LAU XIA TOONG The Factors that Lead to Anorexia Nervosa

Anorexia nervosa, commonly known as anorexia, is a type of eating disorder. More importantly, it is also a type of psychological disorder. In fact, it is a serious mental illness with a high incidence of co morbidity and also the highest mortality rate of any psychiatric disorder. Anorexia is a condition that goes beyond out-of-control dieting. People with anorexia have an extreme fear of gaining weight, which causes them to try to maintain a weight far less than normal. They will do almost anything to avoid gaining weight, including starving themselves or exercising too much. People with anorexia have a distorted body image, where they think they are fat even if they are thin, and will not maintain a proper weight. Therefore, for people with anorexia, it really is true that one could never be too thin. Despite being dangerously underweight, anorexics see a fat person whenever they look at themselves in the mirror. Anorexics usually begin dieting to lose weight. Over time, the weight loss become s a sign of mastery and control and the desire to lose even more weight is triggered. One continues the endless cycle of restrictive eating, accompanied by other behaviors such as excessive exercising and the overuse of diet pills of laxatives in order to reduce weight, often to the extent of starvation just so that he or she could feel a sense of control over his or her body. However, there is a significant difference between healthy dieting and anor exia because the latter involves a control of life and emotions. Anorexia nervosa mainly affects adolescent girls and young women, and is increasingly common especially in industrialized countries where cultural expectations encourage women to be thin. However, fueled by popular fixations with thin and lean

bodies, anorexia is also affecting a growing number of men recently, particularly athletes and those in the military, although the rates are usually higher in gay and bisexual communities. There are several signs and symptoms of anorexia nervosa discovered through the years as it progresses, though people with anorexia often hide their condition, or will typically try to explain their disordered eating behaviors when confronted. Physical Signs: a) b) c) d) e) f) g) h) i) j) k) Excessive weight loss Scanty or absent menstrual periods Thinning hair Dry skin Cold or swollen hands and feet Bloated or upset stomach Downy hair covering the body Low blood pressure Fatigue Abnormal heart rhythms Osteoporosis

Psychological Signs: a) b) c) d) e) f) g) h) i) Distorted perception of self Being preoccupied with food Refusing to eat Inability to remember things Refusing to acknowledge the seriousness of the illness Obsessive-compulsive behavior Depression Obsession with calories, fat grams and nutrition Harshly critical of appearance

Other symptoms: a) b) c) d) e) Skipping meals or making excuses not to eat Eating only a little food Refusing to eat in public Preparing elaborate meals for others but not eating Constantly weighing themselves

f) g) h) i) j) k)

Ritually cutting food into tiny pieces Compulsive exercising Using diet pills, laxatives or diuretics Throwing up after eating Pretending to eat or lying about eating Denying being too thin At this time, no definite cause of anorexia nervosa has been determined . However,

medical experts agree that several factors work together in a complex fashion to lead to the eating disorder, and research within the medical and psychological fields continues to explore possible causes. Firstly, we may look at it from the biological view. Anorexia nervosa is believed to be highly heritable, with estimated inheritance rates ranging from 56% to 84%. If a girl has a sibling with anorexia, she is 10 to 20 times more likely than the general population to develop anorexia herself. R esearchers are currently attempting to identify the particular gene or genes that might affect a person s tendency to develop this disorder, and preliminary studies suggest that a gene located at chromosome 1p seems to be involved in determining a person s susceptibility to anorexia nervosa. Other evidence has pinpointed a dysfunction in the part of the brain, the hypothalamus which regulates certain metabolic processes, as contributing to the development of anorexia nervosa. Other studies have suggested that imbalance in neurotransmitters levels in the brain, which are brain chemicals involved in signaling and regulatory processes, may occur in the people suffering from anorexia. Anorexics tend to have high levels of cortisol, the brain hormone most related to stress, and decreased levels of serotonin and norepinephrine, which are associated with feelings of well -being

and are involved in depression. Starvation has been hypothesized to be a response to these effects, as it is known to lower tryptophan and steroid hormone metabolism. Secondly, there are the psychological factors. People with anorexia are usually perfectionists and overachievers. They are all the good sons and daughters who do what they are told to do, excel in everything they do, and only focus on pleasing others. But while anorexics may appear to have it all together on the surface, in the inside they actually feel helpless, inadequate, and worthless. They view themselves through a harshly critical lens. If they are not perfect, they are a total failure . They are feared to be ridiculed or humiliated, as they have a strong belief that being perfect is necessary in order to be loved. The destructive cycle begins with the pressure to be thin and attractive. A poor self-image compounds the problem. They deliberately deprive themselves from eating in order to look good and they still think they are overweight even though after undergoing extreme weight loss. This is why anorexia nervosa is often related to the statement obsessive fear of gaining weight . Anorexia nervosa can also be caused by severe trauma or emotional stress during puberty or pre-puberty. For example, a tragic loss of a loved one that caused an extreme emotional breakdown. There are also cases where victims from child abuse or sexual abuse develop to become anorexics. Although prior sexual abuse is not thought to be a specific risk factor for anorexia, those who have experienced such abuse are more likely to have more serious and chronic symptoms. Thirdly, there are the environmental factors. Remember, this is the 21st century. In many societies, being extremely thin is the standard of beauty for women and represents success, happiness, and self -control. Women are bombarded with messages

from the media that they must diet to meet this standard. However, this idealiz ed ultrathin body shape is almost impossible for most women to achieve since it does not fit with the biological and inherited factors that determine natural body weight. This conflict leaves most women very dissatisfied with their body weight and shape. People in professions where there is a particular social pressure to be thin, such as models, gymnastics, ballerinas, and dancers, were much more likely to develop anorexia nervosa during the course of their career, and farther research has suggested that those with anorexia nervosa has much more higher contact with cultural sources that promote weight-loss. In short, a cultural environment that puts a high value on thin or lean bodies contributes to this disorder. Fourthly, family and social pressures also lead to the development of anorexia nervosa. Some parents are overly concerned about physical appearances. They put a lot of emphasis and effort on looks and dieting themselves. Often they like to criticize their children s bodies and appearances because they want them to be just like themselves, without knowing that they are actually hurting their children s feelings. They are afraid that their friends or their children s friends parents would look down on their children. This is why they want their children to look good in order to have a perfect-looking family. Some parents tend to be overprotective, which causes their children to be suffocating in their closeness. Besides, some adolescents or teens go through stressful life events as they grow up. For example, arguments with their peers, pressure from teachers, breakups, the onset of puberty, parents divorce, running away from school due to homework pressures etc. All these unhappy events may trigger them to develop anorexia nervosa.

In conclusion, even though anorexia nervosa is very common nowadays, it is still an unhealthy eating and psychological disorder because it does not only affect us physically, but also mentally and psychologically. Not only that, it also affects the people around us, such as our friends and family because they have to put up with all out behaviors. Apart from avoiding ourselves from getting the disorder, we should always try our best to help anorexic patients to recover from their illness. Although there are several treatments such as medical treatments, counseling and different therapies available, I believe that the best way is to approach their hearts. It is very important to encourage them, gently express our concerns and let them know that we are always willing to listen to their problems. If he or she is willing to talk, listen without judgment and provide the best advice. We can also help them by being a good role model for healthy eating, exercising, and body image. Remember that anorexics do need support, not a show -off.

(1518 words)

References
Anorexia Nervosa http://www.umm.edu/altmed/articles/anorexia-nervosa-000012.htm

Anorexia Nervosa Symptoms, Signs, Causes, Diagnosis and Treatment http://www.medicinenet.com/anorexia_nervosa/article.htm

Anorexia Nervosa http://en.wikipedia.org/wiki/Anorexia_nervosa

Anorexia Nervosa: Signs, Symptoms, Causes, and Treatment http://helpguide.org/mental/anorexia_signs_symptoms_causes_treatment.htm

What Causes Anorexia Nervosa? http://www.ehealthmd.com/library/anorexia/ano_causes.html