Introduction:
Imagine just getting out the shower looking in a tall framed stand up mirror along your bedside wall to find a body image of simply frail skin and bones. Your rib cage is protruding out of your side with an indented empty stomach. Your neck is straining to keep your head up, and is lined with shallow holes. You look down at a thigh gap that appears to be normal but in reality it is much bigger than the average persons. Then, slowly turning around you are weak, hunched over, and able to find each vertebrae perfectly visible and sharp. You then start to wonder. Why do I appear over weight?
Anorexia Nervosa (AN) is an eating disorder that is developed by weight loss and a lack of maintaining the appropriate weight in comparison to height, stature, gender, and age ("Anorexia: Overview and Statistics" 1). To be diagnosed the patient must have a fear of gaining weight and becoming fat, even if appearing to be underweight (1). The patient must have a low body mass index and must deny the current deficient weight during evaluation (1). Anorexia can affect people from all ages, races, ethnicities, and sexual orientations (1). Let us further investigate anorexia nervosa and eating disorders in the following text and break down the absurd epidemic as a whole.
History:
Eating disorders can greatly impair health and psychosocial functioning (Dell'Osso 1). Contrary to belief, self-starvation is not a recently diagnosed syndrome and it has been reported throughout history. It is believed that anorexia nervosa was identified in the late 19th century by Leseque in France and Gull in England in 1873 (Bemporad 1). The 19th century was a time when medical description became more accurate by clustering symptoms together to produce a syndrome bearing the founder's name (1). During this time, numerous eating disorders were described in detail that to this day allow doctors to determine whether or not the patient meets the criteria to be diagnosed with AN. Cases were documented where a 17 year old Italian girl ate less and less claiming that her food would simply not go down (1). At the same time her menses stopped and she eventually died within 3 months (1). Doctors could find no physiological defects (1). Another case documented a young girl that was forcibly told to break a relationship (1). She complained of a heavy pressure in her esophagus that rendered her unable to eat (1). This case proved there were "hysterical" symptoms involved that caused her to refuse to eat (1). Prolonged fasting has dated back in the ancient times. Greek and Egyptian cultures were known for ritual fasting, but generally it was only brief periods of time such as 1 to 3 days (1). Fasting for sacred visions such as Jesus in the desert for 40 days and Moses fasting for 40 days before receiving the Ten Commandments (1). Fasting during this time served as a means of penance or purification (1). Today's anorexics are more fearful of becoming fat. It has been found that the increase in the prevalence of eating disorders may show a change in symptom choice (1). In the past, individuals presented with "hysteria", and anxiety. Today, individuals are reading about symptoms in magazines, or are being questioned by their doctor (1). The desire for thinness is a symptom that was never documented in previous findings. In the article, Bemporad states, "a psychological connection between a slender body and success, sophistication, and self control" (1).
Effects of Society:
Anorexia Nervosa and related eating disorders have negative consequences that profoundly affect adolescent females, their family and friends, and cost to society.
Today's media and society profoundly affects adolescent females by portraying an image of thin body types, attractive faces, and youthful looking skin ("Eating Disorders Impact on Individuals, Families, Communities and Society" 1). Teenage girls ranging from thirteen to nineteen years of age aspire to have the ideal fashion model figure (1). However, achieving the societal self-image expectation is nearly impossible. The average female does not possess this body type and are never depicted in magazines, fashion shows, or billboard advertisements. The fashion industry also utilizes photo shop to obtain the most desirable image (1). This subliminal message affects how a female views her body. Designers continue to make clothes in size 0 that place a preconceived idea in the adolescent female mind. The results of females attempting to achieve these proportions can lead to hospitalization, depression, ingestion of weight loss substances, illicit drug use, and even fatalities (1). Drug use helps to ease the pain and burden of inadequacy and exclusion (1). By adding substance abuse to a body with severe physical effects can be detrimental.
AN not only affects the individual, but family and friends as well. Academic performance, school participation, and social interaction are impacted (1). Parents for the most part continue to push for acceleration in school and outside. This adds to the stress and worsens body image (1). Social isolation or the desire to be with others that have the same problem is inevitable. By living in their "own world", it helps to affirm what their body should look like (1). Adolescents of today are tuned into the world by social media, and the internet. Parents are not a part of this process which limits their influence (1). Parents are fighting an uphill battle when society places a huge burden on youth.
Sadly, society does not realize the impact it has for all of us. Even though AN may not be the most prevalent disease, it is a disease that requires long term care. There are mental disorders that go hand in hand with AN. Major depressive disorder, obsessive compulsive disorder, and personality disorder are often diagnosed. There are direct and indirect costs to society (Stuhldreher 1). Direct costs include hospitalizations, emergency room visits, outpatient treatment, pharmaceuticals, social services, and out of pocket costs for the patient and family (1). Indirect costs include reduced productivity at the workplace, disability, sick leave (absenteeism), and premature death (1). Unfortunately, this disease not only affects the victim, but society at large.
Examples:
The story of Annaclaire is one that portrays how AN effects the thinking of an adolescent female. She was a military brat whose father was in the Army (Annaclaire 1). She lived all over the world and was given the opportunity to attend boarding school in order to provide some "stability" (1). Little did her family know that what they thought was good for her was actually the opposite (1). Most of the girls in her school in Spain were anorexic, so she aspired to be just like them (1). She started to skip snack time and joined the gymnastic team (1). It turned out to be the biggest mistake, because she felt that you can't hide anything in a leotard (1). She worried that cellulite showed, her thighs were too big and jiggled when she performed (1). Eventually, more meals were skipped. Breakfast consisted of a half apple and a half cup of juice (1). She began running ten miles a day, in addition to gymnastic practice (1). She would get up at 4:30 am and run 5 miles before breakfast (1). After school was gymnastics, run five more miles, do 150 crunches, study until 1:30 in the morning only to rise to the same routine each and every day (1). She eventually got down to 80 lbs by her 16th birthday all the while thinking that she was fine, just trying to be healthy (1).
AN affected the family of Annaclaire as well. When her housemother found out that she was skipping meals she alerted Annclaire's parents (1). Her parents gave her the lecture (1). She started to rebel in order to get kicked out of the school so that she could have the privacy to diet the way she believed was normal (1). She believed that if she could go home, her parents would not be around to monitor her (1). Unfortunately, the military re-stationed her father which meant school number two for her (1). This time, she purposely befriended every girl that was known to be a diet queen (1). With friends in her same predicament, she learned everything she could about AN (1). She did her homework, read books, went to websites, and became an expert (1). She doesn’t believe that she made a conscious decision to become anorexic, but it was something she considered (1). Eventually her exercise routine and diet made her withdrawn. She no longer wanted friends, as they were too complicated (1). She avoided boys because they did not want a fat girlfriend (1). She became known as the "ice princess" and was glad that no one tried to get close (1). As her weight plummeted to 78 lbs, her parents finally took her home (1). She was hospitalized and lost six more pounds (1). She was threatened, bribed, coaxed, screamed and cursed at to maintain her weight (1). Her parents were rendered helpless.
AN is usually a disease that usually coexists with another disease. As a young child learning how to count over a hundred, she would use food (1). She would eat 200 cheerios at breakfast, count the number of chews, and the number of sips to drink a glass of water (1). This relates to obsessive compulsive disorder. Reaching the horrific 78 lbs, Annaclaire fainted in her school library (1). She could not walk, her hair started to fall out, she had horrible muscles spasms, a heart murmur, and developed pneumonia (1). She eventually went back to school and struggled on and off with the disease (1). She experienced periods of recovery and periods of relapse (1). The disease process for AN is long term with surmounting costs. Her emotions went from nonexistent to obsession (1). She was labeled as "psycho" (1). All these emotions stem from depression. She has had multiple therapist and is currently on Prozac and slowly recovering (1). AN is a devastating disease that takes its toll on one's life, support system, and finances. Together as a society we must realize the impact that media and society plays on our beloved adolescents. Changes need to be made how we advertise to youth and females. We must also not condemn, or shame those that suffer from mental disorders.
Solutions:
Recovering from an eating disorder can be a long and difficult process. Not only are they destructive on the human body, they can be fatal. Eating disorders are considered one of the nation's deadliest psychological conditions (Novotney 1). It is important that one suffering from AN accepts the disease and reaches out for professional help. Typically, anorexic patients start out at individual therapy to validate their role in a pressured society of cultural changes and ideals of perfectionism (1). Sadly, only half of those diagnosed with AN recover fully (1). In order to battle these numbers, psychologists are the forefront for eliminating the disease. Professional organizations are dedicated through research, education, treatment, and prevention. Three possible solutions to fighting this condition will be examined.
Research is the most cutting edge for linking genetic risks factors to eating disorders. Until recently, eating disorders have been customarily associated with environmental influences such as peer pressure and societal expectations. Psychologist are now finding that eating disorders have a strong genetic link just as many other psychological disorders such as bipolar and schizophrenia (1). By tapping into the underlying biology of a condition, it may be possible to develop biologically based interventions (1). A study had showed that those with the disease had greater activation of key reward areas in the brain after consuming a chocolate milkshake (1). This study led researchers to believe that being exposed to high-fat, high sugar diets in early development may be responsible. There was also less activity in the brain that involved self-regulation and impulse control (1).
Innovative treatments are also important for those that are considered hard to reach such as adult women or those that live in rural areas that have limited access to help and intervention. An online cognitive behavioral therapy program with therapist could be beneficial (1). This type of treatment could be cost effective and suitable to in order to help those that may not feel comfortable in a face to face group setting. Adult women may feel more shame since they have not grown out of the disease (1).
Lastly, a third possible solution to the problem is based on a theory of cognitive dissonance (1). Participants would critique the ideal thin standards of a woman through a series of verbal, written and behavioral exercises (1). Basically, the goal is to talk yourself out of pursuing the horrific disease. It was noted that this type of program may work better when it is presented by high school counselors and physical education teachers. Others believe that if it is peer led, it may be more beneficial.
Camus and Absurdity:
Albert Camus questioned the meaning of life itself through three absurd conditions; physical suicide, philosophical suicide, and acceptance (Dodson 1). Camus argues that ending one's life (physical suicide) is just an easy way out of a problem. He believes that in order to overcome one's demons, you have to face them head on (1). Sadly, one out of every five people with AN eventually die from causes that are related to the disorder (Novotney 1). Those diagnosed with AN are fifty-six more times likely to take their own lives (1). Treating AN is a long process and one must realize that it is a disorder that may take years to overcome. People have beliefs about themselves, they interpret past experiences, and they expect their future's worth (Williams 1) . Separating self from AN is crucial in recovery. AN is something that an individual defines themselves by and finds comfort with the disease (1). Camus' theory relates to AN in many ways because one must face fear of the unknown and let go of the disease that they believe brings comfort. Family and friends are a part of the big picture and must understand that support from them is essential along with professional help. Suicide statistics prove that people with this disease need the innovative research, treatment and prevention from professionals (Novotney 1). By linking this disease to biological causes, therapist can intervene and discredit the myth that AN is just for "vain girls who just want to be skinny" (1). Camus also believed that one should not wait for the curing of a philosophical god or transcendent (philosophical suicide) (Dodson 1). Camus believes that one must take responsibility and find meaning and value of life within themselves even though we live in an imperfect world (1). According to Camus, embracing freedom is acceptance and the only means to an end (1). Victims of AN feel incomplete without the disease. They are accustomed to sharing themselves with the disease, being no one without the disease, and they feel protected by the disease (Williams 1). The disease essentially helps them to avoid emotions. In order to recover, one must face the fear of the unknown and take a leap of faith into who they really are without the eating disorder. By creating a new identity, one can find alternatives things that are unrelated to AN (1). By continually reinforcing this new identity, one can find "real self". This action coincides with Camus and the belief that one can overcome if willing to face the challenge.
Conclusion:
Anorexia Nervosa is an absurd epidemic that will never cease on its own. It is our role within a society to accept those that are suffering and are in pain. If you see one that shows signs and symptoms of AN, it is important to reach out and address the problem through education, guidance therapy, research, or prevention. Seeking professional help can save one's life before it is too late. It is time to put an end to eating disorders and to resolve this absurd epidemic as it effects millions of people ranging in age throughout the world.
Works Cited
Annaclaire. “Anorexia Nervosa .” Annaclaire's Story, eating.ucdavis.edu/speaking/told/anorexia/a35annaclaire.html.
“Anorexia: Overview and Statistics.” National Eating Disorders Association, 2016, www.nationaleatingdisorders.org/anorexia-nervosa.
Bemporad, J R. “Self-Starvation Through the Ages.” The International Journal of Eating Disorders., U.S. National Library of Medicine, Apr. 1996, www.ncbi.nlm.nih.gov/pubmed/8704721.
Dell’Osso, Liliana, et al. “Historical Evolution of the Concept of Anorexia Nervosa.”Neuropsychiatric Disease and Treatment, Dove Medical Press, 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4939998/.
Dodson, Eric. “Camus In Ten Minutes.” YouTube, YouTube, 13 Feb. 2014, www.youtube.com/watch?v=ekxXvgbDr3M.
“Eating Disorders Impact on Individuals, Families, Communities and Society.” (It) Magazine, 18 Sept. 2015, itmagazine.org/eating-disorders-impact-on-the-individual-families-communities-and-society/.
Novotney, Amy. “New Solutions.” Monitor on Psychology, American Psychological Association, www.apa.org/monitor/2009/04/treatments.aspx.
Stuhldreher, Nina, et al. "Determinants of Direct and Indirect Costs in Anorexia Nervosa." International Journal of Eating Disorders, vol. 48, no. 1, Jan. 2015, pp. 139-146. EBSCOhost, doi:10.1002/eat.22274.
Williams, K, et al. “Sense of Self and Anorexia Nervosa: A Grounded Theory.” Psychology and Psychotherapy., U.S. National Library of Medicine, June 2016, www.ncbi.nlm.nih.gov/pubmed/26179295.
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