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Cassidy Spatz

Professor Watson

English 1100

1 October, 2018

When Skinny Becomes Deadly

The topic I am going to be discussing with you is anorexia nervosa and bulimia nervosa.

These eating disorders are discussed a lot but not in-depth. I have gathered my information from

multiple sources while inputting my knowledge and opinions too. Many people only know the

surface of these disorders but do they know what causes it? What are the treatment methods?

How does the media make it worse or better? What’s the physical impact of it? Mental impact?

All of these questions and more need to be addressed and answered. Anorexia and bulimia are

diseases that should not be taken lightly.

First, I’m going to start off with what anorexia and bulimia are. The American Anorexia

Nervosa Association defines anorexia as “a serious illness of deliberate self-starvation with

profound psychiatric and physical components.” (Neuman and Halvorson 2) Anorexia is an

eating disorder characterized by two subgroups. Restricting is when weight loss is achieved

through dieting, fasting and excessive exercise. Binge-eating/Purging is when the person has

taken part in binge-eating or purging behavior like self-induced vomiting or using laxatives.

(Robert-McComb 5) Bulimia is more common than anorexia and is when a person takes part in

eating a large amount of food in one sitting and later making themselves vomit, but they can also

use other ways to purge like using laxatives. (Robert-McComb 8) The main difference between

these two is that in anorexia the person reduces their food intake to watch their weight while
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those affected by bulimia binge on big amounts of food then purge or use other methods to

prevent gaining weight.

A great majority of those affected by eating disorders are young women, especially in

adolescence with estimates that up to 20% of high school and college-aged women have eating

disorders, while more than 50% of woman at that age are dissatisfied with their body. (Robert-

McComb 40) Girls and women are 10 times more likely to suffer from anorexia or bulimia, but

they do seem to be getting more common in males. They may be more likely to over exercise

and aim for a more muscular body rather than a skinny one. (Timms) The desire to fit in and be

perceived as attractive is strong during teenage years, and speaking from experience, other peers

can influence you by either bullying or getting you to partake in bad behaviors. Robert-McComb

states, “In addition to attractiveness, social approval is reported by teenagers to be the most

important quality for determining self-esteem. Many people with eating disorders share a fear

that they will be rejected by others and exhibit a marked sensitivity to the social approval of

others.” (41)

Nobody knows the specific cause of any eating disorder and it has been argued about

over the years. It is not uncommon for the onset of the disorder to be a result of a stressful

situation that is not handled correctly. It could be thanks to puberty when your body is changing

and having no control over it, but you would have control over your weight. Sometimes when we

diet and get good results we don’t want to stop because we want to keep that feeling of

accomplishment. Social pressure whether it be from other peers or in the media can play a part in

our self-confidence and vulnerability. Places where thin is beautiful have more eating disorders

than those accepting of all body types like ballet or modeling. Also, depression is a likely factor

that can come into play with eating disorders. If you think about it, have you ever been sad and
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turned to food for comfort? This could explain when people with bulimia decide to binge but

unfortunately purging or using other methods will leave them just as bad if not worse. Other

obstacles in life like break-ups, sexual abuse, a physical illness or even just a big step in life like

marriage can cause the start of anorexia or bulimia. (Timms)

There are multiple complications that come with any eating disorder. There is so many

effects on the body from eating disorders they are impossible to list all of them but I will focus

on select few. Many of the mental and physical effects that come with anorexia nervosa are

related to the effects of starvation. The other traits have to do with the person’s attitude towards

eating and their weight. (Berg) A person may be low in potassium, sodium, and calcium along

with abnormal temperature regulation. Decreased bone density can lead to breaks and fractures

and more. Gastrointestinal issues like vomiting, bloating and constipation which can lead to the

use of laxatives. Overusing laxatives can cause bleeding and injury to the colon. The stopping of

menstruation in females can occur as well along with delayed puberty. (Berg) In approximately

30-50% of the women with anorexia, their cycle is disrupted differing from anovulation to

oligomenorrhea and amenorrhea. In males, changes in the hormonal mechanisms in the body

also point to anorexia. Low testosterone levels, decreased testicular volume, and diminished

sexual functioning are symptoms. (Robert-McComb 53) In bulimia there is a lot of similarities

with anorexia with physical effects. Constant vomiting can result in tears in esophagus and hiatal

hernias. Just like anorexia, overuse of laxatives can damage the colon and cause problems with

bowel movements. More commonly, bulimia leads to puffiness in the face, swollen glands, sore

throats and dental problems like enamel erosions. Dry and tender skin is common with both

disorders and callouses on the fingers from inducing vomiting. The person may become anemic

with nutrition deficiency as well. (Neuman and Halvorson 63)

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Now that we’ve covered the physical effects of anorexia and bulimia we can talk about

the mental side of it. Some of mental changes that can happen when you have anorexia is being

obsessed with your weight and appearance, an intense fear of gaining weight, depression and

anxiety, feeling ‘out of control’, anxiety about eating in public and more. Bulimia can cause

intense stress and anxiety, especially if the person is keeping the disorder a secret. It can cause

major mood swings, depression, self-isolation, self-harm, and low self-esteem. Obsessive

Compulsive Disorder is also common with these disorders. (Johnson)

Anorexia nervosa and bulimia can be diagnosed by a mental health professional, like a

psychiatrist, psychologist, or social worker. Since the person with the eating disorder might not

report all the symptoms correctly, reports from family members or friends. Most of the time, a

pediatrician or primary care physician is the first to notice the symptoms of starvation for

anorexia like low blood pressure, dental problems, dry skin, and of course weight loss. Women’s

Health magazine talks about the duration of the disorder, “Duration varies. Some people with

anorexia nervosa have a single, relatively brief episode after experiencing an isolated stressful

event. For others, the problem becomes chronic (long-lasting) and the person's condition

gradually deteriorates. Many people start by restricting food, then later binge and purge.”

(Anorexia Nervosa) Although, many people go into adulthood with issues with their body image

and dieting habits even if they no longer have the disorder.

Bulimia literally means “ox hunger”. (Neuman and Halvorson 46) The diagnostic criteria

for this eating disorder involves frequent episodes of binge-eating, a large amount of high-caloric

foods in less than two hours. The affected can be over-weight and attempt to lose weight by

serious diets, vomiting, or laxatives and this can cause their weight to fluctuate from bingeing

and then fasting. An important part of diagnosing someone with bulimia is that the bingeing and
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purging is not a symptom of anorexia since we know that anorexia can sometimes involve

bulimic episodes. The main difference between these two disorders is that individuals with

bulimia alone are not underweight. (Neuman and Halvorson 47) “Note that anorexics who

experience episodes of binge-eating fit all the diagnostic criteria established for bulimia except

that the bulimic episodes are not due to anorexia nervosa! This means that any individual with

early anorexic symptoms and binge-eating episodes would be diagnosed as bulimic until an

extreme weigh loss has been attained.” (Neuman and Halvorson 48)

Treatments for anorexia can vary from counseling, hospital treatment, medication and

even compulsory treatment. Counseling involves talking to a therapist for one hour every week

about your problem, how it all started and how you think you can change. This will help get

things off your chest and get opinions and advice from someone. It can also be done in small

groups of people with similar problems or even with your family. Your family members or

spouses can have separate sessions on how to help you as well. Doctors will not recommend

hospital unless this type of treatment does not work. You can also talk about your problems and

control your eating but in a more structured way in this setting. Blood tests will be done to make

sure you are not at risk of infection and regular weight checks to make sure you are gaining

weight. Other checks may be done to the body to make sure no damage was caused. Doctors may

prescribe medicine to help with the anxiety while getting over the illness. Compulsory treatment

is not common but may need to be done if the person cannot make healthy decisions for

themselves or if they need protected from harm. (Timms)

In bulimia treatment there has been found that two kinds of psychotherapy treatment

proven effective. The first one is Cognitive Behavioral Therapy which helps you look at your

thoughts and feelings in detail. You may keep a journal writing about you eating habits and your
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feelings throughout the day. The next type of psychotherapy is Interpersonal Therapy which is

more focused on your relationship with those around you. Some of the causes of bulimia are

because of a big change in life or because of a person. Talking about these things with your

therapist is a replacement for eating. A dietician can also help advise you on healthy eating so

you can stay on track. Anti-depressants can help with appetite even if you are not depressed and

can help start off your psychotherapy. The benefits of this do dwindle down so it is not a

permanent solution. (Timms)

(Figure 1) Society’s Message To Women

In reference to Figure 1, media can also affect how people see themselves and cause eating

disorders. The media has flooded us with images of “perfect” women with no stretchmarks, clear

skin, flat stomachs, and airbrushed look. They usually target women and not men in magazines,
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tv, movies and even billboards. Have you ever seen a magazine cover with an attractive person

on the cover saying that inside there is diet and exercise tips? “A 1998 USA Today poll suggested

that 23% of girls 12 to 17 years old were influenced by magazines in their fashion choices. If

these women are so influenced, do they have the body types to wear that fashion choice, or will

they need to attempt some weight loss tactic to fit in?” (Robert-McComb 181) Plenty of research

has shown that visual media will influence and impact women’s body image. Even worse is

television, with ads on weight loss programs in commercials with the before an after picture

flashed on the screen. Even cartoons support an idealistic body with female cartoon characters

like the Disney princesses with their tiny waists and petite bodies. A very unrealistic body

standard is the Barbie doll which little girls grow up playing with. Thankfully, there are now

more diverse Barbie’s with all different body shapes and sizes. People watching super skinny

models on the runway wearing expensive lingerie and seeing everyone in awe of them can also

influence girls and women to want to look like them. “The average model weighed 8% less than

the average American women, whereas today, models weigh 23% less.” (Robert-McComb 182)

Teaching society that every body type is worthy and to love the skin you’re in is the first step to

overcoming this epidemic of what these people are putting themselves through. There is no right

or wrong body when we all are different and not meant to be the same.
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Work Cited

“Anorexia Nervosa.” Womens Health, Womens Health, 25 May 2018,

www.womenshealthmag.com/health/a19949207/anorexia-nervosa/.

Berg, Frances M. “Complications of Eating Disorders.” Healthy Weight Journal Vol. 15 Issue 2

(2001): p28. 2p.

Jon Johnson. "What are the effects of bulimia on the body?." Medical News Today.

MediLexicon, Intl., 23 Aug. 2018. Web. 24 Sep. 2018.

<https://www.medicalnewstoday.com/articles/322853.php>

Neuman, Patricia A., and Patricia A. Halvorson. Anorexia Nervosa and Bulimia: a Handbook for

Counselors and Therapists. Van Nostrand Reinhold, 1983

Robert-McComb, Jacalyn J. Eating Disorders in Women and Children: Prevention, Stress Management,

and Treatment, Second Edition. CRC Press, 2012

“Society's Message To Women.” 10 Art Therapy Ideas, May 2014, ideastand.com/art-therapy-ideas.

Timms, Philip. “Anorexia and Bulimia.” Improving The Lives of People With Mental Illness,

2015, www.rcpsych.ac.uk/healthadvice/problemsdisorders/anorexiaandbulimia.aspx.