...because I've been busy WRITING! hahaha
Have I mentioned that for one of my three final classes (HOORAY!) this semester I'm doing an independent study? So, it's me, a professor, and whatever the heck I want to study.
I'm super excited about it. I've spent the semester so far reading anything and everything I can get my hands on about eating disorders. I've learned SO much. Like, have you ever heard of EDNOS or binge eating disorder? I know, right? What? And did you know you can't be both anorexic and bulimic at the same time but you can SWITCH BACK AND FORTH BETWEEN ILLNESSES! AND that anorexia has the highest mortality rate for a psychiatric illness - 10% of those diagnosed will die within 10 years of first presentation either from starvation or suicide.
Seriously, this is intense stuff.
Anyway, I've spent WAY too much time today writing a whopping THREE PAGES (double spaced, no less, hahaha!) introduction for my paper on the family dynamic and it's correlation to development, treatment, and prevention of eating disorders.
And prior to today I've been busy collecting, sorting thoughts, etc. etc. Oh yes, and acting/singing in a play (which I have to write about, I know, I know), trying to find my house under all the mess, keeping up with business (boy do WE have exciting things going on THERE!) and OH yes, the two-and-a-half year old who lives in the house.... what? I have a husband? DARN IT! I KNEW I dropped a ball SOMEwhere!
So I wanted to SHARE with you some of the spoils of my labours thus far... this will be TWEAKED before the full paper is submitted at the beginning of May, but I wanted to post what I have so far.
Read it, love it, and HOLY COW keep coming back because I'll be working on it all month long! :D
In today's North American society there is perceived a huge pressure for individual persons to constantly portray their best selves to the world. This best self encompasses many ideas including attitude, temperament, humour, and most easily and immediately presented, appearance. Unfortunately human nature appears to have many using the means of inter-individual comparison to define their best selves in these manifold aspects of life. Persons of all ages compare themselves to their neighbours, friends, co-workers, famous personalities, and family members. Social ideals for appearance have shifted from full figures, indicating nourishment and affluence, to a preference for “a slender, long-legged, and flat-chested look” (Dumas & Nilsen, 2003, p. 312) leaving persons with larger stature ever envious of their surrounding leaner counterparts, embarrassed that they too do not fit the perfect, slender mold.
“This preoccupation with slimness has continued to increase in recent decades. By the 1990s, middle-class European American girls described the 'ideal' body size as 5'7” tall and 110 pounds. Today, the average weight of fashion models – who are seen by many as standards of American beauty – is lower than the weight of over 95% of women!” (Dumas & Nilsen, p. 313).
Interestingly, over the twentieth century as the aesthetic ideal for female appearance has shifted to thinness the occurrence of eating disorders has dramatically increased (Dumas & Nilsen, 2003, p. 311). This is not to say that the increasingly prevalent ideal of thinness as a cultural norm is the only or even main catalyst causing eating disorders; some “non-Western cultures indicate...patients voluntarily reach an emaciated weight for a variety of psychological reasons” outside of body image disturbances (Cash & Pruzinsky, 2002, p 300). Even with these cultural differences it is near impossible to ignore the apparent dramatic correlation between socially driven thin ideals and the increasing development of eating disordered behaviours associated with body dissatisfaction in local society.
The National Institute of Mental Health (2009) defines an eating disorder as:
“...serious disturbances in eating behaviour, usually in the form of extreme and unhealthy reduction of food intake or severe overeating. They are not due to a failure of will; rather, they are real and treatable medical illnesses in which certain patterns of behaviour get out of control.”
Usually it is expected to see these disorders develop in adolescence and/or early adulthood, but with severe cases documented in patients as young as four (Bar-Or & Rowland, 2004 p.__) it is imperative to understand not only the disease but any potential underlying issues causing it that may be used for prevention in future susceptible cases.
Eating disorders are generally categorized under three headings: anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS). While eating disorders are not bound by sex they are found to be much more prevalent in females: it is approximated that only 5% to 15% of AN or BN patients are male (NIMH, 2009). And while AN and BN are believed to afflict a seemingly small percentage of the female population in Western culture, approximately 1% and 1.5% respectively (National Eating Disorder Information Centre, 2008), these percentages translate to 170,074 Canadian women with AN and 255,111 Canadian women struggling with BN during their lives. Both disorders together give an astounding 425,185 Canadian women fighting a life-threatening disease largely characterized by incredibly strong negative body image (numbers calculated based on estimate of approximately 17 million female Canadians in 2009 by Statistics Canada).
The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnostic criteria for AN and BN as reported by Dumas and Nilsen (2003) are listed as follows:
Anorexia Nervosa
Refusal to maintain body weight at or above a minimally normal weight for age and height.
Intense fear of gaining weight or becoming fat, even though underweight.
Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
In postmenarcheal females, amenorrhea, i.e. the absence of at least three consecutive menstral cycles.
Bulimia Nervosa
Recurrent episodes of binge eating
recurrent inappropriate compensatory behaviour in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
The binge eating and inappropriate compensatory behaviour both occur, on average, at least twice a week for 3 months.
Self-evaluation is unduly influenced by body shape and weight.
The disturbance does not occur exclusively during episodes of AN.
Both AN and BN are severely detrimental to one's overall well-being, causing manifold problems for patients of either disease, including, but not limited to: irregular heart rhythm, heart disease, osteoporosis, anemia, constipation and bloating, brain and nerve damage, seizures, tooth decay, dehydration, and kidney failure (Katz Group Canada Inc., 2006; National Institute of Mental Health, 2009). Both illnesses if left untreated are life threatening and do result in death. AN also has “the highest mortality rate for any psychiatric illness – it is estimated that 10% of individuals with AN will die within 10 years of the onset of the disorder” (National Eating Disorder Information Centre, 2008) either from starvation or suicide (Shaffer et al., 2002, p 175).
Eating disorders have been shown to stem from a multitude of causes, a fact which appears to hamper the effective treatment and prevention of these insidious diseases in current and potential patients. Available literature on the subject of causation appears to unanimously cite genetic predisposition as a factor, with research of family histories of eating disorder presentation from mothers to daughters and/or twins upholding this theory. Although it is accepted that genetics play a huge role in determining one's susceptibility to eating disorders le Grange et al. (2010) state that “the idea that genes alone account for the development of eating disorders seems implausible.” Cases such as that previously mentioned, with patients presenting AN pathologies as young as four years of age lead to questions about environment and social settings of these children. Many studies have been done investigating the incredibly complicated dynamic of family and its potential role in aiding either in the development or prevention of disordered eating behaviours, and while it seems impossible that family be the main catalyst for AN and BN (le Grange et al.) it is also impossible to ignore the tremendous influence that parents, siblings, and other family members have on a child's developmental psychology and social understandings.
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