characteristics, measures have to be taken, for example, if he or she is worried about weight gain, a therapist has to be consulted to explain to her about the implications of an anorexic lifestyle. Other preventive measures involve nutrition. An individual with anorexia has to have a good supply of food with vital nutrients to reduce symptoms of the disorder or prevent reoccurrence. Cross Cultural Views Previously, eating disorders including anorexia were regarded as western culture bound disorders. Nevertheless, this disorder has been increasing in non-western countries, which has shifted the focus of publications in the non-western population in regard to the disorder. Populations from non-western cultures have lower prevalence rates as compared to western cultures, but this prevalence rate in non-western cultures seems to be on rise. This shows that people are well aware of the implication of the disorder in western cultures with little attention shown by non-western cultures. For example, studies have been conducted in African-American cultures in western countries, but the results cannot be used in non-western cultures (Rieger et al. 2001, p. 209). Rieger et al (2001) state that differences exist in the view of anorexia with regard to weight concern (p. 213). The author shows that while western cultures focus more on fat-phobia or the fear of being fat, in non-western cultures fat-phobia is not common. Development of anorexia in non-western cultures is attributed to the adoption of western cultures where thinness is valued more. Biblical Worldview As earlier stated, Anorexia Nervosa is not transmitted like others disease but is individually driven. According to the Bible, the disorder is just like any other sinful event such as consumption of alcohol. In order to solve the problem, individuals with the disorder are advised to meet the counsellors so as to break away from the behaviour. Individual are advised to be discipline and have a good relationship with Jesus Christ. They are also encouraged to adopt God’s methods of solving problems. Some of the behaviours regarded as sinful and mainly common in patients with anorexia include self-starvation, manipulation of weight, use of diet pills and other related behaviours. Such habits are viewed as sinful and Christians are advised to avoid practicing. In 1 Corinthians 6: 19-20 (King James Version), the bible stresses that our body is a holy place of holy spirits that lives in us and we have it from God, therefore, our body does not belong to us. God bought us with a high price and we must pay tribute to God with our body. This shows that we must take good care of our body for it has high value and avoid having negative view of our body (Clinton, 2001, p. 69). Conclusion Based on the analysis above, it is clear that the disorder has the highest prevalence rate among women and girls between the age of 12 and 19. From research, it is noted that the disorder is individually driven unlike other disorders that can be spread from one person to another. Studies show that the disorder was marginalised in the previous century despite its existence for a long time. Genes has been associated with the development of disorder. Additionally, inactiveness of serotonin and dopamine is the cause of the disorder. Treatment of the disorder is emphasised more on weight gain and improvement of dietary intake. The disorder can be prevented by identifying some of the root causes of the disorder such as food abstinence and other related features. Studies shows that cross cultural views of the disorder differ, with the western culture emphasising more on the disorder. Additionally, the disorder is currently on the rise in non-western cultures. The bible seems to recognise anorexia as inappropriate for individual and the society, an observation based on a scripture in the Bible that encourages Christians to take good care of their bodies. References Attia, E. and Walsh, B. T. (2007). Treatment in Psychiatry. Am J Psychiatry Vol. 164(12). Pp 1805-1810. Clinton, T. (2001). The Bible for Hope: Experiencing and Sharing Hope Gods Way. Tennessee: Thomas Nelson Inc. Fairburn C. G. and Brownell, K. D. (2005). Eating Disorders and Obesity: A Comprehensive Handbook. New York: Guilford Press. Focker, M., Knoll, S.and Hebebrand, J. (2013). Anorexia Nervosa. European Child and Adolescent Psychiatry, Vol. 22(1). Pp. 29-35. Greenblatt, M. J. (2010). Answers to Anorexia: A Breakthrough Nutritional Treatment That Is Saving Lives. New York: Sunrise River Press. Rieger, E., Touyz, W. S., Swain, T. and Beumont, P. J. V. (2001). Cross-Cultural Research on Anorexia Nervosa: Assumptions Regarding the Role of Body Weight. Int J Eat Disord Vol. 29. Pp. 205–215. Scherag, S., Hebebrand, J. and Hinney, A. Eating Disorders: The Current Status of Molecular Genetic Research. Eur Child Adolesc Psychiatry, Vol. 19. Pp. 211–226. Read More