Anorexia not a `disorder of choice`

[Angel]

New research reveals the development of anorexia nervosa may be linked to genetics and neurotic behavior.

The study from the University of North Carolina at Chapel Hill analyzed participants in the Swedish Twin Registry. Researchers focused on 31,406 twins born between Jan. 1, 1935 and Dec. 31, 1958. The twins were screened for anorexia during four years ending in 2002.

Results show anorexia is 56-percent hereditary, with environmental factors causing the remaining differences. Study participants born after 1945 were more likely to have the disease than those born before. In 2002, the overall prevalence of anorexia was 1.2 percent in women and .29 percent in men.

Investigators looked at seven potential predictors of anorexia among women -- body mass index (BMI), stomach problems, excessive exercise, perceived stress, an extroverted personality, and neuroticism characterized by low self-esteem, emotional instability and feelings of depression, anxiety and guilt. Only neuroticism was found to be a risk factor for the future development of anorexia.

"In conclusion, the prevalence of AN increased in both sexes between 1934 and 1958, while consistently afflicting females disproportionately," study authors say. "Individuals with a history of AN appear to be protected from the development of overweight later in life. Anorexia is a moderately heritable psychiatric disorder that may be predicted by the presence of early neuroticism."

[demon_dissector]

I think there's a huge debate about eating disorders whether they are due to nature or nuture. And though it seems common in the female gender, it's also found in among the boys. I think i recall from one of my tutorials taht anorexia was unheard of in the 50's then Vogue did an article on "skinny" girls and this caused an uproar of people admitting to suffering from the same thing. Also, the most anorexic nation is somewhere in eastern part of the world..not sure indonesia or phillipines, but due to the western ideas of being thin is hot, the old culture of how being obese was sexy/ meant you were rich no longer became important, so all the ladies chose the opposite route.

Anyway.....

Anorexia (or anorexia nervosa) is an eating disorder centered around an obsessive fear of weight gain. Anorexia involves self-starvation and excessive weight loss. Although anorexia is a mental disorder, the physical consequences are serious and sometimes life-threatening.

What are the signs and symptoms of anorexia?
The behavioral warning signs and symptoms of anorexia nervosa are

Avoidance of eating
Denial of the feeling of hunger
Avoidance of social gatherings where food is involved
Food rituals that allow for eating very little: eating in secrecy, eating foods in a certain order, excessive chewing, rearrangement of food on the plate, eating unnaturally small amounts of food
Dramatic weight loss
Refusal to maintain the minimal normal body weight for one’s age and height
Denial of the serious consequences of low body weight
Obsession with dieting and weight loss
Weighing self several times a day and focusing on tiny fluctuations in weight
Fear of gaining weight or of being fat
Even when thin, perception of self as overweight
Basing self-worth on body weight and body image
Excessive focus on an exercise regimen
How is anorexia different from bulimia?
A person with classic anorexia (the Restricting type) loses weight through self-starvation and excessive exercise. In another form of anorexia, the individual not only cuts calories, but also behaves similarly to the bulimic: bingeing on foods, and then purging. This type of anorexia, with symptoms of both anorexia and bulimia, is the Binge-Eating/Purging type of anorexia.

Who is likely to suffer from anorexia?
Anorexia nervosa is more common in females and usually begins in adolescence. Between 1% and 2% of all females develop anorexia. The ratio of females to males with the disorder is 10 to 1. The disorder is more common in industrialized countries where thinness is a positive cultural trait. A person with a family member who has anorexia is more likely to develop anorexia.

What are the effects of anorexia?
Anorexia nervosa can have severe medical consequences. Because a person with anorexia does not consume enough calories or nutrients to maintain the body and grow, all body processes slow down, to conserve energy. This slowing down has serious physical, emotional, and behavioral effects.

Physical effects of anorexia
Loss of menstrual periods
Dry, brittle bones due to significant bone density loss (osteoporosis)
Dry, brittle nails and hair; or hair loss
Lowered resistance to illness
Hypersensitivity to heat and cold
Low threshold for bruising
Less need for sleep than normal eaters
Digestive problems such as bloating or constipation
Muscle loss and weakness
Severe dehydration, which can result in kidney failure
Fainting, fatigue, and overall weakness
Eventual growth of a downy layer of hair (lanugo) all over the body, including the face (the body is trying to stay warm)
In severe cases: heart trouble, low blood pressure, low heart rate, low body temperature, poor circulation, anemia, stunted growth, and even death
Emotional and behavioral effects of anorexia
Difficulty in concentrating on anything else except weight
Isolation from family and friends
Emotional regression to a child-like state
Irritability
Feelings of guilt and depression
Dependence upon alcohol or drugs to handle the negative outlook
What causes anorexia?
Research about the causes of anorexia is not definitive, and no one yet knows the exact cause. A combination of biological, social, and psychological factors may cause anorexia.

Biological causes of anorexia
Some research indicates that higher levels of the neurotransmitter serotonin (a brain chemical) make the individual withdraw socially and have less desire for food. However, the higher level of serotonin may be a result of the anorexia, rather than a cause.

Individuals may have a genetic predisposition for anorexia. Individuals with anorexia often have family members with the disorder.

Social causes of anorexia
The cultural or social environment may cause or reinforce a propensity toward anorexia. Particular professions (fashion model, horse jockey) and sports (ballet, gymnastics) emphasize thinness and low body weight. Female athletes are particularly prone to being anorexic. Coaches may encourage them to lose weight, and they may notice improved performance with some weight loss. However, the anorexic does not know when to stop losing weight, and, ultimately, hinders performance by not consuming enough calories or nutrients to fuel the body.

Some cultures value thinness as a key element of attractiveness, especially for women. Thus, social pressure is a cause of anorexia.

Families that are overprotective or emphasize overachievement or physical fitness often produce anorexic family members.

Psychological and emotional causes of anorexia
Some personality traits are associated with anorexia: perfectionism, obsessiveness, approval-seeking, low self-esteem, withdrawal, irritability, and black-or-white (all-or-nothing) thinking.

Major life events may trigger anorexia: life transitions, emotional upsets, or sexual or physical abuse.

Mental health experts think that the feelings of being overwhelmed and powerless in adolescence can bring about a desire to maintain control in some realm of life, such as control of body weight. Being in total control of what enters the mouth can give the adolescent a feeling of powerfulness. Thus, the period of adolescence may be when anorexia manifests itself.

Other causes of anorexia
Relational or early life trauma (sometimes called developmental trauma) affects the brain, which in turn can impact both biology and psychology. Symptoms of trauma can include obsessive, compulsive eating disorders like anorexia. For example, physical or sexual abuse might trigger anorexia.

Similarly, mental conditions such as depression, anxiety, and ADHD may cause eating disorders such as anorexia.

[demon_dissector]

BULIMIA NERVOSA

Bulimia often starts when a young woman hears others at school talking about an "easy" method to control weight: you can eat anything you want, as much as you want, but never gain a pound! It sounds too good to be true … and, unfortunately, it is.

Bulimia Nervosa is a serious, potentially life-threatening eating disorder characterized by unhealthy methods of getting rid of food — vomiting, abusive use of laxatives or water pills, fasting and extreme exercise — to avoid gaining weight. Bulimics usually resort to these methods after compulsively eating large amounts of food in a short period of time, a behavior known as binge eating. The syndrome is called "binging and purging." However, some bulimics will engage in purging simply if they eat more food than they feel they should.

What are the signs and symptoms of bulimia?
Bulimia is usually well concealed from family or friends and can remain undetected for many years. Bulimia is diagnosed when several of the following symptoms exist simultaneously:

Behavioral signs

Eating unusually large amounts of food with no apparent change in weight
Disappearance of large amounts of food in short periods of time
The presence of wrappers and containers indicating the consumption of large amounts of food
Frequent trips to the bathroom after meals, signs and/or smells of vomiting, evidence of laxatives or diuretics
Going to the kitchen after everyone else has gone to bed; going for unexpected walks or drives at night (bulimics try to binge when other people are not around)
Excessive, rigid exercise regimen
Creation of complex lifestyle schedules or rituals to make time for binge-and-purge sessions
Physical signs

Unusual swelling of the cheeks or jaw area
Calluses on the back of the hands and knuckles (from self-induced vomiting)
Discoloration, staining, or deterioration of tooth enamel (caused by stomach acid)
Broken blood vessels in the eyes
Brittle hair or nails; dry or sallow skin
Stomach pain
Weakness or fatigue
Loss of menstrual cycle
Swelling of the lower legs and feet, or loss of sensation in the hands or feet (from malnutrition or dehydration)
Emotional signs

Withdrawal from usual friends and activities
Preoccupation with body weight, weight loss, dieting, and control of food
Depression and mood swings
Extreme or impulsive behavior, such as excessive spending sprees or substance abuse
Severe self-criticism
Sense of a loss of control
How is bulimia different from anorexia?
Unlike anorexics, bulimics do not avoid eating. People with bulimia can be hard to pick out because their weight may be average or above average. Bulimics and anorexics do share an obsessive concern with body size, fear of weight gain, guilt, poor self-image and eating in secrecy. Some people can have both anorexia and bulimia. About 50% of anorexics develop bulimia.

Who is likely to suffer from bulimia?
Like anorexia, bulimia is most often found in young women ages 11- 17, but has been seen in women even into their 60s. Although once considered a disorder suffered strictly by Caucasian, affluent women, bulimia has become common among all races and income levels. Although not as common, males can also become bulimic.

What are the effects of bulimia?
Bulimia has serious medical and psychological implications. Some of the major damage that results from bulimia includes:

Physical effects

Electrolyte imbalance caused by dehydration (can lead to irregular heartbeats, heart problems, and even death)
Inflammation of the esophagus from frequent vomiting
Tooth and gum problems
Chronic irregular bowel movements and constipation from laxative abuse
Vitamin and mineral deficiencies
Chronic kidney problems or failure
Emotional effects (some of which may also be causes)

Shame and guilt
Depression
Low self-esteem
Impaired family and social relationships
Perfectionism
"All or nothing" thinking
What causes bulimia?
Bulimia often begins as what seems to be a good idea: a way to manage weight without dieting. It continues as a means of self-control, which paradoxically becomes habitual and out of control. Some of the precursors to bulimia include:

Feeling out of control because of difficulties at home
Suppressed anger
Unmet needs
Feeling undeserving
Major life changes, such as divorce, family problems, loss of a relationship, a move
Because bulimia sometimes occurs in more than one family member, there is also research being conducted to determine whether this is a genetic or learned behavior.

A cultural or social environment that values thinness as the key element in attractiveness may also cause or reinforce a propensity toward bulimia.

What should you do if you suspect bulimia in a family member or friend?
Confronting a bulimic may encourage her to seek help and begin the process to recovery. Before confronting the person, have a plan. Decide:

why you are concerned
who will be involved
where to confront
how to talk, and
when is a convenient time.
What is the treatment for bulimia?
Like all bad habits, the longer someone takes part in them, the harder they are to break. Recognizing and addressing the problem as soon as possible is most important. Because bulimia involves both the mind and body, medical doctors, mental health professionals, and dietitians often are involved in the patient's treatment.

Goals of treatment for bulimia are likely to include:

Psychoeducation about the medical implications of bulimia
Identification of triggers for binging and purging behavior
Interrupting the "rituals" of bulimic episodes
Challenging weight and body image beliefs
Improving self-esteem and ability to communicate needs and feelings
Treatment provides a support system and ends the isolation and shame commonly felt by bulimics. Some bulimia treatment programs include an OA (Overeaters Anonymous) 12-Step Program, self-help groups conducted by the Eating Disorders Association, or self-help groups run by hospital outpatient units. Some programs also use antidepressant medications to treat bulimia.