Eating Disorders: Anorexia and Bulimia

According to researchers, the motivation of abnormal behaviour (like seen in anorexia and bulimia) could be caused by the contribution of psychological, environmental, and biological factors. Researchers are unable to experiment on individuals affected by these disorders in order to manipulate possible causes to check if individuals become anorexic or bulimic, but they are able to examine the factors associated with the disorders, as well as the changes that occur in the individuals when they are treated successfully.

Risk Factors

Two college freshmen named Sara and Lisa suffered from eating disorders. Sara was a victim of anorexia nervosa, which was an intense fear of being fat, causing her to severely restrict her food intake to the point of self-starvation. Despite looking emaciated and weighing 85 percent less than a person would be expected to be according to the said person's age and height, anorexic patients continue to view themselves as being fat. Anorexia causes a cease in menstruation, produces bone loss, stresses the heart, and increases risk of death.

Individuals like Lisa, who suffers from bulimia nervosa, are also in fear of getting fat. They tend to binge-eat, after which they purge the food by inducing vomiting or using laxatives. Often individuals suffering from bulimia consume between 2,000 to 4,000 calories during their binges. In some cases, they tend to consume around 20,000 calories per day. Although most bulimics are of normal body weight, repeated purging can cause severe physical consequences; which include gastric problems and badly-eroded teeth. Whereas most anorexics do not see their food restriction as problematic, bulimics typically do. However, they find it extremely difficult to alter their binge-purge pattern.

According to Becker, in 1999, around 90 percent of anorexic and bulimic individuals were women. According to some surveys, up to 10 percent of college women exhibited symptoms of bulimia although the general prevalence among North American women was 1 to 3 percent compared with 0.5 percent for anorexia. The latest statistics will be higher.

Sociocultural Factors

Anorexia and bulimia are more common in industrialized cultures, where being thin is equated to beauty. However, cultural norms alone cannot be held accountable for eating disorders as only a small percentage of women within a particular culture tend to be anorexic or bulimic; personality factors can be part of the issue. Anorexic individuals are often perfectionists. For example; Sara, who was a high-achiever (a highschool valedictorian), strove to live up to lofty self-standards which included strict ideals of an acceptably thin body. For Sara and Lisa, losing weight became a battle for success and control.

Their upbringing too may have played a role in their need for perfectionism and control. According to their description of their parents; they are disapproving, with expectations of abnormally-high achievement standards. For some anorexic children and teens, food refusal may be reinforced by the distress they cause their parents to feel; making self-starvation a way to punish their parents while gaining some control over their lives. As one anorexic patient said in a therapy session: it was like a power thing; I was showing my mother that  I don't need to eat and I can make her mad. The last thing a  parent wants is for you to die. You can get back at anyone, but if I  need to find a way, I had to forgive her as I am killing myself.

For individuals with bulimia, a different pattern from anorexia emerges; tending to be depressed and anxious, with an exhibition of low-impulse control, as well as lacking a stable sense of personal identity. Their food cravings are often caused by stress and negative mood, causing them to binge-eat to temporarily reduce their negative emotional state; followed by feelings of guilt, self-contempt, and anxiety—which is followed by the purging, maybe as a means of reducing these negative feelings.

Genetic Factors

On the biological side, genetic factors appear to predispose some individuals towards eating disorders. The concordance rate of eating disorders is higher among identical twins than among fraternal twins. The concordance rate between first-degree relatives, such as parents and siblings, are also higher than third and fourth-degree relatives. Researchers are searching for specific genes and combination genes that could be contributors to eating disorders.

Anorexia and bulimia exhibit abnormal activity in serotonin, leptin, and other body chemicals. According to the belief of some researchers, neurotransmitter and hormonal imbalances help in the causing of eating disorders; but others propose that the abnormal eating patterns are the initial cause of the chemical changes as a response that, once started, perpetuate eating and digestive irregularities. Other bodily changes also help in the perpetuating of eating disorders. An example of this is the stomach acid which is expelled into the mouth during vomiting, which causes those suffering from bulimia to lose taste sensitivity and also makes the usually unpleasant taste of vomit more tolerable.

Treating eating disorders can be difficult, taking years; but with professional help, around half of all anorexic and bulimic patients are able to make a full recovery while others are able to eat more normally while still maintaining their preoccupation with food and weight.