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Introduction WORDCOUNT: 410

Anorexia Nervosa:
Anorexia nervosa is an eating disorder in which a person deliberately tries
to lose weight. Anorexics often discover that food dominates their lives
and soon consumes them. They avoid eating as they have a severe desire
to keep their body weight as low as possible. Anorexia nervosa is a mental
health condition and is often confused with the general term anorexia as
people may reciprocate between the two - anorexia simply means having
an absence of appetite whereas anorexia nervosa is the actual mental
health condition as mentioned before.
Attempting to lose weight can be in many methods such as: exercising
excessively, extreme dieting and forcefully vomiting. These persons see a
distorted image of themselves and thus they avoid eating all together as
they have a morbid fear of weight gain.
The eating disorder was rst discovered in !"ellenistic era# whereby it
began with religious fasting dating - it then persisted to the medieval
period. $n %&'( )ichard *orton had created the earliest medical
descriptions of anorexic illnesses, on the other hand, it was not until the
late %(
th
century until the illness was widely accepted and recognised in
the wide eld of medicine.
Today, - on average - one in every one hundred young women are
diagnosed with anorexia nervosa. This has consistently increased over the
last few years+ since ,---, the rate has increased by a whopping %./
making me believe that anorexia nervosa is a growing problem which must
be highlighted.
0$t is a demon and you can#t ght it, they can#t ght it. 1ou don#t know what
to do.2 3efore nalising my idea on what $ should do my extended pro4ect on,
$ had watched a documentary on anorexia named !5ana the ' 1ear 6ld
Anorexic#. After having watched the documentary $ felt, $ didn#t truly know
enough about the disorder and on that account, $ desired to know more.
*oreover, $ have a cousin which su7ers from anorexia nervosa and so it
makes it that much more worthwhile to learn more about a topic as such. This
particular 8uote really made me think and $ felt the mere emotion on the girls
face, expressed far more than an eating disorder. $ believe anorexia nervosa
is a topic which is merely touched upon and people have negative views
towards and they may not understand why people develop such a sorrowful
disorder.
Literature review WORD COUNT: 2248
%
29igns that someone may have anorexia or another eating disorder
include:
%. *issing meals, eating very little or avoiding eating any fatty foods
,. 6bsessively counting calories in food
:. ;eaving the table immediately after eating so they can vomit
<. Taking appetite suppressants, laxatives or diuretics =medication that
helps remove >uid from the body?
.. )epeatedly weighing themselves or checking their body in the mirror
&. @hysical problems, such as feeling light headed or diAAy, hair loss or
dry skin2
Anorexia can also be associated with other psychological problems such as
depression, anxiety, low self-esteem and alcohol misuse and self-harm.
There are many di7erent explanations as to how anorexia is developed and
what the causes of it are+ these can vary from being due to social factors
to biological factors i.e. it can be due to nature or nurture. The disorder of
anorexia nervosa is typically associated with females, this can be
explained through the learning approach within @sychology.
@eople with anorexia often go to great lengths to hide their behaviour from
family and friends by lying about what they have eaten, or by pretending
to have eaten earlier.
Psc!o"o#ica" $actors:
There has been much speculation as to exactly what anorexia nervosa is
caused by however evidence from the ;earning Approach within
@sychology suggests that anorexia nervosa is developed due to
environmental factors i.e. nurture, for instance *umford et al B(% had
found that Arab and Asian women are more likely to develop anorexia if
%
http:CCwww.nhs.ukCconditionsCanorexia-nervosaCpagesCintroduction.aspx
they are to move to the Dest, so this suggests a society that embellishes
the idea of being thin, is more likely to withhold a larger population of
anorexics. Experts say that anorexics strive on success and perfectionism.
F*any scientists think anorexics brains might be wired for willpower, for
good and ill.F
5r.Games ;ock then goes on to say,
,
0$t#s very rare for me to see a person
with anorexia in my oHce who isn#t a straight-A student.They will work and
work and work. The problem is they don#t know when to stop.2 This
enhances the idea that anorexics endeavour to be perfect thus have no
faults, this also suggests that perhaps anorexia is more than 4ust having a
constant need to lose weight. $t may be argued that this source is reliable
as $ had gathered it from a reliable source and this is proven by the fact
that the I); name end in 0org2
http:CCwww.sciencenews.orgCarticleCanorexic-brain
:
F@erfectionism J indicates excessive personal expectations for superior
achievement. 3ruch =%(K'? has suggested that the struggle to live up to
perfectionist achievement standards is a characteristic theme in anorexia
nervosa.F This source further suggests that perfectionism is indeed a factor
within the disorder and this need to be perfect may therefore further
enhance the want to be thinner. F9he interprets the patientBs typical
superior academic performance as an Fover compliant adaptationF which
breaks down in the face of increasing pressures to succeed.F This source
may provide strong evidence with the correlation between the need to be
perfect and being diagnosed with anorexia nervosa as mentioned before in
a previous source whereby 5r. Games ;ock had mentioned that young
anorexics need to be perfect and get straight-ABs. FDe have described the
perfectionism in anorexia nervosa as part of a FdichotomousF thinking style
=Larner et al., %(',?. The families in which anorexia nervosa occurs have
been discussed as highly achievement-oriented =Malucy et al., %(KK+ 5ally,
%(&(+ 3ruch, %(K:? and thus may magnify our cultureBs emphasis on
success.F Ninally, this source suggests again that self-criticism may play a
large factor in a person that su7ers from anorexias life.
:
0$ne7ectiveness J assesses feelings of general inade8uacy, insecurity,
worthlessness and the feeling of not being in control of oneBs, life. This
feature has been described by some as the fundamental disturbance in
anorexia nervosa2 This 8uote suggests that 0ine7ectiveness2 plays a ma4or
part in being diagnosed with anorexia, in other words, due to ones
psychology, they learn to believe they are of little value, that they are
0worthless2. The anorexics then develop 0a negative self-concept2 thus
allowing them to degrade themselves and again, develop anorexia.
9ource adapted from:
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5avid *. Larner, @h.5., *arion @. 6lmstead, *.A.
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%nviron&enta" $actors: 'nurture(
3oth psychological and environmental factors may overlap when it comes
to anorexia, for instance as mentioned before, the study *umford et al
found that teenage girls were more likely to develop anorexia when they
moved to the west, similarly it may be found that it is more likely for a girl
to develop anorexia due to the region in which they live in.
<
0*iscellaneous statistics
Nrom England: A %((' survey done by Exeter Iniversity included :K,.--
young women between twelve and fteen. 6ver half =.K../? listed
appearance as the biggest concern in their lives. The same study indicated
that .(/ of the twelve and thirteen-year-old girls who su7ered from low
self-esteem were also dieting.
5ieting teens: *ore than half of teenage girls are, or think they should be,
on diets. They want to lose all or some of the forty pounds that females
naturally gain between ' and %<. About three percent of these teens go
too far, becoming anorexic or bulimic.
Inrealistic expectations: *agaAine pictures are electronically edited and
airbrushed. *any entertainment celebrities are underweight, some
anorexically so. "ow do we know what we should look likeQ $tBs hard. The
table below compares average women in the I. 9. with 3arbie 5oll and
department store manne8uins. $tBs not encouraging. ="ealth magaAine,
9eptember %((K+ and NE5$R, a Ranadian eating disorders advocacy
group?.F
Suse tableS http:CCwww.anred.comCstats.html
This source emphasises that teenagers care far too much about their
appearance, although it may not be the most reliable source as it was
done in the %((-Bs. 9ince the gender highlighted appears to mainly revolve
around females, it may be fair to claim that environmental factors play a
rather large part in their lives as now-a-days most - mainly teenage girls -
have lives which revolve around social networking sites, magaAines, TO
programmes and 4ust general di7erent forms of media and so the so-called
role models that are advertised do 4ust so happen to be extremely thin and
beautiful. Again, from the learning approach, one supporting study for the
idea that more girls develop anorexia as opposed to boys and this could
explained by the fact that female models tend to be very thin and male
models tend to be muscular, therefore boys may not particularly aspire to
be thinner for this reason.
.
FAdvertisements in 9panish womenBs magaAines have been analysed in
order to verify the impact of commercial advertising encouraging
slimming. 5irectly or indirectly, ,,../ of advertisements encourage weight
loss.F This again emphasises the fact that people - in this case, 9panish
people - are a7ected by their environment, specically the media. $t is said
that the media plays a huge role in the lives of those that are anorexic,
encouraging them to, for example, be slimmer will therefore make them
prettier.
Ssource adapted from 9ocial @sychiatry and @sychiatric Epidemiology
%('', Oolume ,:, $ssue ,, pp %:,-%:&
Nurthermore, it is said that in some cultures such as the Rhinese anorexia
is rare as being large is valued as opposed to cultures such as the 3ritish
or the American where it is clear that most girls wish to be thinner, this
may be due to the media and their role models, for example in magaAines.
Nor further prominence, this source indicates that it may be the
environment in which those that su7er from anorexia are around makes
them develop anorexia nervosa,
&
F%.& million people in the IM are a7ected
by an eating disorder, of which around %%/ are maleF. 6ne interpretation
of this 8uote is that the ma4ority of females in the media are extremely
thin and anorexics - mainly teenagers - may see that these celebrities are
getting rewarded for their thinness thus making them imitate the
behaviours they observe. This is supported by the learning approach in
psychology which states that we observe and later imitate the behaviours
we see, however for anorexic males, it is unlikely that this process is to
occur as for male celebrities it is more likely that they are to be
stereotypically bulky and muscular.
http:CCwww.b-eat.co.ukCabout-beatCmedia-centreCfacts-and-guresC
K
*oreover, one study conducted by An4a 9plinder and Labrielle *ilos found
that 0All three subscales of the 39)$Jfemininity, masculinity, and social
desirabilityJcorrelated negatively with self-reported E5 behavior and
attitudes. $ndividuals with high levels of androgyny reported lower levels of
E5 symptomatology compared with undi7erentiated individuals who showed
higher levels of E5 symptoms.2 This source demonstrates that self-may be
esteem a7ected by the those around us, in other words, the environment as
they may a7ect those that develop anorexia nervosa.
S$nternational Gournal of Eating 5isorders
Oolume :K, $ssue :, pages ,,KT,::, April ,--.
)io"o#ica" $actors: 'nature(
9ome may argue that anorexia nervosa is due to ones biological make-up, i.e
the genes they have inherited and therefore passed down to other family
members which may persist throughout generations. 5ue to the fact that
'
0there is an increased risk of Anorexia Nervosa among rst-degree biological
relatives of individuals with the disorder2 it may highlight that Anorexia
Nervosa is if not entirely due to ones 3iology it is indeed at least a7ected by
ones 3iology.
SThe 5iagnostic and 9tatistical *anual of *ental 5isorders, Nifth Edition.: 59*
.
$n addition
(
0studies of Anorexia Nervosa in twins have found concordance
rates for monoAygotic twins to be signicantly higher than those for diAygotic
twins2 this accentuates the idea that the more closely related you are to one,
the more likely one is to develop the disorder of Anorexia Nervosa. A specic
supporting study comes from "olland et al which showed that
%%
0monoAygotic
twins have concordance rates of .&/ in terms of anorexia and diAygotic twins
have a signicantly lower rate of only ./. This demonstrates that the closer
one is related to another, the more likely the are to develop anorexia
nervosa2.
Also,
9
the risk of someone developing anorexia is also thought to be greater
in people with a family history of eating disorders, depression or substance
misuse, which suggests genes could play a role.2
SEdexcel A9 @sychology - 9tudent 3ook
%,
0$t has been suggested that changes in brain function or hormone levels
may also have a role in anorexia, although it is not clear if these lead to
anorexia or if they develop later as a result of malnutrition.2 This source
advocates that anorexia may be attributibale to the biological make-up of an
individual. Additionally,
%,
0The risk of someone developing anorexia is also
thought to be greater in people with a family history of eating disorders,
depression or substance misuse, which suggests genes could play a role.2
This is arguably a valid and authentic source as the website has been
certied as a reliable source of health and social care, the content is
evidence-based and uses the best scientic knowledge accessible.
%:
The source above underlines that anorexia nervosa has an extremely high
rate of heritability of .'/ to K&/ which again puts emphasis on the fact that
the mental health disorder may indeed be due to ones biological make up.
This source may be 8uite valid as it is based on a factual study by 3ukk R* et
al ,--<.
%<
0...early results found a couple of Flikely suspectsF: areas on chromosomes %
and %- that appear to be signicantly linked with anorexia and bulimia.
Nollow-up studies of candidate genes have identied several genes that may
increase a personBs vulnerability to these disorders.2
%.
0$t has been suggested that changes in brain function or hormone levels
may also have a role in anorexia, although it is not clear if these lead to
anorexia or if they develop later as a result of malnutrition.2 This source
advocates that anorexia may be attributibale to the biological make-up of an
individual. Additionally, 0The risk of someone developing anorexia is also
thought to be greater in people with a family history of eating disorders,
depression or substance misuse, which suggests genes could play a role.2
This is arguably a valid and authentic source as the website has been
certied as a reliable source of health and social care, the content is
evidence-based and uses the best scientic knowledge accessible.
Possi*"e cures $or +nore,ia Nervosa:
6ne therapy created solely for treating Anorexia Nervosa is highlighted by
9igmund Nreud which had devised a model in order to illustrate how
(
0irrational, self-defeating thoughts can lead to maladaptive behaviour2
can be applied to anorexics through di7erent examples.
SEdexcel A, @sychology - 9tudent 3ook
This model attempts to help the client i.e. the anorexic in order to
recognise their unfounded, pessimistic and cynical views in order to
substitute them for optimistic and rational ways of thinking. This therapy is
called !)ational Emotive Therapy# =)ET?. The reason as to why this model
may have been created supports the idea that Anorexia Nervosa may
indeed be down to psychological reasons as it aims to tackle the negative,
arguably unrealistic thoughts and views that anorexics have about
themselves such as being overweight or !fat# when in reality, they are
undoubtedly underweight.
Also, there are psychological talking treatments
%-
...For example, cognitive
behavioural therapy (CBT), cognitive analytic therapy (CAT), interpersonal
psychotherapy (IT) an! "ocal psycho!ynamic therapy. Tal#ing treatments
help to loo# at the reasons $hy you may have !evelope! anorexia, an! aim
to change any "alse belie"s that you may have about your $eight an! bo!y,
an! to help sho$ you ho$ to i!enti"y an! !eal $ith emotional issues.% The
idea of this treatment emphasises that anorexia nervosa is a psychological
issue as it is to do with therapy and it highlights that it completely revolves
around how an anorexic thinks and changing the ways in which they think.
These treatments may further emphasise that anorexia cannot be tackled
simply by gaining weight and eating regularly, they must in other words, keep
the mind at peace and resolve further issues such as their thoughts and
relationships with those around them.
According to the N"9,
%.
0medication is not usually e7ective in treating
anorexia nervosa. $t is usually only used in combination with the measures
mentioned above to treat associated problems, such as obsessive compulsive
disorder =6R5? or depression.2 This 8uotation underlines that again, anorexia
nervosa needs psychological treatment, perhaps not completely however in
order for the treatment to be potent, it is necessary.
An article on the 33R news found that
%&
0A hormone released during childbirth
and sex could be used as a treatment for the eating disorder anorexia
nervosa, scientists suggest2. This source may be reliable as it is from
scientic evidence from this year and proof of its success is proven as 0small
studies by IM and Morean scientists indicated patients were less likely to
xate on food and body image after a dose of oxytocin2
Swww.nhs.com
T!e i""nesses associated wit! +nore,ia Nervosa:
%
0Anorexia can also be associated with other psychological problems such as
depression, anxiety, low self-esteem, alcohol misuse and self-harm.2
%K 0
Almost .-/ of people with eating disorders meet the criteria for
depression.2
3ibliography:
%
http:CCwww.nhs.ukCconditionsCanorexia-nervosaCpagesCintroduction.aspx
,
http:CCwww.sciencenews.orgCarticleCanorexic-brain
:
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AN5 3I;$*$A
5avid *. Larner, @h.5., *arion @. 6lmstead, *.A.
$NTB; G6I)NA; 6N EAT$NL 5$96)5E)9CO6;., N6., C D$NTE)
<
http:CCwww.anred.comCstats.html
.
9ocial @sychiatry and @sychiatric Epidemiology
%('', Oolume ,:, $ssue ,, pp %:,-%:&
&
http:CCwww.b-eat.co.ukCabout-beatCmedia-centreCfacts-and-guresC
K
$nternational Gournal of Eating 5isorders
Oolume :K, $ssue :, pages ,,KT,::, April ,--.
'
The 5iagnostic and 9tatistical *anual of *ental 5isorders, Nifth Edition.: 59*
.
9
Edexcel A9 @sychology - 9tudent 3ook
%-
http:CCwww.patient.co.ukChealthCanorexia-nervosa-lea>et
11
*rs )ichardson - "ead of @sychology at 6aks @ark "igh 9chool
%,
http:CCwww.nhs.ukCconditionsCanorexia-nervosaCpagesCintroduction.aspx
%:
http:CCwww.psychiatrictimes.comCarticlesCexploring-gene-environment-
nexus-anorexia-bulimia
%<
http:CCwww.webmd.comCmental-healthCeating-disordersCanorexia-
nervosaCfeaturesCanorexia-bulimia-genetic-code
%.
www.nhs.com
%&
Article from the 33R news, %:
th
*arch ,-%< 0#;ove "ormone may treat
anorexia2
%K
http:CCwww.anad.orgCget-informationCabout-eating-disordersCeating-
disorders-statisticsC