The Eating Disorder Machine: How America Generates Eating Disorders
The Ideal Body
In a society where thinness is associated with attractiveness, high status, and desirability, it’s no wonder that more and more young women and men are developing eating disorders. According to Medical Daily, 80% of 10 year olds are afraid of being overweight, and almost 80% of girls are unhappy with their bodies by the time they are 17. With the development of eating disorders starting primarily at the onset of puberty, teenagers are exposed to a potentially deadly disorder while also going through emotional and hormonal changes. In other words, the perfect storm.
The National Association of Anorexia Nervosa estimates that at least 30 million people of all ages and genders suffer from an eating disorder in the U.S, and that women are 10x more likely than men to develop this disease. Eating disorders have the highest mortality rate among any mental illness, with one out of five people with anorexia dying from suicide, and one person dying of an eating disorder every 62 minutes. Despite these horrifyingly large statistics, eating disorders often go dangerously unnoticed by those family members that are close to the victim. This article will mostly focus on Anorexia Nervosa and Bulimia Nervosa, two of the most deadly types of eating disorders.
Cultural Impacts and Causes of Eating Disorders
Eating disorders are rapidly increasing in countries around the world. While there has not been one distinct factor identified, there are multiple hypotheses as to why this may be happening.
Studies show that gender and sociocultural factors play a role in the increase of abnormal eating attitudes. Specialists believe that rapid economic and socio-cultural changes such as cultural evolution and human migration may cause a change in the number of eating disorders, as anorexia may be more present during times of cultural change and confusion for immigrants and individuals in developing countries.
Cultural change such as generational conflict or worsening family networks may increase the number of eating disorders. In the 1990s, Hong Kong did not have many anorexia sufferers because obesity was thought to be a symbol of wealth at the time, but in 2001, 3-10% of women suffered from some type of eating disorder.
Westernization or modernization may cause an increase in eating disorders. For example, Asian women are at risk of an eating disorder because they are growing up in westernizing countries or are migrating to the west. Modernization in Japan led to increased Anorexia Nervosa diagnoses in 1985-1992. BMI in women decreased from 21.5 to 20.5 in 1995 which reflected the trend of young females dieting after being employed. On the other hand, Iranian women who were more interested in Western culture are more likely to be satisfied with their body shape–this shows that the cultural effect hypothesis on eating disorders may not apply to all cultures.
Urbanization or population density also causes more eating disorders. One psychologist reported that eating disorder patients more frequently came from medium-sized cities (population 60,000 to 250,000) compared to smaller districts.
While these are all valid theories as to why eating disorders are increasing in the world outside of the U.S, more data needs to be collected on this dangerous disease. The most widely supported hypothesis may be the Westernization hypothesis, however, as there are still statistically more people with eating disorders in Westernized nations.
What are signs of eating disorders?
According to psychiatry.org, the Diagnostic and Statistical Manual of Mental Disorders (the DSM) is the handbook used by healthcare professionals in the U.S (and most of the world) as a guide to the diagnosis of mental illnesses. It contains what is recognized, legally and professionally, as the most up to date descriptions, symptoms, and other criteria for diagnosing mental disorders.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) currently diagnoses Anorexia Nervosa as a combination of the following symptoms:
- Restrictions of calories causing a comparatively low body weight to others of the same age
- Fear of weight gain or enacting behaviors that interfere with weight gain even though they are underweight. (This includes overexercising, calorie restricting, and other methods)
- Dissonance in the subject’s view of his/her body and what is real, and a lack of realization of the seriousness of his/her situation.
The severity for adults is based on their BMI, and ranges from mild (BMI > 17 kg/m2), to extreme (Extreme: BMI < 15 kg/m2). While the diagnostic criterion in and of themselves may not seem like life threatening instances, the duration and constant repetition of the symptoms may cause unhealthy outcomes, and in severe cases, can lead to death. Almost 50% of anorexia nervosa patients simultaneously have anxiety or mood disorders including depression, obsessive-compulsive disorder, and social phobia.
The DSM-5 currently diagnoses Bulimia Nervosa as a combination of the following symptoms:
Recurring episodes of binge eating that includes
- Eating a large amount of food in a discrete amount of time that is more than what others would eat in a similar period of time under similar circumstances
- Feeling of no control over eating
- Recurring behavior to prevent weight gain such as
- Self-induced vomiting
- Misuse of laxatives, diuretics, or other medication
- Excessive exercise
Binge eating and behavior to prevent weight gain occur at least once a week for three months. The self-evaluation is influenced by body shape and weight, and it’s important to note that the cycle of binge and preventative behavior does not occur exclusively during episodes of anorexia nervosa.
The minimum level of severity based on the weight loss (WL) behaviors after the binge from mild (an average of 1-3 episodes of WL behaviors per week) to extreme (an average of 14 or more episodes of WL behaviors per week). Bulimia nervosa primarily consists of the uncontrolled instances of overeating and then the consistent action that follows the eating. Nearly half of Bulimia Nervosa patients simultaneously experience mood disorders (such as depression) and anxiety disorders, and 1 in 10 bulimia patients will simultaneously have substance abuse disorder (primarily with using alcohol).
While the symptoms for Anorexia Nervosa and Bulimia Nervosa may seem very clear, the disorder itself often varies on a case by case basis. Understanding symptoms is not meant to immediately identify the disorder, but rather obtain insight as to how a medical professional may try to diagnose a subject with an eating disorder. With this in mind, the misdiagnosis of an individual with a mental illness may cause injury to self esteem, and should be left to a professional. However, there are alarming signs that may hint at an eating disorder.
How can you identify an eating disorder in someone you love?
The identification of eating disorders may be difficult to spot in someone suffering from Anorexia or Bulimia, as the actions of such behaviors may make the subject want to hide the actions they’re taking to lose weight. However, there are often some common side effects or traits that people with Anorexia and Bulimia share.
Anorexia nervosa primarily consists of the belief that weight loss, dieting, and limiting food consumption are their absolute priorities. They might appear to be uncomfortable eating around others, and skip meals or take small portions. They may be fast to jump on every fad weight loss diet and often cut out entire food groups (such as carbs, fats, or sugars). Eventually, anorexia sufferers may begin to withdraw from friends, family, and interests, and experience frequent mood swings and dramatic weight loss.
Bulimia nervosa sufferers may be seen taking frequent trips to the bathroom after meals and drinking excessive water while eating to make the purge easier. The toilet seat may be left up (which may be confusing if they’re female) and there may be leftover food particles in the toilet after flushing. They might have watery eyes and a runny nose after they’ve used the bathroom and have swollen cheeks and salivary glands. Bulimic sufferers typically consume dense, high caloric food in one sitting. Long term visible effects include cuts and calluses across the tops of finger joints, dental problems like enamel erosion, cavities, and tooth sensitivity. The dental problems may increase the consumption of mint or gum.
Both anorexia nervosa and bulimia nervosa sufferers may experience stomach cramps or gastrointestinal complaints, including constipation or acid reflux. There may be a temporary to permanent loss of menstruation, and they may develop sleep problems. Due to low thyroid, hormones, and potassium, they may develop anemia or be in a constant state of coldness. Dizziness upon standing or fainting may also happen, along with dry skin, hair loss, and brittle nails.
Without proper treatment, temporary symptoms may turn deadly and ultimately cause the victim of the illness to die suddenly. Bulimia has been known to cause death through cardiac arrest caused by low potassium or an electrolyte imbalance. Others have died from a ruptured esophagus. Anorexia can cause decreased bone mass and heart problems from starvation.
Although body positive movements are spreading around the U.S., many other parts of the world still trail behind and raise concern in the ever growing number of people with eating disorders. Eating disorders were once thought of as a disease that applied mostly to developed countries, but are now more commonly seen in developing countries too, making it even more important to spread awareness for the dangerous disorder.
If you have an eating disorder and need help, it’s important you reach out to a professional. Please schedule a free consult call with one of our therapists at My LA Therapy to learn more.
Guest Writer Bio
Alice Chen is a second year Honors Psychology student at UCLA. She plans on getting her PhD and becoming a therapist. She has been part of My LA Therapy as of November 2019. In her free time she enjoys singing, drawing, and playing the violin.