Anorexia Nervosa is an eating disorder that presents three main characteristics. The individuals practice restricted diet, over engage in fear of being overweight, and insist on weight loss even when they are underweight according to their height. As a result, the individuals develop a depleted body, withdraw from their close friends, and relatives and occasionally become depressed due to the concern of their overweight situation. An extended period of having the disorder leads to deprivation of the necessary nutrients to the vital organs of the body and may lead to the death of individuals (Whitbourne, 2017) . Several pieces of research have been conducted that seek to establish the treatment criterion and also the effect of weight suppression on the symptoms and treatment response of Anorexia Nervosa (AN) as discussed by (Attia & Roberto, 2009) and (Berner, Shaw, Witt & Lowe, 2013). This paper reviews the two mentioned articles, compares and contrasts their finding then reflects on the whole exercise of developing the present paper.
Review of Article One
Berner, L., Shaw, J., Witt, A., & Lowe, M. (2013). The relation of weight suppression and body mass index to symptomatology and treatment response in anorexia nervosa. Journal of Abnormal Psychology , 122 (3), 694-708. DOI: 10.1037/a0033930
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This article seeks to establish the relationship between weight suppression and body mass index (BMI) and their relation to the symptoms presented and response to treatment in Anorexia Nervosa (AN) patients. The hypothesis of the research is to investigate weight suppression, BMI, and their interactions as cross-sectional and prospective predictors of psychological symptoms and weight in AN diagnosed patients. The article defines weight suppression as the difference between the highest weight after attaining the adult height.
Method
The research adopts a quantitative approach. It collects data between the 1 st of July 2007 and 31 st of December 2008 on patients admitted in two residential treatment facilities for eating disorders. The facilities were located in Pennsylvania and Florida and owned and operated by the association of eating disorders. It bases on a sample size of 337 women all below the normal BMI of 18.5kg/m 2 . Some of the common criterion of those diagnosed with AN included fear of gaining weight, over-evaluation of their shape and weight, indicating significant clinical symptoms of the AN for more than two weeks in the past four weeks, and feeling fat. The women’s birth control practices and menstrual experience data was also queried.
Procedure and Measurement
The research received relevant approval from the facilities, the research committee that oversees both treatment facilities and institutional review board at Drexel University. The patient also gave informed consent before being subjected to the measuring. The measuring instruments included the Eating disorder symptomatology; a 36-item self –report questionnaire that covers eating disorder symptoms observed for the past 28 days. Depressive symptomatology was also used in the assessment of depression. It included a 21-item self-report. Finally, the patient’s weight was measured using a digital scale recorded before asking them to provide their highest weight ever recorded. The recorded weights facilitated the calculation of the weight suppression by subtracting the measured weight from the reported highest weight.
Analysis
The results were analyzed statistically using hierarchical multiple regression method. Many of the variables did not satisfy the criteria for a normal distribution. As such their square root, log and inverse were computed and compared with the normal distribution criterion before being rechecked for conformity to the normal distribution criterion. It was reported that 68% of the participants completed the measures at discharge. However, it was noted that the significant difference between those who failed to complete was as a result of shortened periods of stay at the facility.
Discussion
It was identified that the BMI of individuals diagnosed with AN was objectively low. And a majority of the low weight was as a result of suppressed weight. As such, high suppression rate among individuals beyond the absolute weight status was correlated to eating pathology, physiological abnormalities, and general distress. However, the recovery of most of the AN diagnosed patient including those with suppressed weight showed no significant variations. Finally, it was concluded that the absolute and relative weight status are common indicators of the severity of AN.
Review of Article One
Attia, E., & Roberto, C. (2009). Should amenorrhea be a diagnostic criterion for anorexia nervosa? International Journal Of Eating Disorders , 42 (7), 581-589. DOI: 10.1002/eat.20720
The article seeks to investigate whether amenorrhea can be retained as a diagnostic criterion for Anorexia Nervosa (AN). As such the study aims to establish the arguments for maintaining as well as rejecting the approach. It then concludes by presenting the best possible proposal on the subject.
Method
The article adopted the review and analysis of secondary sources. It reviewed literature that contained information about the menstrual status and AN diagnosis. The research focused on identifying AN diagnosed patients and their menstruation status and history. The study also included research questions that cover amenorrhea and its relation to the resumption of menses statistics, restraint diet, bone health, and BMI.
Results
It was identified that there is potentially biological differences among women with amenorrhea. Whereas there was a consistent association between women with low BMI and amenorrhea, the low, BMI was not exclusively a result of AN. Some of the women experienced stress, restraint diet and others were of normal weight. The study also indicated a reduced variance in the clinical features of those diagnosed with AN and those with amenorrhea. The patients diagnosed with amenorrhea were also reportedly having questionable bone health due to reduced mineral density.
Discussion
The retention of the amenorrhea criterion would base on the research result that indicates that amenorrhea is present in a majority of the patients with AN. However, research suggests that the development of amenorrhea in AN patients is not a primary or predisposing element. Furthermore, the use of amenorrhea criterion is irrelevant when dealing with other patients that have AN such as male patients. The comparison of the two arguments led to the possible conclusion that is prudent to retain amenorrhea criterion as one of the signs of the presence of AN but inquire for more medical findings for diagnosis.
Comparison and Contrast of the Two Articles
The two articles as discussed by Attia & Roberto, (2009) and Berner, Shaw, Witt & Lowe, (2013) investigate the treatment and AN patients. Attia & Roberto, (2009) seeks to determine whether the amenorrhea criterion should be retained in the diagnosis of anorexia nervosa. Whereas, Berner, Shaw, Witt & Lowe, (2013) seeks to investigate the relation of weight suppression and body mass index in symptomatology and treatment response in Anorexia nervosa patients.
Despite the shared interest of seeking an in-depth understanding of AN, the two research takes different approaches. Attia & Roberto, (2009) adopts a descriptive approach by focusing on the review of previous research articles on the subject. Findings of the various secondary sources were analyzed to guide the conclusion arrived at in the discussion. Berner, Shaw, Witt & Lowe, (2013), on the other hand, adopts a quantitative approach. The research is based on data obtained by patients in two health facilities. They are administered several measuring techniques that include the administration of questionnaires and measurements and findings analyzed statistically to guide the conclusion in the discussion section.
A review of both articles reveals how the two conditions share symptoms. The similarity of the symptoms goes to the extent that the amenorrhea criterion is used in the diagnosis of AN. Some of the common characteristics of the two conditions include reduced BMI, and suppressed weight. The usage of two different research approaches; quantitative and literature review yet, the findings share similarity emphasizes the commitment of the researchers to adhere to principles of the methodologies used.
Self-Reflection
Doing the exercise was extremely insightful. I was keen to identify the disease that I was to research about from chapter ten of (Whitbourne, 2017); however, meeting the selection criterion of the journal at first proved challenging. Nonetheless, the guidance of the reference page of the first article combined with the condition under discussion guided me through to the selection of the second articles. One by Attia and Roberto, (2009), and the other one by Berner, Shaw, Witt and Lowe, (2013). Both articles taught me more details about anorexia nervosa. From the textbook (Whitbourne, 2017), it was clear that AN is an eating disorder. Eating disorders significantly impaired individuals physically and psychologically. However, before the research, it was not clear to what extent. The study made me understand more the concept of suppressed weight and amenorrhea in addition to the already known symptoms and manifestation of the conditions. I also appreciated how the choice to review the literature and carry out quantitative research was correlated although the two studies adopted different techniques, samples, and time, their finding of AN correlate.
References
Attia, E., & Roberto, C. (2009). Should amenorrhea be a diagnostic criterion for anorexia nervosa? International Journal Of Eating Disorders , 42 (7), 581-589. DOI: 10.1002/eat.20720
Berner, L., Shaw, J., Witt, A., & Lowe, M. (2013). The relation of weight suppression and body mass index to symptomatology and treatment response in anorexia nervosa. Journal Of Abnormal Psychology , 122 (3), 694-708. DOI: 10.1037/a0033930
Whitbourne, S. (2017). Abnormal psychology (8th ed., pp. 245-263). New York: McGraw-Hill.
