Issues relating to eating are so varied based on social, economic, and cultural bearing factors that most people doubt that eating patterns can be predicated on psychological problems. After all, even a child of tender age will have a good command of eating habits and many of the mentally impaired are still able to eat enough to sustain themselves. However, as defined by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), an issue with food consumption or the lack thereof can be considered as a mental problem if it has a direct adverse effect on the health of an individual (Brownell & Walsh, 2018). A variety of social, cultural, and biological issues cause eating disorders in the modern world. Similarly, the outcomes of eating disorders vary exponentially and may be as limited as mere discomfort and as extreme as death. Eating disorders are a set of serious mental disorders, which if not properly managed and handled will continue to affect an increasing proportion of the populace.
Causes of Eating Disorders
Just as the nature of eating disorders vary exponentially, so does its causation, with general trends showing genetic, social, and cultural causation factors. Available primary research based on identical twins has provided definitive proof that there is a genetic causation of eating disorders (Stice, Gau, Rohde, & Shaw, 2017). Some individuals will be highly inclined to develop eating disorders by their genetic nature, in spite of any and all environmental factors. Closely associated with the genetic causation factors are the biological factors. Certain diseases, ailments, or medical conditions can contribute to eating disorders. For example, a person who has a digestive tract problem and experiences pain after eating will be inclined to eat less if at all, hence developing an eating disorder. Similarly, a person with an illness that creates a feeling of constant weakness will be inclined to eat more, a fact that may encourage binge eating disorders (Smink, Van Hoeken, & Hoek, 2012). When genetic and biological factors are involved, managing the eating disorder may be more complicated than when social or cultural causation factors are involved.
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The social and cultural factors, however, are the greatest contributors to eating disorders in the modern developed world, more so in the United States. Among the leading social factors that contribute to eating disorders are a lifestyle and fashion-based inclination. For some unexplained reasons, the idea developed that good looks are synonymous with limited weight, small sizes and most importantly, small waists for the ladies (Brownell & Walsh, 2018). Indeed, fashion shows and beauty contests even provide limitations on who can contest or participate, based on physical features. Based on the presupposition that only a slim woman can be beautiful, many young ladies and girls try to eat as little as possible to look beautiful in the eyes of the world, leading to anorexia nervosa. Others will eat then overdo exercises to maintain low weight, leading inter alia to bulimia nervosa as the individual struggle with the vagaries of over-exercising (Smink, Van Hoeken, & Hoek, 2012). Another common concept that has affected both men and women is that a slim body is a sign of success while putting on weight is considered as a sign of laziness, folly, or lack of class.
From an entirely different perspective, stress is another leading social cause of eating disorders. Some people will either react to stress by refusing to eat or by eating too much, hence contributing to eating disorders. Most binge eaters, for example, will be trying to use food as an escape route for other social issues just as some people use drugs and other vices. Unfortunately, eating too much will then have adverse effects on the body or even take the semblance of an addiction (Stice et al., 2017). It is also important to note that the bearing factors of eating disorders outlined above will normally not operate exclusively within an individual as, in most cases, different factors will play different roles in a single individual’s eating disorder.
Prevalence and Impact of Eating Disorders in America
The prevalence of eating disorders in the USA has in recent years reached worrying levels according to Leavitt (2018), an article published by the Harvard School of Public Health. The article divides eating disorders into two main categories, the clinical and non-clinical eating disorders. The clinical eating disorders are those that have attained the threshold of requiring clinical attention while the non-clinical are mild enough for patients to manage them on their own. Available research places the prevalence of clinical level eating disorders in America at almost 10% of the US population, which is approximately 30 million people. However, the 30 million prevalence includes all Americans who have suffered an eating disorder at some point in life. Actual prevalence’s at any moment in time for clinical-level eating disorders is about 4% of the population which still amounts to millions of people. An interesting statistic presented in Leavitt (2018) is that none-clinical eating disorders prevalence is up to double or up to triple the prevalence of clinical eating disorders. This means that as many as 90 million Americans could have dealt with an eating disorder at some moment in their lives.
The impact of eating disorders vary exponentially based on the specific nature of eating disorders involved. A common misconception in America is that eating disorders are synonymous with anorexia nervosa merely because it is the most popular form, despite the fact that it is not the most common form of eating disorder. The popularity of anorexia nervosa is mainly predicated on the severity of its impact. Based on available research, anorexia nervosa is arguably the most deadly forms categorized under DSM-5 (Brownell & Walsh, 2018). Not only is the condition deadly in itself due to the vagaries of nutritional deficiency in the body but also increases the propensity for suicide by over 50 times. Among the non-suicide causes of death include heart and kidney failure and also a failure of other organs. Bulimia nervosa, on the other hand, combines binge eating or even normal eating with regurgitation to prevent the impact of food ingestion on the body. Among the vagaries caused by Bulimia nervosa is adverse effects on teeth and gums due to the excessive regurgitation. Individuals suffering from Bulimia nervosa are also likely to have high rates of suicide ideation and attempts. Binge eating disorder in itself can also adversely affect the patient (Brownell & Walsh, 2018). Its effects include obesity and vagaries such as cardiovascular disorders. Risk of suicide is also high among binge eaters. Finally, all the eating disorders outlined above also increase the propensity for stress, depression, and substance abuse as the patients try to deal with the psychological impact of the respective disorders.
Diagnosis and Management
All recognized eating disorders are diagnosed under the Feeding and Eating Disorders section of DSM-5. However, a varied diagnosis is applied for the three major forms of eating disorders which are anorexia nervosa, Bulimia nervosa, and Binge eating disorder. The diagnosis for anorexia nervosa is mainly based on the body mass index (BMI) of the patient. A BMI of between 17 and 20 will reflect mild anorexia nervosa (Brownell & Walsh, 2018). Moderate anorexia is between 16 and 17 while severe anorexia is between 15 and 16. Any BMI levels that fall below 15 is considered as extreme anorexia and, in most cases, as a medical emergency. After the BMI assessment, however, a differential diagnosis will be carried out to rule out Bulimia nervosa or a variety of minor eating disorders. Diagnosis for Bulimia nervosa is more complicated as it does not necessarily have physical signs and symptoms. Under DSM-5, a positive diagnosis will be made in a 3-month period, an episode of binge eating and respective compensatory behaviors takes place every week (Brownell & Walsh, 2018). In case binge eating happens but without respective compensatory behaviors, a diagnosis for Binge eating disorder will be made.
Management of eating disorders combines a medical approach to treat biological effects and a psychiatric intervention to solve the psychological aspects of the disorders. Most medical approaches are symptomatic in nature and include reversing the impact in mild cases and acute care in extreme cases (Brownell & Walsh, 2018). With regard to the psychological aspects, the American Psychology Association (APA), recommends group therapy. The nature of therapy will, however, differ exponentially depending on the nature of the disorder. The general idea is to eliminate the psychological causes of eating disorders. Among the common therapies utilized include Cognitive behavioral therapy (CBT), Acceptance and commitment therapy and Interpersonal psychotherapy (IPT) (Brownell & Walsh, 2018). In extreme cases such as when the propensity for suicide or self-harm is inordinately high, the patient may also be institutionalized.
Conclusion
Eating disorders are a serious health problem that needs to be urgently addressed. Several versions of eating disorders exist, categorized both on process and outcome. They include anorexia nervosa that is characterized by very little eating and binge eating disorder that involves uncontrollable episode of overeating. Other versions include individuals who will eat then try to get rid of the food through regurgitation or over-exercising. It is important for the modern society to accept the fact that eating disorders are not a result of people acting up but rather a serious mental problem, which needs urgent and specialized clinical attention. With tens of millions of Americans suffering from mild to acute eating disorders, society must adjust its way of life and belief patterns to assist in mitigating the problem. Most importantly, anyone with an eating problem no matter how mild should not shy away from seeking professional help before the problem gets out of hand as eating disorders can also be fatal.
References
Brownell, K. D., & Walsh, B. T. (2018). Eating disorders and obesity: A comprehensive handbook . New York: The Guilford Press.
Leavitt, N. (2018, June 22). A call for the CDC to track eating disorders. Retrieved from https://www.hsph.harvard.edu/news/features/cdc-eating-disorders-tracking/
Smink, F. R., Van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports , 14 (4), 406-414
Stice, E., Gau, J. M., Rohde, P., & Shaw, H. (2017). Risk factors that predict future onset of each DSM–5 eating disorder: Predictive specificity in high-risk adolescent females. Journal of Abnormal Psychology , 126 (1), 38-51
