Anorexia Essay, Research Paper

It seemed to me that the older I got, the more obsessed people seemed about their

bodies. Whether it was the diet soda boom of the 80’s, or the fact everyone has always

been unhappy with his or her natural bodies; it just took me a while to comprehend. It always seemed like there were diets here, diets there; these drugs can do this, or

these herbs can do that? “Stop the insanity!” This paper is going to discuss anorexia nervosa, an alarming disease that is usually developed during puberty of both boys and girls. Like bulimia, in which the subject binges and then disposes of ingested food by purging or use of laxatives, those suffering anorexia nervosa have an obsession with the amount

of fat on her body (although one of every ten suffering this disease are male, I

will use the female pronoun since they are the majority). This results in the

loss of appetite completely and dangerous weight loss. More than thirty years

ago one of this century’s major sex symbols sang, “Happy Birthday, Mr.

President,” on television. With her size fourteen to sixteen figure, it is doubtful

that society’s standards would approve Marilyn Monroe today. Back in those

days men and women alike ate what tasted good or what the body needed

and simply bought clothes that would hide any unwanted weight gain. Today

the story is different. Psychologists that study the influence of television on

children say that television is the most influential medium in our “visually

orientated” society (Velette, 1988, p.3). With the influence of television and

celebrity role models, children don’t care that they see a variety of sizes

outside of their home, what they care about are the majority of people shown

on the television set, perfect. Teenagers have typically watched 15,000 hours

of television in their lifetime (Valette, 1988, p.4), absorbing the opinions on

the shows or the commercials burning into their retinas. The message

transmitted: “To be successful, beautiful, popular, and loved you must be thin,

you must be thin, you must be THIN.” After a lifetime of hearing this message

over and over and over again, children may not think there is any reason to

be happy with what they are and feel thinness is the ultimate goal to be happy

and accepted by others. As a result, some children may skip breakfast, eat a

little for lunch, or even adopt some form of diet. This may only last for a

week or so, but for others, the obsession of thinness is higher and the price

they pay is frightening. This paper is going to discuss the cycles of anorexia

nervosa. It will detail the symptoms, behavior, and clinical observations. It

will describe the possible causes of anorexia nervosa through childhood

growth and puberty, childhood eating and social behavior, and the maturation

of children during puberty. Finally, I will discuss the treatment and results of

treatment for anorexia nervosa. Before diving into the details of anorexia

nervosa, there are a few individual traits that may appear in a person that may

have an eating disorder: low self-esteem, feelings of ineffectiveness or

perfectionism, issues of control, and fear of maturation. The more physical

description is chilling. The anorectic victim does not look “thin” as society’s

standards portray, but are in fact a walking skeleton with the absence of

subcutaneous fat. Her weight may range from as little as 56-70 pounds or

77-91 pounds. Though clothes are likely to cover most of her figure, her face

appears gaunt and her skin is cold and red or blue in color. Do to the lack of

fat in her body, her menstrual cycle is likely to have ceased. Despite these

conditions, she still sees herself overweight and thus unacceptable. Thinness is

idealism and perfection. It is her independent choice that no one else can take

away from her. At the beginning of anorexia nervosa the subject will first

change her diet, restricting how much she eats and usually cutting out starchy

foods. Seventy-percent of a particular study claimed they were simply

dieting. The rest used excuses of abdominal pain, difficulty swallowing, or

simply a lack of appetite (Dally, 1979, p.14). Those dieting had innocent

intentions at first, even the approval of family members or peers, but as they

reached their target weight the dieting did not slow down. In some cases it

only became more intense. Hunger does not just disappear into thin air. There

is a long and hard battle against stomach pains, sometimes resulting in lapses.

However, the guilt or disgust felt from giving into the temptation of food

results in more willpower for resisting food in the future. The process of

eliminating hunger usually takes up to a year (Dally, 1979, p.14). Sometimes

hunger cannot be ignored. The girl will think about food all day long as if in

pleasure. Ritualistically, she’ll eat very slowly, savoring each bite of food that

is cut into small pieces. She will insist on cooking food for herself and

sometimes preferring to eat only alone, where she can enjoy her food without

feeling self-conscious. Another approach towards hunger is indirect

satisfaction by reading cookbooks, reading about healthy foods and ways to

eat, cooking for others, or just watching others eat. Though an anorectic

avoids fattening foods by all costs, oddly they enjoy cooking fattening feasts

for family members to enjoy and are even offended if any food is not eaten. A

majority of anorectic patients are above average in intelligence, physically

attractive, and of the upper class. They have low self-esteems and strive for

perfection. The family they come from usually tends to be weight-conscious,

such as a mother that is always on diet plans, and somewhat controlling over

the daughter’s life. Although there are two types of anorexia nervosa, primary

and secondary, primary anorexia nervosa is the most common, and the type

being discussed in this paper. Secondary anorexia nervosa is developed

adults of average intelligence and of middle or lower class. Primary anorexia

nervosa is developed during puberty between the ages of 11 and 18 and

usually by females. Only one of every 10 anorexia nervosa patients are male.

Childhood is a very sensitive time period for all human beings. The brain is

developing while the body grows. Morals and knowledge are being absorbed

by daily activity and outside influences. It is this time that a danger zone may

develop, negative behaviors are adapted and cannot be stopped. There is no

overall difference between the childhood growth of a normal child or the

childhood growth of an anorectic. Most likely they were skinny but had a

high fatness and height growth rate before their peers. As a result, during

puberty the subject may be more sensitive about her appearance. Recalling

past experiences from anorectic patients is difficult because these patients

already have an exaggerated perspective of themselves and are likely to

exaggerate what they went through as children. Through the careful

recollection of families, however, a more likely picture of a

soon-to-be-anorectic child can be drawn. As a child, anorectics are

described as tomboys that shared interests with her father such as sports and

watching football. They are described as obedient children that never wanted

to grow up (Crisp, 1980, p.48). Maturation in puberty develops anxiety in

most girls. The first step for females in puberty is the development of breasts,

leading to embarrassment and the feeling of “fatness”. Other changes happen

that are very undesired such as the thickening of the stomach and thighs and

menstruation. Girls tend to take these natural changes as changes happening

to them instead of a natural process that happens to all females. They develop

distorted images of their bodies, such as a little potbelly as looking pregnant,

or breasts that are bigger than those of their mothers. Some of these girls get

over these self-conscious thoughts while others become obsessively

preoccupied. The first step of treatment for anorexia nervosa is for family

members or loved ones to step in and take her to get serious help. Most

doctors and psychologists suggest that the subject be separated from her

family. A family or an inexperienced therapist may allow the anorectic to

promise and thus procrastinate the process of healing, resulting in no real

physical or mental healing (Dally, 1979, p.106). After being admitted into

treatment starts the difficult process of healing involving psychiatrists,

physicians, nurses, and dieticians. The first goal of treatment is to determine a

target weight for the patient by figuring out the average height and weight of

their age set and to reach approximately 90% of that ideal weight. The

reasons it is important to gain back the weight before psychological treatment

is because anorexia nervosa brings a halt to physical and psychological

maturation as well as emotional development when it is most important. There

are two major ways in which therapists approach feeding. The more passive

technique is to give the patient the food she must eat but allowing her to

consume it at her own pace. The side effects of this is that lack of patience a

nurse may cause some disturbance and frustration, for sometimes the subject

may not even finish her meal before it is time for her next one. The second

approach is much more aggressive. In this approach, tube feeding is forced if

the patient refuses to eat, resulting in much more rapid weight gain. In both

techniques, the more the patient cooperates and recovers, the more freedom

and visitors they are permitted. However, when a patient is difficult, she will

be restrained to her bed and tube fed until she eats regularly. The next step is

cognitive treatment, also known as the “Interview”. In this step the therapist

can really build a case on the patient and listen to her story. Questions will be

asked about what she thinks of her body, usually with negative results. On the

other hand, when asked about another anorectic with the same weight and

height, the subject studied will comment on how she is too thin. She will also

be asked questions such as, “What worst thing that could happen if you ate

more?” Questions like these may bring a reality into the anorectic’s mind after

similar questions are brought up to think about (Long, 1992). Once both

weight and clear thinking is resolved, the patient is ready to return home. Like

alcoholics and other substance abusers, once freedom is allowed, chances of

relapse are possible. The therapist must make sure the patient is

self-disciplined with lifetime goals by resolving any emotional conflicts that

may lead the patient back to her previous lifestyle for satisfaction. It is also

important for the family of the anorectic to attend family therapy as well, to

get over being too protective or in denial of any conflicts and to approach the

problem of their daughter or son in a different fashion. The support of peers

and family are very important for the anorectic so not to return to the

self-satisfying lifestyle of pursuing a “perfect” weight. Anorexia nervosa is a

frightening disease for the families and for society to deal with. As social

animals, the signals sent out by the people around us and the media tell us that

if we want to be happy, successful, or loved we need to be thin and beautiful.

When we were children our mom would be talking on the phone to a friend,

“I think Jennifer could date Mike easily if she just lost 15 pounds.” Almost

every female is envious of another and unhappy with the body that she is

blessed to have. Being skinny has been pounded into our minds since the day

we develop self-esteem by those depicted on television and the natural need

to feel desired or accepted by others. When I was in high school I was

always self-conscious about how others viewed my physical appearance. I

would compare my body to that of other girls in the class. I went on varying

diets, from eating healthier food to crash diets. It was a ridiculous mindset

when I look back upon it. It wasn’t until my last year of high school that I

decided that I was happy with my appearance and did not need to be

preoccupied by what others thought of me or what the media told me I

should be. What was frightening to me was learning in health class about

anorexia and bulimia and in the back of my mind thinking of those ruinous

lifestyles as future alternatives. Afterwards, I thought about how many other

girls in that class, or that has seen that video, were thinking the same thing and

possibly acting upon these thoughts. What can parents and peers do about

this problem? With 1 out of every 500 teenage girls suffering this disease, I

believe parents and teachers should be educated about the subject, this way

as soon as symptoms become apparent, intervention occurs before major

growing or developing problems may occur. We cannot change society’s

general view of what perfection is, or expect influences to consider what it

has done to the self-esteem of our children. However, we can influence the

way our children view weight and physical appearance by teaching them how

to accept who they are. This may be accomplished by explaining the natural

changes in their bodies during puberty and offering healthy approaches

towards building self-confidence such as activities that do not revolve around

physical ability or appearance. Children cannot help but absorb the world

around them, it is our duty as adults to help them filter out what may lead to

self-destruction.

References

Banks, Tyra. (1998). Tyra’s beauty: inside and out. New York.

Harper Pernnial.

Berk, Laura E. (1997). Child development. Boston. Allen

and Bacon.

Crisp, A.H. (1980). Anorexia nervosa: let me be. London.

Academic Press Inc.

Dally, Peter and Gomez, Joan. (1979). Anorexia

nervosa. London. William Heinemann Medical Books Ltd.

Long, Phillip W. (1997). Eating disorders. Harvard Mental Health Letter, 9. 47 paragraphs.

[Online]. Available at http://www.mentalhealth.com/mag1/p5h-et03.html

[1999, March 1].

Valette, Brett. (1988). A parent’s guide to eating

disorders. New York. Walker