Abstract
Anorexia nervosa among the eating disorders which is considered in the psychiatric illness. There are categories that have been advanced in the diagnosis of this illness. This paper has critically examined the various research findings related to this disorder, various interventions that are common in treatments of the illness, prevention strategies, its historical backgrounds, cross cultural issues concerning the disorder as well as theological/Christians perspectives concerning the illness.
Introduction
Anorexia nervosa is a type of eating disorder which entails someone eating less food or rather, an individual starving him/herself. Most of the people who suffer from this disorder are the individuals who are all the time more obsessed with becoming thinner thus they limits their food intake in a way that put their health into a compromising situation (Woodside et al, 2001).
In the recent years, it has been put in the category of psychiatric disorder especially in the DSM IV. People with this disorder are considered irrational since they usually have inexorable pursuit of losing more weight irrespective of how much their health is compromised.
Description
To recognize how the disorder begins is not that easy. In many cases, the trigger for Anorexia Nervosa is dieting; which is a person’s step towards developing it. Future signs of developing anorexia starts when someone begins omitting meals and in some cases, taking only little portions. In many case, females looks for justifications for not eating such as pretending they are ill, explaining that they are not feeling hungry, having eaten somewhere else as well as disliking the foods they have been served among others (Newmark-Sztainer, 2005).
Diagnosis for Anorexia Nervosa
Diagnosis of the eating disorder at times does changes.
- Physical assessment. A thorough physical examination for the disorder starts with assessing the weight as well as the blood pressure of an individual. The examiner moves through various signs that are known to portray its existence. Physicians may request for laboratory tests which consist of complete blood test, blood chemistries, tests that examines the functions of the liver and urinalysis. In many cases, this diagnosis is carried out when one fail to keep the weight of the body at a normal weight. Many physicians contend that weight loss of more than 85 percent is an indicator that one has the disorder (Woodside et al, 2001).
- The second criteria evaluates whether an individual has deep fear of the gaining more weight, becoming an obese despite them being underweight.fat phobia is more common among the female population and especially among the anorexia cases. By making use of Eating Disorder Inventory, it is possible to measure fat phobia in anorexia patients. The inventory comprises of 64 items that helps in assessing symptomatology of cognitive behavioral which is construed to be the principal factor in most eating disorders.
- The fourth criteria entail distortion of body image. People do in many times carry out self-evaluation concerning their body weights. Some of them go on denial when they find out that they have significantly lost weight.
- If there is nonappearance of three successive menstrual cycles, which is known as amenorrhea, then it means that an individual suffers from the disorder.
Research work on anorexia nervosa
Researchers have found out that anorexia nervosa is a complex disorder as opposed to what many people might construe as a desire to be slim in the quest for beauty. After gathering much data, researchers have been able to find a correlation between genetic component and the disease. International group of researchers have been carrying out various studies to identify the functions genes in anorexia nervosa. The driving force for the research was the fact that pressures that faces societies makes many young people develop eating disorder such as anorexia. Researchers have demonstrated that social pressure is not the only contributing factor to the development of anorexia nervosa. According to Bulik (2005), genes play a very significant role in determining the vulnerability of people to develop anorexia nervosa. They also agree that societal pressures cannot be relegated since it may be the one that could be acting as environmental triggers individual’s genetic vulnerability.
Surprisingly, this disorder is potentially lethal and it has been found to have a mortality rate of close to ten percent. The features of the illness include emaciation, pursuit of thin bodies, as well as fear of becoming an obese. This illness mostly begins during adolescence period and then continues for a long time. Anorexia is more frequent in women than men. It also greatly affects people with particular personality traits such as perfectionism, obsession as well as those who often suffer from anxiety. Studies have shown that among the mental illnesses, anorexia nervosa records the highest rates of death. Ironically, people do not divert greater portion of funds towards curing it (Kaye 2005).
Researchers have found that due to psychological factors, some people with particular personality types are more susceptible to develop anorexia nervosa. For instance, most of those individuals who tend to be perfectionists are in many cases concerned on the ideals of their image. In the verge of keeping fit they develop this disorder.
Historical context of Anorexia nervosa
Anorexia nervosa is presently considered to present significant clinical difficulties especially in the western world. This disorders frequency has continued to rise throughout the centuries. The disorder is now present ant an alarming rate such that scholars cannot ignore it anymore.
Various surveys that explored historical background of anorexia nervosa have established that the syndromes and symptoms of this disorder which might be considered as a self-starvation has been in existence for a long period of time. The modern epidemic of the disorder has also affected many young people especially women in the verge of retaining thin bodies which are construed to be an ideal body.
For many years, western cultures have been known to hold beliefs as well as norms that adore thin bodies. This has been among the motivating factors for self-starvation which lead to the development of anorexia. There are different eras in which this has occurred:
The classical period and the Gnostic Asceticism
In the classical period, self-starvation was not a common phenomenon. During the roman period, the idea of self starvation was non-existent. Description of extreme behaviors that was associated to self starvation as well as fasting in the European cultures begun as an influence from the Eastern religion. The eastern religions at that time started preaching a combination of the material world, perceived senses of the world sacred realities as well as matters concerning the body. They upheld the idea of beauty as demonstrated by how they praised the daughter of the king of Portugal at that time (Kaye, 2005).
Late middle ages, the renaissance and the period of Holy Anorexia
At around 13th century, self starvation was very common in the southern Europe. Among some cities such as Genoa and Venice, social classes were highly upheld aesthetic values and arts. Among the portraits that were those that portrayed a thin woman as an ideal beauty. During that time, women began to be allowed greater freedom that made them rebel against conventional roles and began to become preoccupied with external appearance and beauty.
Between the renaissance and Victorian period
At the end of the renaissance freedom of women was curtailed especially during the reformation whereby the protestant valued sought to return women to their customary roles. However, even though there was a critical decline of the rate of anorexic demeanor, self starvation on the grounds of religious asceticism in the seventeenth century. In 18th century, self starvation especially among the young women was shifted from religious or rather theological connotation to medical sphere as well as towards physical illness perception and later to mental disorder. It is during this period that the anorexia gained popularity as a medical disorder.
Victorian Period- 19th Century
Due to increase in education increased knowledge concerning this disorder. It was a time when aesthetic values were highly refined and advanced research was highly appreciated. During this period, voluntary self starvation was considered to be a case that required medical attention.
20th century
It is during the 20th century that anorexia nervosa has gained increased popularity. Extensive research has taken place during this period. Several approaches to eating disorder have been established. The two basic ones are, psychogenic and the organic approach. Psychogenic conceptualization has taken the perspective of the psychoanalytic explanation where it is taken as a defense for unconscious sexual wishes. Organic approach contends that people suffering from anorexia nervosa may result to damaged pituitary glands.
Cross cultural issues
Anorexia nervosa can be adequately understood in the framework of culture bound disorders. A study carried out in 2000 clearly indicated a correlation between culture, ethnicity and the eating disorders. It has been shown that majority of those who suffer from this disorder are from western cultures as well as Caucasians. Among the Japanese, women who are overweight are not construed to be beautiful. This significantly affects their eating habits and they are preoccupied in cutting weights in order to maintain what they construe as the ideal body image. Japanese values are similar to those of the western countries which include valuing thin body as a sign of women’s attractiveness (Kaye, 2005).
A study carried out on Asian girls in Britain revealed that their culture upheld thin bodies as a sign of beauty. The motivation for that research was the fact that majority of them were suffering from anorexia nervosa. The research findings showed that the girls were struggling with identity issue since they grew up in two types of cultural values. Asian families adopt a rigid structure which seems to uphold thin bodies ideals. This made the young girls to feel inclined to keeping their bodies slim in order to fit in.
Eating disorder is also common within Arabic culture. As opposed to this, the Egyptian society and the British society do not over value thin bodies. In those societies, plump bodies are highly regarded. Cultural eating habits, attitudes and perception in a significant way contribute to the development of anorexia nervosa. Research has shown that such disorders are common in upper social class and especially in highly industrialized countries. In many non-western countries, plumpness had been considered to be the ideal for the weight of the body until recently (Woodside et al 2001).
Treatments for Anorexia Nervosa
Psychosocial intervention
There are several psychosocial approaches that immensely contribute to the treatment of anorexia nervosa. This includes cognitive behavioral therapy and family therapy. Psychosocial issues as well as dysfunctions in the families which may be among the factors that contribute to the development of anorexia are tackled in these two methods in order to treat the patients.
Cognitive behavioral therapy (CBT)
CBT is one of the best methods that have shown positive results in treating anorexia as well as other disorders. Through various statistical and clinical trials, the method has proven to be the best in the treatment of anorexia. It focuses on changing the negative thoughts that individuals withhold towards foods and encouraging people to embrace effective thinking as a proactive solution. In this kind of treatment, the patient must show willingness to receive the treatment for it to bear fruits. CBT usually modifies irrational beliefs and perceptions concerning the fear of weight gain.
This approach contends that modification of patients thought concerning their eating pattern and the idea of beauty which compromises their health, the patient can be able to come out of their unwarranted behaviors since they would now be in a position to recognize the triggers and then replacing them with more rational thoughts. The benefits of this method are that it shows high success rates compared to other treatments and it is simple to put to effect.
Family therapy
Family and couple therapy is also treatment approaches aimed at elevating the rates of anorexia. They focus on. The benefit of these methods is that they help individuals understanding the framework in which anorexia disorder arises. With such understanding, patients together with the members of the family are able to mobilize resources which are essential to help the patient overcome the illness.
Pharmacological interventions
This is the approach whereby medical interventions are used in the treatment. Medication such as giving antidepressants is used in curing people with anorexia nervosa. The benefit of medical interventions is that they lessen the pressing physical problems that relates to anorexia nervosa.
Combined interventions
This mode of treatment combines pharmacological and psychological interventions in the treatment of the patients. According to (Bulik, 2005), there are significant benefits that arise due to combinations of both psychotherapy and antidepressants in the treatment of anorexia nervosa. Such benefits include reducing remission rates, lessening the symptoms for the moods as well as encouraging the patient to eat appropriately.
Prevention
To prevent this disorder from occurring, a healthy and nurturing family environment at its initial stages is very important. It is very important for individuals to seek early treatment once they recognize some signs of the illness. This does prevents further progression of the disorder. There are various ways in which anorexia nervosa can be prevented.
It is very important for parents to avoid being obsessed with their weights as well as appearance especially at the present of their children so that they don’t inculcate the standards of ideal weight and appearance to their children. It is also important to avoid teasing children concerning their body shapes, size or even comparing them with other children. Such behavior would set standards for weight and children might refuse to eat in the name of maintaining the ideal beauty. Parents should also love their children equally and accept them the way they are. It is important to avoid putting children on diet without any good reason such as an advice from physicians. People should seek professional help whenever they realize they have developed eating disorders.
Christians’ perspectives concerning Anorexia nervosa
There has been empirical literature concerning religion and development of eating disorders. There is a multifaceted relation between religious faith and eating disorders.
Christians’ perspectives concerning the causes
According to Christians, this illness just many other illnesses are caused by the devil. Christians believes that sometimes illnesses arise as a result of falling in the traps of Satan (Lewis, 2001).
Treatment- a Christian perspective
Christians and especially the religious leaders argue that it is indispensable to include spiritual healing in the treatment of anorexia nervosa. Christians argued that God infuse everything. Colossians chapter one verse seventeen contends that in God all things hold together. They also look at Gods having created the universe in His own image. From this point of view, they believe that since human are spiritual beings are spiritual beings; they need particular ways of curing them. It is therefore very vital to note that spirituality is basic in the healthcare of the Christians. Many Christians do advocate the blending of psychotherapy with the spiritual healing as part of the treatment of people with maladaptive behavior. Christians believe that church support groups and prayers usually allow tolerance of painful feeling caused by an ailment. Christians believe that God’s love is unconditional and irrevocable and he is the one who heals (Wall & Eberly 2002).
Prevention of anorexia according to Christians
Christians are very unresponsive concerning prevention of anorexia nervosa. The reason for that being that they construe the disease as a fight against denial and fasting.
Conclusion
Anorexia nervosa is among the eating disorders that disorder that is highly harmful. It results from individuals’ quest to cut of weight as well as the fear for gaining more weight especially in the quest for keeping the body thin for aesthetic values. The disorder has been found to cause many deaths among many individuals.
Christians embrace a different standing point concerning the disorder as compared to the non- Christians. Research has shown that anorexia may not only be caused by societal pressure only but also genetically induced. Various interventions are embraced in the treatment of this disorder.
References
Bulik C.M., (2005). Exploring the gene-environment nexus in eating disorders. Journal of Psychiatry & Neuroscience. 30(5),335-9.
Kaye W.H., (2005). Serotonin alterations in anorexia and bulimia nervosa: new insights from imaging studies. Physiology & Behavior. 85(1), 73- 81.
Lewis, C.S., (2001). The Weight of Glory. San Francisco: Harper San Francisco.
Polivy, J., & Herman, C. P., (2002). Causes of eating disorders. Annual Review of Psychology, 53, 187–213.
Newmark-Sztainer, D., (2005). I’m, Like, SO Fat!: Helping Your Teen Make Healthy Choices About Eating and Exercise in a Weight-Obsessed World. New York, NY: TheGuilford Press.
Wall, A.D. & Eberly, M. (2002). Five Biblical factors in eating disorder development. The Remuda Review: The Christian Journal of Eating Disorders, 1, 6-10.
Woodside, B. Det al (2001). Comparisons of men with full or partial eating disorders, men without eating disorders, and women with eating disorders in the community. American Journal of Psychiatry, 158, 570–574.