Everything about Food
Many agree that food is life; however, very few know that some eating habits are signs of disorders. Minton and Kianpour (2020) state that approximately 8 million Americans suffer from clinically significant eating disorders. Out of this population, adolescents are the most susceptible group. The claim is evident from a report by the department of health and human services of the US government, which shows that almost 3% of adolescents aged between 13 and 18 years are diagnosed with an eating disorder (HHS.gov, 2018). Literature also suggests that most eating disorders originate during adolescents and progress into adulthood (Salafia et al., 2015). Unfortunately, if left untreated, the conditions can be life-threatening, leading to death in some scenarios. Due to the significant threat that eating disorders pose to adolescents’ life, research is required to identify ways in which various ailments, such as binge eating, anorexia nervosa, and bulimia nervosa can be prevented at an early stage.
Definition of Eating Disorders
The National Institute of Mental Health (NIMH) refers to eating disorders as serious illnesses that cause disturbances to people’s eating behavior. The definition issued by the NIMH is universally accepted and often used in all scholarly works that investigate the related illnesses. For instance, a similar meaning is adopted by Galmiche et al. (2019) in their systematic review. As such, the term eating disorders, as utilized in this research, is in conformity with the NIMH definition.
Galmiche et al. (2019) further classify eating disorders in three groups, namely: anorexia nervosa, bulimia nervosa, and binge eating. Among the three, binge eating is the most prevalent and it affects adults and adolescents of all ages. According to international research, 26% of female and 13% of male adolescents are said to have experienced an episode of binge eating at least once in 2001 (Marzilli, Cerniglia & Cimino, 2018). Based on these statistics, it is evident that teenagers are the most vulnerable population to binge eating disorders. However, a significant fraction of clinical cases among this category of individuals may go unnoticed due to their unique eating habits. As observed by Marzilli, Cerniglia and Cimino (2018), it is typical of adolescents to indulge in large food consumption due to the developmentally specific growth spurts. Therefore, binge eating can easily be confused with nonclinical behaviors, resulting in delayed treatment at an early stage.
Causes and Symptoms
Identifying the causes and symptoms of binge eating disorder is a milestone in determining the most sustainable preventive and treatment measures. Studies conducted among persons with such conditions revealed that individual and sociocultural factors are the most dominant causes of binge eating (Salafia et al., 2015). For instance, people who experience a considerable degree of body dissatisfaction are at a higher risk of exhibiting binge eating and purging. Additionally, there are some cultural beliefs that gaining weight equal happiness and beauty, which can drive individuals to consume unusually large amounts of food. While anyone can fall victim of factors that contribute to binge eating, adolescents may be the most vulnerable group as it is during this stage that people experience body changes. Consequently, changes that cause body dissatisfaction and failure to conform with one’s cultural beliefs can lead to binge eating disorder.
Various criteria are used to assess the prevalence of binge eating disorders. Among the most common symptoms for adolescents with the disorder include lack of control during the episode of binge eating (Lee-winn et al., 2016). Notably, persons with the illness may experience difficulties in controlling what and how much food they consume. the condition may also be characterized by the habit of eating until feeling uncomfortably full, eating when not hungry, eating alone due to embarrassment about binge eating, and being often upset both during and after binge eating (Lee-winn et al., 2016). As can be seen from these symptoms, they vary significantly from regular eating habits, an aspect that makes them potential indicators of the ailment.
Anorexia nervosa is also a prevalent eating disorder among adolescents. The illness is often characterized by refusal to eat, making it a complete opposite of binge eating. Individuals who suffer from the condition experience reduced and low body weight, compared to the recommended level of age and gender (Grzelak et al., 2016). Based on prior studies, anorexia nervosa usually occurs among adolescents with a median age of 17 years, affecting about 0.5% to 1% of teenage girls in the West (Hisam, Rahman & Mashhadi, 2015). Compared to adolescent males, there are more incidences of anorexia nervosa among teenage females. For instance, Ahmed (2016) avers that based on some studies, 13% of adolescent girls suffer from the disorder compared to 0.1-0.3% of men. As is evident from research conducted among 48 males and females at two sites, the discrepancy between the two genders is caused by their varying concern over shape and weight (Darcy et al., 2012). Notably, adolescent females often endorse the desire to lose weight and have a flat stomach, making them vulnerable to anorexia nervosa. If proper management of the condition is not taken during adolescence, the condition may lead to the development of bulimia anorexia nervosa during adulthood.
Causes and Symptoms
Studies suggest that like binge eating disorder, anorexia nervosa stems from individual and cultural factors. Among the most common factors that lead to the condition is self-esteem. As hypothesized by Grzelak et al. (2017), people suffering from anorexia nervosa consider appearance and body mass as the base of their self-esteem, which drives them to pursue extremely low anthropometric measurements, which they consider ideal. Based on this hypothesis, it may be argued that emotional concern about one’s body appearance and the need to maintain a certain body mass is the key motivational factor among humans to indulge in abnormal-food related habits, such as anorexia nervosa.
Research also suggests that self-perception has a significant influence on alterations in eating habits among people suffering from anorexia nervosa. Notably, this finding is based on Higgins’ self-discrepancy theory, whereby there exist three types of self, “actual”, “ideal” and “ought” (Grzelak et al., 2017). For instance, if there exists a discrepancy between the state that is aspired (ideal self), and state perceived as actual (actual self), individuals may tend to indulge in consumption of less food or refuse to eat to achieve the aspired body image. Often, media is said to have a considerable influence on these two types of self. For example, exposure to photos on body images promoted by social media may lead one to have a negative body perception about themselves. A similar scenario may occur in society whereby communities hold a different opinion about the desired self. In such cases, individuals who fail to meet society’s feature of desired self, may deviate from healthy eating habits to fit in the social context.
Various criteria are used to assess symptoms of anorexia nervosa, bodyweight being the most common indicator of the condition. Studies reveal that individuals with the disorder may maintain a body weight that is at least below 15% the expected (Morris & Twaddle, 2007). The authors also add that prepubertal victims may fail to gain the expected weight during the prepubertal growth spurt. Although there may be other underlying medical conditions associated with specific body weights, research shows that it can be caused by the refusal of individuals to eat or restricting their consumption rate to minimum amounts of food.
Studies also reveal that weight loss is a prevalent symptom of anorexia nervosa. Notably, individuals who suffer from the disorder may exhibit an alarming rate of weight loss. As suggested by scholars, the decline in weight among victims can sometimes be self-induced by avoiding “fattening foods”, inducing vomiting, purging, excessive exercising, and use of appetite suppressants and diuretics (Morris & Twaddle, 2007). Based on this information, it might be argued that adolescents with the condition are often in search of ways to attain or maintain their “ideal” body type during the growth spurts. As such, many choose to indulge in practices that facilitate achievement of the desired body shape, such as excessive exercising and to greater extents use of drugs to suppress appetite.
Apart from the major symptoms that can be clinically measured, individuals suffering from the condition may exhibit some unusual behavior changes. For instance, it may be common for adolescents suffering from the disorder to lie about their food intake, develop an unusual obsession with a particular diet, and frequently inspect their bodies, especially by measuring their weight. Furthermore, some people may develop an unexpected concern about body weight and begin monitoring the type and amount of food that they consume. Some of these habits may be normal among adolescents, especially females, thus making it difficult to detect an underlying disorder at such a stage of development.
Prevention Measures
Synthesis of existing literature on eating disorders reveals two key facts. First, eating disorders mainly emerge during adolescent and progresses to adulthood if not properly managed. The finding is evidenced by conditions such as bulimia nervosa, which typically develop during adolescents in the form of anorexia nervosa. Second, the research reveals that apart from underlying medical conditions, disorders such as binge eating, bulimia nervosa, and anorexia nervosa stem from individual and cultural factors, including overestimation of one’s self shape and distorted beliefs on appearance and happiness. The two findings imply that effective management of eating disorders can easily be attained at the adolescent stage.
Several prevention programs have been lab-tested to determine their efficiency in reducing the onset of eating disorders among adolescents and adults. Among programs that have shown promising results is the dissonance induction intervention. The program is based on a simple theory of helping girls and women argue against culturally-distorted idealization, such as thin-idealization to prevent them from indulging in eating pathologies (Shaw, Stice & Becker, 2009). For instance, helping female adolescents take an active stance in denouncing thinness as being equal to happiness can help reduce a host of disturbances, such as unhealthy dieting purposed to achieve the thin-idealization. Studies reveal that when effectively adopted, the intervention can lower thin-ideal internalization, body dissatisfaction, negative affect, bulimic symptoms, and psychosocial impairment by 2-to-3 years follow-up (Shaw, Stice & Becker, 2009). The significant reduction in disturbances associated with eating disorders upon implementation of dissonance induction intervention makes it an ideal prevention program.
Research also shows that healthy weight intervention has the potential to prevent the occurrence of eating disorders among adolescents. According to scholars, the intervention helps to enlighten participants about how to achieve and maintain a healthy weight through small and gradual changes in diet and exercise (Shaw, Stice & Becker, 2009). Healthy weight intervention helps prevent the onset of eating pathology by assisting individuals in learning ways of maintaining the desired weight without indulging in unhealthy dieting and using appetite depressants. Shaw, Stice and Becker (2009) also add that when in use, the intervention can reduce the onset of eating disorders at 3-year follow-up. The effectiveness of the intervention makes it ideal for use among adolescents since it is at the teenage stage that people experience growth spurts and develop the need to maintain healthy weights.
As the research findings show, eating disorders may stem from psychological problems, such as body dissatisfaction and media influence. For this reason, scholars suggest that girl talk can help prevent occurrences of similar issues among adolescents. The talk entails an interactive session consisting of a peer-support group that helps in promoting critical media use, body acceptance, and healthy weight control behaviors (Shaw, Stice & Becker, 2009). The intervention is mainly anchored on ensuring that peers do not fall victim of distorted beliefs and misleading media images that appear to promote thin-idealization. Further studies reveal that participation in the intervention reduces cases of dieting at post-test and 3-months follow-up and increases weight-related esteem among middle school girls (Shaw, Stice & Becker, 2009). The promising outcome of the intervention on prior studies reveals that it can efficiently be utilized to prevent a host of disturbances associated with eating disorders.
Both trained interventionists and endogenous providers can implement the suggested preventive measures. Endogenous providers include teachers and counsellors who work closely with adolescents. However, prior studies show that trained interventionists are more effective compared to endogenous providers (Shaw, Stice & Becker, 2009). For this reason, careful selection should be made in choosing an interventionist.
Conclusion
Findings from the research reveal that eating disorder is a rare, yet life-threatening condition associated with consumption of abnormally large amounts of food or refusal to eat. Although the disorders may affect people of all ages, they are most prevalent among adolescents, especially females. Among the most common eating disorders are binge eating, anorexia nervosa, and bulimia nervosa. The study also reveals that eating disorders often stem from individual and socio-cultural factors, such as body dissatisfaction and thin-idealization. Among the most promising measures of preventing eating disorders, as proven by research, include dissonance induction, healthy weight intervention, and girl talk. If done correctly, research shows that the three measures can facilitate a significant reduction in thin-ideal internalization, body dissatisfaction, negative affect, bulimic symptoms, and psychosocial impairment. While the study provides considerable insight on food and its associated disorders, further research may be required to validate the effectiveness of the identified prevention measures, as some have in the past yielded negative results upon replication in different trials.
References
HHS.gov. (2018) “Eating disorders in adolescence.” U.S. Department of Human Health Services. Retrieved from https://www.hhs.gov/ash/oah/news/e-updates/april-2018-eating-disorders/index.html
Darcy, A., Doyle, A., Lock, J., Peebles, R., Doyle, P., & Grange, D. (2012). The eating disorders examination in adolescent males with anorexia nervosa: How does it compare to adolescent females? International Journal of Eating Disorders, 45(1), 110-114. doi: 10.1002/eat.20896
Galmiche, M., Dechelotte, P., Lambert, G., & Tavolacci, M.P. (2019). Prevalence of eating disorders over the 2000-2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402-1413. https://doi.org/10.1093/ajcn/nqy342.
Grzelak, T., Dutkiewicz, A., Paszynska, E., Dmitrzak-Weglarz, M., Slopien, A., & Tyszkiewicz-Nwafor, M. (2016). Neurobiochemical and psychological factors influencing the eating behaviors and attitudes in anorexia nervosa. Journal of Physiology and Biochemistry, 73, 297-305. https://doi.org/10.1007/s13105-016-0540-2
Hisam, A., Rahman, M., & Mashhadi, S.F. (2015). Anorexia nervosa among teenage girls: Emerging or prevalent? Pakistan Journal of Medical Sciences, 31(6), 1290-1294. doi: 10.12669/pjms.316.7617
Lee-Winn, A., Reinblatt, S., Mojtabai, R., & Mendelson, T. (2016). Gender and racial/ethnic differences in binge eating symptoms in a nationally representative sample of adolescents in the United States. Eating Behavior, 22, 27-33. doi:10.1016/j.eatbeh.2016.03.021
Marzilli, E., Cerniglia, L., & Cimino, S. (2018). A narrative review of binge eating disorder in adolescence: Prevalence, impact, and psychological treatment strategies. Adolescents Health, Medicine and Therapeutics, 9, 17-30. doi: 10.2147/AHMT.S148050
Minton, M., & Kianpour, C. (2020). How federal policy puts eating disorder sufferers at risk. Competitive Enterprise Institute, Issue Analysis No. 1. https://www.academia.edu/42549330/How_Federal_Policy_Puts_Eating_Disorder_Sufferers_at_Risk_Dietary_Guidelines_for_Americans_and_Affordable_Care_Act_Menu_Labeling_Rules_Fail_to_Take_Vulnerable_Population_into_Account
Morris, J., & Twaddle, S. (2007). Anorexia nervosa. BMJ, 334(7599), 894-898. doi: 10.1136/bmj.39171.616840.BE
Salafia, E.H., Jones, M.E., Haugen, E.C., & Schaefer, M.K. (2015). Perceptions of the causes of eating disorders: A comparison of individuals with and without eating disorders. Journal of Eating Disorders, 3(32), 1-10. https://doi.org/10.1186/s40337-015-0069-8
Shaw, H., Stice, E., & Becker, C. (2009). Preventing eating disorders. Child and Adolescent Psychiatric Clinics of North America, 18(1), 199-207. doi: 10.1016/j.chc.2008.07.012
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