Running head: EATING DISORDERS: ANOREXIA NERVOSA
Eating Disorders: Anorexia Nervosa
Paul Smith
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EATING DISORDERS: ANOREXIA NERVOSA
Abstract
Eating disorders impact various individuals and cultures all around the world. Eating disorders
are psychiatric disorders that can overcome patients’ lives. There are many different eating
disorders such as anorexia, bulimia, and binge eating disorder, but the main disorder that will be
discussed in this essay is anorexia nervosa. There are two types of anorexia including the
restrictive type and the binge/purge type as well. Both types of anorexia are extremely disturbed
with body image and will do whatever it takes to not gain any weight. Individuals with anorexia
nervosa view themselves as overweight even when they can be extremely underweight. Anorexia
Nervosa is a serious illness that can lead to various mental and health disorders and can
ultimately lead to death. Because anorexia nervosa is an extremely serious life-threatening
disorder, this essay will discuss multiple ways to treat and prevent this disorder.
Keywords: eating disorders, anorexia nervosa, treatment, prevention, culture, Christianity
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Introduction
Anorexia nervosa is a serious eating disorder that everyone must be properly educated on.
The DSM-5 classification for anorexia nervosa includes when the individuals have a serious fear
of gaining weight even when they are underweight, another is the restriction of food intake into
their bodies which leads to them becoming underweight, and the last DSM-5 classification is the
distortion of body weight and shape (Nolen-Hoeksema, 2020). The individual views themselves
differently than they really are in reality. The individual may not think they have a disorder
because they may not realize how underweight or malnourished they truly are. The article
“Anorexia Nervosa” explains a few behavioral warning signs include substantial weight loss,
refuses to eat certain foods, denies hunger, can be isolated due to avoiding gatherings with food,
is preoccupied with food, has food rituals, expresses body concerns, has a need to burn calories
off and many more behavioral signs (2018). The patient will suffer many behavioral issues
regarding anorexia nervosa and may feel that their life is out of control. They are consistently
worrying about calories and how to burn them off which could include exercise or purging.
Without energy entering the body the individual will feel lethargic. They may exercise no matter
how tired they feel because of their need to stay thin.
In addition to behavioral issues, there are physical symptoms as well. Physical symptoms
may include low thyroid and hormone levels, anemia, stomach pains, fainting, dental issues,
menstrual irregularities, yellow skin, decrease in muscle mass and many more (“Anorexia
Nervosa”, 2018). These physical symptoms can get extremely seriously and even life
threatening. Since the body is not getting any fuel from food, the body begins to break itself
down including muscle and tissue for energy. Anorexia Nervosa takes a heavy toll the body both
mentally and physically.
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Historical
Anorexia Nervosa has been around throughout history way before the disorder was
discovered. Although people used to believe that anorexia nervosa began around 19th century, the
disorder has been around much before that period of time (Fairburn & Brownell, 2005)
Individuals have been starving themselves due to many reasons from culture to religion.
Voluntary self-starvation has been used throughout history and was not viewed as a serious
illness. Later, long term food refusal began to become an issue that was considered a mental
disorder. During the end of the 17th century physician Richard Morton reported anorexia
nervosa, but his findings did not reach the communities until centuries later. Anorexia nervosa
was not discovered until 1874 when Lasègue and Gull both discovered anorexia and found that it
was a psychogenic affliction in mainly females (Fairburn & Brownell, 2005). The symptoms that
Lasègue and Gull found are the same symptoms that define anorexia to this day. Although
Lasègue and Gull made these significant discoveries, many individuals did not listen to what
they had to say. Thus, their findings on anorexia nervosa were not accepted or popular in society
at that time.
It took a while for people to understand the implications of this disorder. Many other
countries besides mainly France and Britain did not believe in anorexia nervosa until around the
20th century (Fairburn & Brownell, 2005). Throughout the 20th century false information spread
about the disorder but eventually were proven incorrect. Before 1960 psychiatry was mainly
taken over by psychoanalytic views which affected the view of anorexia. It wasn’t until after
1960 that Hilde Bruch an American psychiatrist discovered finding of anorexia nervosa that
matched with Lasègue and Gull’s ideas (Lasègue and Gull, 2005). Bruch found that individuals
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with anorexia are constantly wanting to lose weight and have a distorted body image of
themselves. Hilde Bruch’s findings compliment the findings that are still relevant to this day.
Cause of Illness
Although mental disorders may be part of the cause of anorexia nervosa, they may also
be part of the results of anorexia nervosa too. Even though individuals with anorexia nervosa
show symptoms of depression, there is no evidence of depression before they developed anorexia
(Kalat, 2019) Thus, depression may not be a cause of anorexia after all. People with anorexia do
not improve their symptoms on antidepressants. Likewise, anorexia nervosa patients do not have
many relatives with depression as well (Kalat, 2019). In conclusion, anorexia can cause
depression in the victim and cause their mental health to decline.
One cause of anorexia is the constant fear of gaining weight (Kalat, 2019). Even when
the individual is underweight, they can see themselves as overweight through body distortion.
They are so consumed with losing weight that they will continue to starve themselves in order to
reach quick results. Mainly, anorexia nervosa patients have a negative self-image. Likewise,
another cause can be a loss of control in one’s life and the feelings of stress and anxiety during
this time. They may lose their appetite and become severely depressed in this period of time.
In addition to stress and anxiety, other psychological issues such as obsessive-
compulsive disorder may lead to anorexia because of the pressure for everything to be perfect.
Therefore, they may feel their body weight must be a certain number to remain “perfect” through
their own eyes. Biological issues may also have an effect because genetics relating to food
sensitivities are associated with anorexia nervosa. Having a food sensitivity may discourage a
person to eat because they may feel sick or bloated when they eat a certain item of food. Thus, it
is essential to diagnose food sensitivities in individuals whether they struggle with an eating
disorder or not.
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Lastly, one major cause of anorexia nervosa is culture and how society promotes
thinness. Culture especially in North America extremely values thinness. Society portrays this
through models, celebrities, advertisements, and social media. Society’s idea of beauty is
everywhere and there is a high expectation to meet these unrealistic weight goals. Many younger
girls and women struggle with anorexia nervosa thinking that being thin equals beauty. The
lifetime prevalence of anorexia nervosa in the United States for young girls was .3% and for
adult women .9% while about .3% of men struggle with this disorder (Nolen-Hoeksema, 2020).
Women especially struggle with anorexia because they feel more pressure from their culture to
look a certain way in order to be accepted.
Treatment
Despite anorexia nervosa being a disorder that can cause many health implications and
ultimately lead to death, there is treatment for the disorder. The best time is to treat the disorder
is early on so that the individual will have more of a chance to recover from the illness. Therapy
can help those struggling with anorexia nervosa. Specifically, goodbye letters in therapy can
help those struggling with anorexia. Goodbye letters are used by the therapist to write to the
patient in the therapy session. They describe how the therapy session went, what the client has
achieved, and what the client needs to work on. Goodbye letters help patients have a consistent
summary and understanding of their therapy sessions. Goodbye letters of higher quality were
associated with an increase in body mass index for 12 months and letters that identified areas of
change and discussed preventing setbacks for anorexic patients were also associated with a
higher BMI over 12 months (Simmonds, et al., 2020). Therapy sessions with goodbye letters
have shown an increase in the weight of anorexia nervosa patients. Therefore, increasing the
likelihood that the patients will fully recover from the disorder.
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Although psychotherapy can work for anorexia patients, it may be a long process.
Because individuals with anorexia nervosa are extremely proud of the weight they lost, it can be
difficult for the client to want to gain the weight back. The therapist must build up trust between
the client and themselves in order for the patient to get better. The constant use of therapy can
begin to help see results in the client, but both the therapist and the client must have patience
because therapy can be an extremely long process. Cognitive-behavioral therapy is commonly
used for anorexia nervosa patients. It focuses on rewarding the patient when they show good
behaviors such as gaining weight (Nolen-Hoeksema, 2020). Cognitive-behavioral therapy is an
acceptable treatment plan that may overall help the patient reach their goal weight through
rewards for good behavior.
Although the treatment process of anorexia nervosa can be lengthy and daunting, many
patients can fully recover. It is estimated in clinical recover rates that about 67% of anorexia
patients recover in five years (Schaumberg, et al., 2017). These recovery rates mainly focus on
physical recovery. The patients reach a healthy weight and leaves any food restricting
tendencies behind. In order to not relapse again, psychological recovery must be met as well.
Psychological recovery is a positive mindset of food and body image. In conclusion, to reach a
full recovery of anorexia nervosa both physical and psychological recovery must be met in order
to not relapse later on.
Prevention
One way to prevent anorexia nervosa is to look for early signs of the disorder and get
help right away. The longer someone struggles with anorexia nervosa, the less effective
treatment will be for the person and the harder it will be to recover (Schaumberg, et al., 2017).
The sooner one finds themselves or others beginning to develop an eating disorder the sooner
they can
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develop normal eating habits. Another way to prevent anorexia nervosa is through education on
the issues especially among younger girls. They need to know that anorexia nervosa is a
serious life-threatening illness that should not be taken lightly. All individuals must be
educated on the early signs, symptoms, and the horrific mental and physical side effects of
anorexia nervosa.
There must also be educated on proper nutrition and how to accurately sustain the body.
Social media, advertisements and many more instances promote thinness. Although
advertisements and social media seem inevitable to avoid, encouraging the spread self-love
instead of unrealistic standards on these platforms may have a positive effect on society. One
reason women and younger girls develop eating disorders can be through self-image issues and
the need to be thin. Preventing anorexia nervosa in females could be setting more realistic
expectations for women meaning less photoshop and a better representation of diverse body
types in advertisements and social media. Platforms such as these have a lot of influence on
society as a whole. Therefore, if these platforms are used to spread positivity, self-love, and the
acceptance of diverse weights and body types, then they can be used to prevent eating disorders
such an anorexia nervosa.
In order to prevent anorexia, the various environmental and gene influences must be
accounted for. A person’s environmental factors can influence many of their genes causing them
to either be more or less prone to develop an eating disorder (Schaumberg, et al., 2017).
Comprehending the genetics and environmental factors behind eating disorder may help with the
prevention of anorexia nervosa. Additional research must be conducted in order to receive
further information on the prevention of anorexia nervosa through genetics and environmental
influences.
Cross-Cultural
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Eating disorder affect people of all ethnicities, nationalities, cultures, worldviews, and
religions. A study across 30 countries found that there was no association between race/ethnicity
and eating disorders (Schaumberg, et al., 2017). Eating disorders can be found throughout any
culture and race. Even though many cases of anorexia nervosa are seen in the western cultures,
they exist in numerous other cultures as well. Eating disorders have been developing in countries
such as the Middle East and Asia (Schaumberg, et al., 2017). Anorexia and other eating
disorders impact many people from different cultures which is why it is necessary to educate
various cultures on the implications of anorexia nervosa. Some of the information to this day
does not accurately represent other cultures and ethnicities regarding anorexia because of the
under representation of minorities. Thus, minorities must be accurately represented in further
studies conducted.
Stigma about anorexia is also prevalent among cultures. There is a lot of false
information that is spread throughout cultures. There are places in the world too that do not have
access to highly nutritious food. They may be malnourished and experience more anorexia in
their cultures. All cultures must be aware of proper nutrition and every individual should have
access to food. In addition, some cultures fast for long periods of time due to their religion.
Muslims fast during Ramadan from dawn till dusk. They do this for one month due to their
religious beliefs. Self-starvation is encouraged in this culture and can lead to physical side
effects such as being lethargic, irritable, and a difficulty concentrating. Many cultures have
different views on anorexia and fasting due to religion, beliefs, social media, and various other
instances as well.
Biblical Worldview
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Anorexia nervosa from a Christian worldview perspective is a serious illness that
Christians must pray and be there for those struggling with the disorder. The Bible says, “Do you
not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received
from God? You are not your own; you were bought at a price. Therefore, honor God with your
bodies” (1 Corinthians 6:19-20). God calls His people to take care of their bodies to glorify His
name. Which means giving the body proper fuel and nutrition to better themselves. Individuals
who have anorexia struggle with anxiety, depression, and may be extremely stressed. God has
called His followers to cast their anxieties on Him and rely on Him to help them through their
struggles. They may have anxiety about the future but knowing that God has a specific plan for
their life should help ease their worry. The Bible explains, “For I know the plans I have for you,
Declares the LORD, plans to prosper you and not to harm you, plans to give you hope and a
future” (Jeremiah 29:11, NIV). Individuals struggling with anorexia must realize that God will
take care of them and has a wonderful plan for their life. The cause of anorexia can be many
things, but one may be feeling the need to look a certain way to be accepted in society. The Bible
also says, “You are altogether beautiful, my love; there is no flaw in you” (Song of Solomon 4:7,
NIV). God has created each human in His image made with purpose and beauty. Humans are not
called to compare themselves to others and hate the bodies they’re in but rather understand that
God has created every individual unique with different talents, abilities, and appearances.
Christians are not supposed to find their value in earthly desires but rather in the things of
heaven.
Treatment can include going to Christian counseling to receive counseling from a
Biblical perspective. Even though it may be a long process, it is necessary for the client to
receive therapy to help them recover from anorexia nervosa. One thing that many people with
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anorexia struggle with is an excessive amount of exercise. They abuse exercise when it should be
used to make the body healthier. Taking care of our bodies is an act of worship to God.
Therefore, exercising and eating healthy and the right amount of food is glorifying to God.
Physical fitness can be a form of spiritual discipline that shows an expression of healthy love to
the self in addition to the love of humanity to God (Greenwood & Delgado 2013). Humans are
created by God with a spirit, soul, and body. Thus, humans need to honor God with all of their
being including their spirits, souls, and their physical bodies.
Conclusion
Throughout history, a great deal of false information regarding anorexia nervosa was
circulating around the world. It wasn’t until after 1960 that the true definition of anorexia
nervosa was released. Anorexia nervosa not only impacts the individuals struggling with the
disorder, but also their family and the community around them. Anorexia Nervosa can cause
physical symptoms such as fatigue, stomach pains, fainting, dental issues, a decrease in muscle
mass and various other negative effects that could very well lead to death. Many anorexic
patients experience behavioral symptoms too such as anxiety, depression, and great amounts of
stress. Although anorexia nervosa is a life-threatening illness, anorexia can be fully treated
through therapy. If the disorder is caught early on, then there is more of a chance the patient will
fully recover. Goodbye letters can be used in therapy for the patient to understand what they
have achieved and what they further need to achieve in their therapy sessions. Cognitive-
behavioral therapy works especially well for those who struggle with anorexia because it focuses
on rewarding the patient when they show good behaviors such as gaining weight and eating
nutritious foods.
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In order to prevent this disorder, educating individuals on the implications and early
signs of anorexia nervosa is necessary. Social media, culture, and advertisements can all also
contribute to the cause of anorexia nervosa. Thus, it is important to understand the effects these
have on individuals especially younger girls. Every culture must spread the idea of self-love
rather than unrealistic standards for women no matter what ethnicity, belief, or religion.
Christians must be alongside those who are struggling with anorexia praying for them and
supporting them through their recovery. Christians are called to honor God with their all their
being including their physical bodies, spirit, and soul. Therefore, Christians must glorify God by
taking care of their physical bodies with enough nutritious foods and the right amount of
physical exercise. Anorexia nervosa effects the victim physically, mentally, and spiritually,
impacting every aspect of the individual’s life. Despite the negative effects of anorexia nervosa,
there is hope for those who struggle with the disorder. Through treatment, prevention, and faith
in God, full recovery from anorexia nervosa is attainable.
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