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Self-Image: Anerexia Nervosa
Anorexia nervosa is a potentially life-threatening eating disorder characterized by a lack of self-esteem, an intense fear of becoming obese, and self-induced starvation due to a distorted body image (Durham, 1991). Anorexia can occur later in life, but it is most common in girls between the ages of fourteen and eighteen. According to the Center for Change, recent estimates suggest that 1% of Americans within this age range will, to some degree, develop anorexia and 10-20% will eventually die from related complications.
I have experienced this deteriorating disease from a bystander’s point of view. After making a pact with my friends to get physically fit for the summer, the four of us exercised and dieted daily for nearly four months. I never thought that this effort to become healthy (or just look good in our bikinis) would have such dire consequences. While everyone ended this exhaustive diet plan, one of my friends became obsessed with her body image and without our knowledge, gradually developed the eating disorder anorexia nervosa. She went unnoticed for several months because she masterfully disguised her eating habits by consuming large quantities of fruit, vegetables, and salads in our presence while secretly fasting at home. Moreover, in spite of her attitude toward eating, she took an avid interest in buying and preparing food for us. Looking back, I think that we were all anorexic to some degree. Personally, I was 16 years old, 5’7 and only weighed about 105 pounds. If I had lost a couple more pounds, I would have been 25% below my normal body weight, which would be enough to also diagnose me with anorexia nervosa (Shaw, 2002).
The majority of people who suffer from anorexia begin, as we did, with an innocent diet that gradually progressed to extreme and unhealthy weight loss (Shaw, 2002). Unlike normal dieting which stops when the desired weight is reached, people who become anorexic atribute positive feelings to their ability to control their weight and become dangerously preoccupied with food and fear weight gain. Research suggests that stringent dieting can play a key role in triggering eating disorders. Adolescent and young adult women are more vulnerable to these disorders due to their tendency to go on strict diets in order to achieve an “ideal” figure (Lehrman, 1987).
Even thought the cause of anorexia nervosa is not known several different studies suggest that social attitudes toward body appearance, family influences, genetics, and developmental factors are possible contributors to anorexia (Selzman, 1999).
Because eating disorders tend to run in families, adolescents who develop anorexia are more likely to come from families with a history of weight problems, physical illness, and mental health problems, such as depression or substance abuse (JAMA, 1998). According to Dr. Ira Sacher, parents who are overly concerned with their weight and physical appearance may put their children at increased risk of developing anorexia.
Given the value society places on being thin, it is not surprising that eating disorders are on the rise (Lague, 1993). Everywhere we look in society, on magazine covers, television, and colossal billboard advertisements, illustrations of being thin are associated with happiness, success, beauty and sexual appeal. Research conducted by Dr. Nicole Hawkins examining the effects exposure to the thin-ideal image portrayed in the media had on women’s body satisfaction and self-esteem concluded that: brief exposure (30 minutes) to thin images produced heightened levels of body dissatisfaction, F (1, 143) = 44.76, p<.001, and negative mood states (i.e. depression and anger), F (1,143) = 22.79, p<.001 as compared to women who viewed neutral images. In contrast, society it taught to hate fat and associates heavier individuals with negative attributes such as laziness and stupidity (Durham, 1991).
If not treated immediately, anorexia nervosa can cause severe and irreversible damage to the body (Shaw, 2002). Extreem food restrictions cause the body to break- down and cease to function properly. Medical complications associated with anorexia include: life threatening cardiovascular problems like arrhythmnia, bradycardia and hypotentions; blood problems like thrombocytopenia (low platelet count) and leucopenia (low white blood cell count); intestinal problems; kidney dysfunctions like polyuria; and skeletal problems that put people at greater risk of fractures, tooth decay and tissue and bone loss (Shaw, 2002). Persons with anorexia can also suffer psychological problems like insomnia, hyperactivity, low self-esteem, fatigue and depression. It is estimated that 30% of anorexics will either die from the above complications or commit suicide as a result of the emotional turmoil.
Administered by a team of doctors, psychiatrists and social workers, treatment for anorexia nervosa usually consists of nutritional therapy, individual psychotherapy, and family counseling (Russesl et.al, 1993). While some physicians prefer to work with the patients in a safe and secure family setting, others feel that until the patient is nutritionally stable, hospitalization is necessary. The goal of such treatment is to get the patient to eat and gain weight, which is accomplished by gradually adding calories to the patient’s daily intake. Individual psychotherapy is also required in the treatment of anorexia nervosa (People Weekly, 2001). This therapy often focuses on the patient’s relationships with family and friends as well as understanding the disease and its long-term effects. Hopefully, when patients learn more about themselves and their condition, they will be more motivated to recover. Unfortunately, when treating anorexia nervosa, it is important to realize that success does not guarantee a permanent cure. Treatment can be extremely difficult, especially when the person finds self-identity and a sense of purpose in the disease. According to the British Journal of Psychiatry, patients from well-functioning families or those with precipitating life events improved more in the first year than those with dysfunctional families or without events. Healthy family functioning and presence of a precipitating life event predict good short-term outcome.
Anorexia nervosa is an eating disorder in which people intentionally starve themselves. People with anorexia commonly have low self-esteem and feelings of helplessness, and they commonly starve themselves in order to gain a sense of control in their lives. Fortunately, anorexia is curable, but there is an increased risk of medical complications like bradycardia and bone loss. No one knows exactly what causes anorexia; however, current research suggests that genetic and environmental influences contribute to the disorder ( JAMA, 1998).