Introduction: Statement of the Problem
Generally speaking in Western society, the incidence of eating disorders is on the rise, and no longer limited to the teenage female demographic. Startling statistics now indicate that onset of anorexia nervosa in females is beginning at a much earlier age and across more racially and ethnically diverse lines (Grover, Keel, & Mitchell, 2008). While the characteristics of the afflicted population are changing, so too are some of the theories about the disease’s origin. Consequently, the current literature has done and in depth exploration and outline of some of the more prominent etiological models of eating disorders. Overall, the scope of the modern literature is limited to a discussion of the causes and implications of eating disorders in females. Much of the body of present research conducted on this topic has been done with an exclusively female population. Since the underlying causes of anorexia nervosa are different for women than they are for men, it is nearly impossible to draw parallels across both genders (Grove et al., 2008). However, acknowledging that the disease is devastating to both groups, the exclusion of males from the discussion is in no way an attempt to minimize the effects of eating disorders on this population. Summary: Purpose of the Study
Before launching into a discussion of the underlying causes of anorexia nervosa, it is important to clarify exactly what the disease entails. The Diagnostic and Statistical Manual of Mental Disorders (Text Revised, Fourth Edition), defines anorexia nervosa as a mental disorder characterized by “severe disturbances in eating behavior” and a “refusal to maintain a minimally normal body weight” (APA, 2000). Additionally, the individual exhibits an extreme fear of gaining weight, and harbors intense distortions in body image perception (APA, 2000). This fear of “becoming fat” persists despite weight loss. In individuals with anorexia nervosa, weight loss is generally accomplished through limiting caloric intake, as well as, other methods for weight loss such as purging or excessive exercise (APA, 2000). Also, there are a number of other psychological symptoms that are associated with anorexia nervosa. These depressive symptoms, generally side affect of malnutrition, may include depressed mood, negative affect, social withdrawal, increased irritability, and insomnia (APA, 2000). Obsessive-compulsive tendencies are also not uncommon. In addition, there are a number of medical and physical complications that also are critical components of this disorder (Cash & Henry, 2009). Additionally, eating disorders in general and anorexia nervosa in particular, are often considered to be “culture bound syndromes” (Halliwell & Dittmar, 2008). Those who make this claim, argue that the reason incidences of anorexia nervosa occur almost exclusively in the Western world is a reflection of Western culture. Western culture and its “narrowly defined” standards for beauty and physical attractiveness may increase female concern with body image (Markey & Markey, 2008). The DSM-IV Text Revised (2000) supports this idea of centralization of incidence. Cases of anorexia nervosa are most prevalent in industrialized societies, where food is readily accessible, and where thinness is considered to be a mark of physical attractiveness (Rieves & Cash, 2008). Among the countries where anorexia nervosa is seen most often are the United States, Canada, Europe, Australia, New Zealand, South Africa, and Japan (APA, 2000). Furthermore, the DSM-IV Text Revised, reports that the prevalence of anorexia nervosa among women is approximately half of one percent of the population (APA, 2000). The number is even larger when it takes into account those individuals who fall below the anorexia nervosa diagnostic threshold, qualifying instead for a diagnosis of “Eating Disorder Not Otherwise Specified” (APA, 2000). Hence, the manual notes...
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