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Anorexia Nervosa

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Anorexia Nervosa, a disturbing disease of denial, consisting of self -imposed starvation and the intense fear of gaining weight, is becoming an epidemic among many teenage girls due to the environment, biochemistry, and personality of the individual. I. The immediate environment, friends and family, directly influence the development of anorexia. A. Anorexics tend to come from families placing strong emphasis on food and the family may have used food for purposes other than nourishment such as a sign of love for the providers or used when family members face unpleasant situations. B. There is a greater risk of a person developing anorexia when a member of their family has had the disorder or when a parent is either very thin or obese. C. Overly critical brothers and fathers of the girls weight and attractiveness have a forceful impact on the development of anorexia. D. Special dietary needs of a family member, emphasis on nutrition, and power struggles over eating assist in the self-imposed starvation. E. Nutritional labeling on the foods and mothers stocking their refrigerators with low fat and no-fat foods may actually lead to eating problems. 1. The mothers eating habits greatly influence the daughters and it is recommended that the daughters favorite foods are in the house. 2. The mother should invite her daughter to the grocery store to choose some of her favorite fruits, vegetables, meats, and cereals. 3. Making this a routine can help provide a positive aspect on the importance of nutrition. F. It is important for family members to promote self-esteem in intellectual, athletic, and social endeavors. 1. The parents should examine their own attitudes toward weight to discover how they could be affecting the children. 2. Discussing the dangers of dieting, the value of moderate exercise, and the importance of eating a variety of foods can help minimize the chances of developing anorexia. II. Biochemistry also contributes to the development of anorexia. B. In the neuroendocrine system, a combination of the central nervous and the hormonal systems, there are seriously disturbed mechanisms in people with eating disorders. 1. The neuroendocrine system regulates sexual function, physical growth and development, appetite and digestion, kidney functions and emotions. 2. The common symptoms of anorexia directly relate to the disturbed mechanisms in the neuroendocrine system. 3. Common symptoms such as serious depression, bingeing and consuming large amounts of food and showing no noticeable weight gain, and loss of menstrual periods are directly associated with the disturbed neuroendocrine system that normally regulates these functions. B. There have been several chemicals found that can be directly related to symptoms of anorexia. 1. The neurotransmitters serotonin and norepinephrine, key chemical messengers in the central nervous system, are significantly decreased in ill anorexic patients. 2. The decrease of the chemicals serotnin and norepinephrine cause severe depression, one symptom of anorexia. 3. Another brain chemical found to be abnormal in people with anorexia is the hormone vasopressin. 4. Vasopressin is what contributes to the obsessive-compulsive behavior of the patients. 5. There have also been higher than normal levels of cortisol found in anorexic patients, a brain hormone released in response to stress. 6. The high levels of cortisol are caused by a problem that occurs in or near the hypothalamus. 7. The hypothalamus is the part of the brain that regulates menstruation, eating, metabolism, body temperature and sleep. 8. It has not been established if anorexia causes the hypothalamus disturbance or if the hypothalamus directly influences the occurrence of anorexia. 9. By exploring the roles of chemicals played in the brain, the findings are making it possible to explain why and how this disease is occurring. III. Personality traits are a source of psychological symptoms of anorexia nervosa patients. A. Anorexics tend to have self-critical and obsessional personality traits. 1. They are known for their compliant behavior and attainment of good grades, and are often perfectionists. 2. There is often repugnance at sexual development. 3. Associated with the perfectionistic personality is an all-or-none kind of reasoning and the setting of unattainable goals. B. Family personality traits that encourage anorexia are enmeshment, rigidity, overprotectiveness and inability to resolve conflict within the family. 1. Thirty-six of 39 young female patients refer to their fathers as emotionally distant. 2. Mothers of anorexics frequently suffer from depression, are domineering, and intrude in the anorexics hour-to-hour-life. IV. Antidepressant drugs, behavioral techniques, and psychotherapy are the most frequently used treatments. A. One successful medication used is the antidepressant fluoxetine, because it affects serotonin function in the body which is significant in the biochemistry of anorexics. B. One behavioral technique used is a token system for food eaten, consisting of reinforcements contingent on weight gain. 1. Behavioral techniques work especially well for social phobic behavior. 2. Obsessive-compulsive disorder has also been successfully treated with behavioral techniques. C. Psychotherapy is needed for the underlying emotional issues of the anorexic and to help the patient begin to understand and cope with their illness. D. The combination of psychotherapy and medication has been found as an effective treatment, and it prevents relapse after the medication is discontinued. E. When excessive and rapid weight loss, serious metabolic disturbances, clinical depression or risk of suicide, or psychosis take place, hospitalization may be necessary. F. For emotional and psysiological treatment, there is a variety of experts needed such as a nutritionist, an individual psychotherapist, a group/ family psychotherapist, and a psychopharmacologist- someone who is knowledgeable about psychoactive medications useful in treating the disorder. V. Symptoms of anorexia are widespread and can sometimes be difficult to pinpoint. A. Excessive weight loss in a relatively short period of time and the continuation of dieting although bone thin is one of the very common symptoms. B. There is usually an extreme dissatisfaction with body appearance and the belief the body is fat, even though severely underweight. C. Anorexics often show an unusual interest in food and the development of strange eating rituals. D. They are always collecting new recipes and preparing gourmet meals for family and friends, but not eating the meals themselves. E. Many anorexics abuse drugs and alcohol, suffer from serious depression, eat in secret, and obsess over exercise. F. Some use drugs particularly to stimulate vomiting bowel movements and urination. G. Following these symptoms are usually severe medical problems such as premature osteoporosis, abdominal pain, lethargy, intolerance to cold, impaired



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