Adolescent Eating Disorders

With children as early as age 7 showing dissatisfaction with their body, and as young as 9 starting dieting, eating disorders are a serious issue in our society. Taking a look at perceptions, behaviors, and medical issues associated with the disorders of anorexia and bulimia, scholars have tried to categorize and find answers to the problems which certain adolescents suffer. In this paper I focused on the two major eating disorders of anorexia and bulimia.
In 1978, Brunch called anorexia nervosa a “new disease” and noted that the condition seemed to overtake “the daughters of the well-to-do, educated and successful families.” Today it is acknowledged and accepted that anorexia affects more than just one gender or socio-economic class; however, much of the current research is focused on the female gender. “Anorexia nervosa is characterized by extreme dieting, intense fear of gaining weight, and obsessive exercising. The weight loss eventually produces a variety of physical symptoms associated with starvation: sleep disturbance, cessation of menstruation, insensitivity to pain, loss of hair on the head, low blood pressure, a variety of cardiovascular problems and reduced body temperature. Between 10% and 15% of anorexics literally starve themselves to death; others die because of some type of cardiovascular dysfunction (Bee and Boyd, 2001).”
Bulimia nervosa is a slightly less serious version of anorexia, but can lead to some of the same horrible results. Bulimia involves an intense concern about weight (which is generally inaccurate) combined with frequent cycles of binge eating followed by purging, through self-induced vomiting, unwarranted use of laxatives, or excessive exercising. Most bulimics are of normal body weight, but they are preoccupied with their weight, feel extreme shame about their abnormal behavior, and often experience significant depression. The occurrence of bulimia has increased in many Western countries over the past few decades. Numbers are difficult to establish due to the shame of reporting incidences to health care providers (Bee and Boyd, 2001).

Many scholars have employed a variety of research methodology to try and answer the questions of: Why do some adolescents resort to extreme measures to resolve their problems? What can be done to improve the current state of the situation? The literature base on this topic seems endless. Some believe that these eating disorders are a result of society; others believe it is a result of parents, while still others believe it is an internal chemical balance. The list goes on and on. The truth is that it is not known why the disorder begins or what each individual experiences while consumed with these disorders, but we do know that recovery is possible. A supportive friend and family base, along with education in early childhood seems to be a logical step in the right direction.
The inaccurate obsession with food seems to be the cause of bulimia; however, the inaccurate obsession with weight seems to be the cause of anorexia. A majority of research suggest that the media is responsible for this, due to the fact they idolize the thin, slender figure. For bulimics, the delight of binging comes at the cost of extreme guilt which can only be resolved by purging; a never ending cycle. For anorexics, these thin messages on the media can make them feel shameful and hate to look at their own body, which makes food the sworn enemy. In one research article it was proposed that individuals with an external locus of control (believing that their lives are determined by outside forces such as fate and other people) were found to exhibit more of the bulimic and anorexic traits than those individuals who had an internal locus of control (believing that one controls his/her own fate) (Fouts and Vaughn, 2002).

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There are two sides to the issues of participating in sports. Some individuals who participate in sports find a need to lose weight and develop unhealthy ways of dealing with weight issues. “The Committee on Sports Medicine Fitness reported that thinness or “making weight” is perceived to be important in sports such as bodybuilding, cheerleading, dancing, distance running, diving, figure skating, gymnastics, horse racing, rowing, swimming, weight-class football, and wrestling. Athletes in these sports often partake in dangerous practices such as over-exercising, prolonged fasting, vomiting, and the abuse of licit or illicit drugs such as laxatives, diuretics, steroids, or diet pills. For these reasons, the American Academy of Pediatrics has urged pediatricians to identify young athletes at risk of eating disorders and to offer support concerning nutritional behavior (Muise et. al, 2003).

On the other side of the issues is that involvement in sports is also a chance to improve body image and self-esteem which would keep a person from developing improper self-image. “The most common source of physical activity for adolescents is related to their activities during the day, particularly in relationship to school, either through walking or biking to get there, through scheduled physical education classes, or from organized activities at school (Elkins et. al, 2003).” Those individuals who participate in sports make life-long friends and learn key concepts of team-work. This seems to also play into the self-image concept which helps adolescents to stay healthy and deal with the issues in a healthy manner. My personal opinion on the subject is that school sports are essential to a healthy, active life-style. Now, while I may not have a true athletic bone in my body, I was very active in the band. As I look back now, I can see that those band practices from 5:00 in the morning or till 9:00 in the evening were really keeping me from sitting at home in front of the television. Not to mention that my fellow band members were the ones who I ate almost all my meals with. Luckily I can say that we were a team and we would never let anyone in our group do something like that to themselves.
Moving on, another interesting perception that has been vehemently protested by some is the fact that this is a disease which only girls suffer from. In reality about 5% of all anorexic and bulimics are boys. Some research has even suggested that “there is a greater tendency for males with anorexia and bulimia to declare a homosexual or bisexual orientation compared with females. (Muise et. al, 2003).” Reality is that a well-designed prospective study that follows boys into adulthood and that continually surveys not only eating behaviors but emerging sexual orientation and types of peer group involvement to determine whether a link between eating disorders and homosexuality in adolescent boys truly exist still needs to be done (Muise et. al, 2003). It is fairly easy for me to see how a homosexual male would feel the pressures a female would feel with concerns about weight, I mean, after all, they are both trying to attract a man, and the media lets us believe that the ideal is thin and tall; however, I think more research in this area is necessary in order to draw that correlation.

What could be causing bulimia? Some believe that eating disorders are caused by a chemical imbalance in the victim’s brain. Everyone has a chemical in their brain called serotonin. This is what controls your appetite. In bulimia patients, this chemical is deficient and so they keep eating and eating. At that point they feel guilty and have the urge to dispose of the consumed food either by vomiting or having a bowel movement promptly after eating. Subsequently, after a period of time a chemical called vasopressin takes over, making the disposal of food the norm.
The opposite occurs in anorexia patients. The nor-epinephrine chemical in their brain is deficient. Nor-epinephrine is the appetite stimulant. In the advanced cases of anorexics, they have no desire to swallow anything for fear of becoming obese. It has been hypothesized that pharmacists might be able to create an inhibitor for the vasopressin or possibly an enhancer for the nor-epinephrine to assist in individuals who are trying to improve their current state.

What are some solutions to dealing with eating disorders in adolescents? A few which have been hypothesized already are: education in early childhood on the effects of eating disorder, participation in school activities and sports, sending messages via television so that it reaches the sedentary adolescents, and encouraging a positive self-image. Some other options might be counseling for those adolescents that are showing signs of possible eating disorders, or even decreasing the amount of unhealthy foods in schools. One research even suggests that dietetics professionals become partners with school health programs to increase awareness on healthful eating habits (Gross and Cinelli, 2004).

What does all this mean? Emphasize “healthy” bodies. The goal should be on fitness, not thinness. Praise kids for the things they do, rather than for the way they look. Commit to lifelong healthy eating, rather than quick-fix diets. If a child insists on dieting, insist that the diet be medically supervised. Prepare kids, especially girls, for the changes of puberty, which may be interpreted as “getting fat.” Encourage an active lifestyle. This needn’t involve organized athletics necessarily, but rather any movement – walking, dancing, biking – that is pleasurable enough to do everyday.


References
Bee, H. and Boyd, D. (2001). Physical and cognitive development in adolescence. Lifespan Development. 3ed., 292-293.


Brunch, H. (1978). The Golden Cage. Cambridge, MA: Harvard University Press.


Elkins, W. L., Cohen, D. A., Koralewicz, L. M. and Taylor, S. N. (2004). After school activities, overweight, and obesity amoung inner city youth. Journal of Adolescence, 27, 181-189.


Fouts, G. and Vaughan, K. (2002). Locus of control, television viewing, and eating disorder symptomatology in young females. Journal of Adolescence, 25, 307-311.


Gross, S. and Cinelli, B. (2004). Coordinated school health program and Dietetics professionals: Partners in promoting healthful eating. Journal of the American Dietetic Association, 793-798.


Muise, A. M., Stein, D. G., and Arbess, G. (2003). Eating disorders in adolescent boys: A review of the adolescent and young adult literature. Journal of adolescent Health, 33, 427-435.