● Social factors: Society glorifies thinness in women and muscularity in men. The media help to perpetuate this glorification to the point that even young children are consumed with worry about their weights. ● Type 1 diabetes: Recent research findings have shown that about 25% of women with type 1 diabetes will develop an eating disorder. A common pattern is skipping insulin injections, known as diabulimia, which can be fatal. ● Teasing or bullying: Persons who are teased or bullied, especially about their weight, are at higher risk of developing eating disorders.
● Acculturation: People from racial and ethnic minorities, especially those who are dealing with rapid Westernization, may be at increased risk for developing eating disorders because of complex interactions among stress, body image, and acculturation. Healthcare consideration : Eating disorders have some commonalties. But it is important to study each disorder for those issues that are specific to development, recognition, and treatment.
ANOREXIA NERVOSA
Cathy is 17 years old and a junior in high school. She is a star on the girls’ basketball team and hopes to earn an athletic scholarship that will pay her college expenses and allow her to continue her athletic career. Despite her active lifestyle, Cathy is a few pounds overweight and admits to a love of desserts. One day after practice her coach casually remarked, “You might want to lose a few pounds, Cathy. That may help you to pick up some speed on the court.” Cathy takes this suggestion seriously. She begins a strict diet and quickly loses 10 pounds. Her running speed does improve, and her friends and family tell her she looks “fantastic.” Convinced that if she continues to lose weight her game will improve even more, Cathy continues to diet. She monitors everything she eats and makes sure to eat no more than 600 to 800 calories per day. This meager nutritional intake, compounded by the calories burned during practice and basketball games, leads to a dangerous weight loss. Cathy denies that she is hungry and becomes obsessed with what she eats. She stops menstruating and has trouble sleeping. Her family, friends, teammates, and coach all try to persuade her to eat normally. Cathy, however, believes that she is fat and needs to continue to lose weight, no matter what anyone else tells her. Cathy is displaying signs and symptoms of anorexia nervosa, which is characterized by self-induced starvation brought on by a distorted body image and an extremely irrational fear of gaining weight. Despite being extremely thin, persons affected by anorexia nervosa still see themselves as fat (American Psychiatric Association, 2013; Gersch et al., 2016). Incidence and Prevalence of Anorexia Nervosa The usual age of onset of anorexia nervosa is between 15 and 19 years of age (Gersch et al., 2016). It is estimated that 0.9% of females and 0.3% of males suffer from anorexia nervosa in their lifetimes in the United States. Based on national epidemiology surveys, there has been an increase in the diagnosis of anorexia nervosa in the age group of 15- to 19-year-old girls (Psychology Today, 2018). Anorexia nervosa usually begins during adolescence or young adulthood and rarely begins before puberty or after the age of 40. However, cases of both early (before puberty) and late (after the age of 40) onset have been reported (American Psychiatric Association, 2013). The disease is most prevalent in post industrialized, high-income countries, including the United States, many European countries, Australia, New Zealand, and Japan (American Psychiatric Society, 2013). In the United States, the prevalence of anorexia nervosa is rather low among Latinos, African Americans, and Asians. However, it should be noted that the use of mental health services among Possible Causes and Risk Factors of Anorexia Nervosa The exact etiology of anorexia nervosa is unknown. Research has shown that onset is often linked to a stressful life event such as leaving home for college, moving, death of a loved one, or divorce (American Psychiatric Association, 2013; Gersch et al., 2016).
Healthcare consideration : Referring to anorexia nervosa as anorexia can be confusing and misleading. Anorexia is defined as loss of appetite and is a common symptom of gastrointestinal and endocrine disorders, or an effect of chronic pain, anxiety, or some medications. Anorexia nervosa is an eating order characterized by a distorted body image and extremely irrational fears of gaining weight (Gersch et al., 2016). When discussing eating disorders, healthcare professionals should use the term anorexia nervosa rather than anorexia . Following are characteristics of anorexia nervosa typically seen in clients (American Psychiatric Association, 2013; Psychology Today, 2018): ● A distorted body image: Despite an obviously gaunt, emaciated appearance, the clients still perceive themselves as fat and unattractive. Even though family, friends, teachers, and coworkers try to convince clients otherwise, they firmly believe that they must continue to lose weight. They have an unshakeable belief that they are fat and see themselves as such no matter what evidence to the contrary is presented to them. An extremely irrational fear of gaining weight: This fear makes clients go to extremes to lose weight and to avoid gaining weight. Such extremes include literally starving themselves and, possibly, exercising to the point of exhaustion. Healthcare consideration : It is imperative that healthcare professionals know about this subtype and that clients may exhibit not only starvation behaviors but also binging and purging behaviors. these populations is lower than other groups, which may not accurately reflect the occurrence of the disease (American Psychiatric Association, 2013). Anorexia nervosa has the highest mortality rate of any mental health disorder. The course of the disorder is complicated by its chronic nature. Clients progress through treatment successfully but often relapse into periods of malnutrition, which can have life-threatening consequences (Hamilton et al., 2018). A review of 119 studies consisting of 5,590 participants who were dealing with anorexia nervosa was published in English and German literature. Among those who survived the disorder, fewer than 50% recovered, 33% improved, and 20% remained chronically ill (Hamilton et al., 2019). Healthcare consideration : It is imperative that healthcare professionals, clients, and families monitor for suicidal ideation and actions.
Other issues have been linked to the development of anorexia nervosa. Following are risk factors for the development of the disease (American Psychiatric Association, 2013; (Gersch et al., 2016):
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