Eating Disorder
Eating DisorderEating Disorders
A vast amount of research has been done on the subject of eating
disorders and their causes. Many eating disorders have been proven to emerge
during adolescence and often serve as the foundations to more serious
problems like anorexia and bulimia. This essay will explore the development of
eating disorders in adolescent girls. It will show that these disorders are closely
connected to the biological and psychosocial changes that occur during the
adolescent period.
Many teen girls suffer with anorexia nervosa, an eating disorder in which
girls use starvation diets to try to lose weight. They starve themselves down to
skeletal thinness yet still think that they are overweight. Bulimia, meanwhile, is a
disorder in which young women binge on food and then force themselves to
vomit. They also often use laxatives to get food out of their system. All of these
young women who suffer from this problem are considered to suffer from a
psychiatric disorder. While the causes are debatable, one thing that is clear is
that these young women have a distorted body image. (Wolf, pp.214-216)
What is extremely alarming is that the current thin ideal for women in
Western society, which is unattainable for all but a very small percentage of the
population, is compounding this problem. It is a very serious issue when
someone's body shape is determined by genetic disposition and yet they try to
alter it to fit some kind of imaginary ideal of how a person should look.
Thus, one of the most serious problems is that female nature is not what
society says it should be. Some researchers theorize that anorexia is a young
woman's way of canceling puberty. Since they lack body fat, anorexics don't get
their periods and often lose their sexual characteristics such as public hair. They
remain, in other words, little girls. There is also the complex issue of women
feeling that by having an eating disorder they are finally in control of something
in their life. This may sound strange, but much research has shown that women
who have been abused or neglected in their childhoods develop these problems
of control. (Attie and Brooks-Gun, pp.70-71).
Studies suggest that eating disorders often begin in early to
mid-adolescence. They are directly connected to pubertal maturation and the
increases in body fat that occurs during this phase. These biological changes
are associated with increased dieting and unhealthy behaviours in early
adolescence. This problem is aggravated by various problems, including
negative body image, which has a close association with weight, perfectionism
and depression. Family and socialization also play significant roles. It has been
found, for instance, that mothers with girls with eating disorders are often critical
of their daughters' weight and physical appearance. Families with adolescents
who have eating disorders are also often characterized by enmeshment,
overprotectiveness, rigidity and lack of conflict resolution. This is connected to
the "control" issue mentioned previously. Interestingly enough, girls who are
more involved in mixed-sex social activities and dating boys are also more likely
to exhibit disordered eating tendencies. (Attie and Brooks-Gun, pp.70-71).
Thus, eating disorders must be studied in the context of what certain
individuals face during their developmental stage, or what they may have
suffered in childhood. In general, a combination of the pubertal phase of the
female body, the loosening of the individual's ties to parents, and the
development of a stable and cohesive personality structure play profound roles
in this process. Psychologists Ilana Attie and J. Brooks-Gun have done some
work on this issue. They considered eating disorders within the so-called
"developmental" perspective, which examines the emergence of eating disorders
in adolescent girls as a function of pubertal growth, body image, personality
development, and family relationships. The two psychologists examined 193
white females and their mothers during the former's middle-schooled years
(13.93 years) and then two years later. They set out to see how much the
development of eating problems represented a mode of accommodation to
pubertal change. Taking a "developmental" approach, the authors studied the
impact of the pubertal transition relative to other aspects of the female
adolescent experience. (Attie and Brooks-Gun).
These researchers emphasized one very significant fact: that as girls
mature sexually, they accumulate large quantities of fat. For adolescent girls,
this growth in fat tissue is one of the most dramatic physical changes associated
with puberty, adding an average of 11 kg of weight in the form of body fat. This
increase in fat is, in turn, directly connected to desires to be thinner. (Attie and
Brooks-Gun, p.7O) This reality is due to the fact that, as Attie and Brooks-Gun
demonstrate, female body image is intimately bound up with subjective
perceptions of weight. Prepubescent girls who perceive themselves as
underweight are most satisfied while the opposite occurs for those who are
overweight or perceive themselves to be such. Thus, Attie and Brooks-Gun
found that dieting emerged as the female body developed, and that is was a
function of the body image transformation occurring at puberty. (Attie and
Brooks-Gun, p.71)
Aside from the pubertal changes that the authors found significant in this
issue, family relationships were also detected to influence the emergence of
eating disorders. Families that set high standards for achievement, gave little
support for autonomy, and blurred interpersonal boundaries left adolescent girls
with deficits in their self-esteem. (Attie and Brooks-Gun, p.71) Once again, as
mentioned earlier, it makes sense in a very complex way that young girls who
have been abused in this way end up "controlling" things that are ultimately not
good for them. For instance, a young girl who was made to feel powerless in
some ways in her family (i.e. sexual or physical abuse) may end up feeling a
sense of individual identity if she can "control", for example, when she vomits
and when she does not. Now, at least, she can have control over something in
her life.
Personality factors were also found to contribute to the development of
eating disorders. Characteristics such as perfectionist strivings, feelings of
ineffectiveness, depressive symptoms and self-regulatory deficits were seen
frequently in patients with eating disorders. (Attie and Brooks-Gun, p.71)
The authors found, for instance, that girls who early in adolescence felt
most negatively about their bodies were more likely to develop eating problems
two years later. (Attie and Brooks-Gun, p.76).
Thus, overall, Attie and Brooks-Gun found that eating problems emerged
in response to physical changes of the pubertal period. Personality variables
entered this problem, but only at a later stage. Attie's and Brooks-Gun's findings
suggest that body shape becomes a primary focus and that efforts to control
weight intensify during the middle-school years. In other words, the rapid
accumulation of body fat that is part of the female experience of puberty often
functions as a triggering effect, in the sense that it starts the attempt of
weight-loss diets.
Attie's and Brooks-Gun's study did, of course, have its limitations. The
authors themselves admitted that their investigation focused only on a sample of
white girls from upper-middle-class families. Yet most evidence has suggested
that bulimia nervosa is more prevalent in middle-and-upper middle class white
girls, although there is evidence suggesting that eating disorders are increasing
in other ethnic and social class groups, especially for girls who experience more
pressure to acculturate to white, middle-class standards. (Graber, Brooks-Gun,
Paikoff and Warren, p.823) In other words, what we see here is that the values
and ideals held by the dominant society are an important issue as well. Recent
studies have shown us that adolescent girls in competitive environments that
emphasize weight and appearance experience increased social pressures to
meet the thin ideal. (Attie and Brooks-Gun, p.7O)
Another study that very much confirmed the findings of Attie and
Brooks-Gunn examined 116 adolescent girls drawn from a normal population of
students enrolled in private schools in a major metropolitan area. These girls
were followed over an 8-year period from young adolescence to young
adulthood. Over a quarter of the sample scored above the level identifying a
serious eating problem at each of the 3 times of assessment (14, 16, and 22
years of age.) (Graber, Brooks-Gunn, Paikoff, and Warren). Like Attie's and
Brooks-Gunn's study, this project also found that eating disorders were triggered
during the pubertal stage of girls. This is why the researchers recommended,
among all else, that primary prevention be indicated for all girls in early
adolescence. (Graber, Brooks-Gun, Paikoff, and Warren, pp.831-832).
Together with pubertal causes, there has also been evidence suggesting
that dating is an ingredient to this phenomenon. Psychologists Elizabeth
Cauffman and Laurence Steinberg examined 89 12-13 year old girls and
examined their dating and other heterosexual activities in relation to their dieting
behaviours and attitudes. The two researchers found that girls who were more
involved in mixed-sex social activities and dating boys were more likely to exhibit
disordered eating tendencies. (Cauffman and Steinberg.) The authors made the
intriguing finding that sexual activity is correlated with more symptoms of
disordered eating. This is especially interesting in as much as adults with eating
disorders tend to be less sexually active. It thus appears that physical
involvement in early adolescence leads to increased concern about appearance
and attractiveness, but that when this concern becomes so great that it leads to
disordered eating, the end result is often a decrease of the activities that
contributed to the disorder in the first place. (Cauffman and Steinberg, p.634)
Eating disorders, therefore, have some common denominators but also
remain complex. The causes range from everything from sexual abuse to the
social forces that construct certain female ideals that most women can simply
not live up to. Then, of course, there is a blending of causes. Overall, of course,
while we must emphasize personal problems, it is necessary to keep an eye on
social messages. Feminist-writer Naomi Wolf has discussed how cultural ideals
for beauty emphasize a slender body shape typical of prepubertal development
that is unattainable for most adolescents and women after puberty. Thus,
adolescent girls may engage in excessive dieting in an attempt to meet these
unattainable cultural ideals even though they are not over-weight. In a chapter
entitled "Hunger" in The Beauty Myth, Wolf writes:
...female fat is the subject of public passion, and women feel guilt about female
fat, because we implicitly recognize that under the myth, women's bodies are not
our own but society's, and that thinness is not a private aesthetic, but hunger a
social concession exacted by the community. A cultural fixation of female
thinness is not an obsession about female beauty but an obsession about
female obedience. (Wolf, p.187)
In light of all of these factors, it is possible to make some generalizations
regarding a significant portion of eating disorders. We know that they can be,
and are, compounded by the social messages that Wolf describes. But the
causes obviously also run deeper into the personal realm. It appears that
problem eating develops during early to middle adolescence, and that these
early patterns influence later eating behaviour. Body image becomes crucial in
this development, as does the social and familial setting. We have learned this
from the "developmental" perspective, which crystallizes the significance of
changes in girls during their adolescent years. The potential remedy, therefore,
exists in the understanding of these changes and how they affect self-image.
Women with eating disorders are often in severe denial. The control of
their body weight serves an important purpose in their lives, for one
dysfunctional reason or another. It is a way they can cope with their problems.
Many women, as we have learned, use food to repress their emotions. They are
out of touch with their feelings and use food as a form of escapism. They need
psychotherapy.
In order to help women suffering from eating disorders, it would first be
important to follow the advice given by David Burns in Feeling Good. The New
Mood Therapy. (Burns) Burns teaches certain steps in psychotherapy practise
that teach people to make charts of tables charted "cognitive distortion" and
"rational response". This entails a person writing down what is bothering them
and then honestly answering the questions. (Burns, pp.62-69) This might seem
too simple, but it is incredible what healing can reside in a person honestly
facing their personal secret pain and working through it. The key here, of course,
is that many young women who having eating disorders would simply not do this
because of their denial. The crucial aspect, therefore, is to make them reconcile
themselves with their pain. Though this is the most difficult process, it simply has
to be done. Burns shows throughout the book that the only way out of the pain is
through the pain. After that, different treatments can be applied, but the first step
is for a person to be honest with themselves.
For instance, a young girl with an eating disorder who wants to get better
must write down whatever is haunting her: "I ate a hot dog today." After this,
under the heading "Cognitive distortion" she should answer why this would
bother her. Let us suppose she writes: "Well, because now I will get fat." Then
she must ask why this would bother her. It is here that we begin getting to the
dark recesses of the psyche and where many people who are in denial would not
be able to continue. But this girl must continue if she wants to get better.
Suppose she writes: "Well, because then I would be worthless and no one would
like me." Then she must ask again why this would bother her. She answers:
"Then I would be alone and would have no reason to live." But ultimately, there
might be even darker things at the bottom of the list, perhaps something like: "I'll
prove I can stay fat, then men wouldn't like me and then they would not sexually
violate me anymore." The point here is that the dark reasons for distorted
thoughts would have to be faced. The person must recognize the root of their
dysfunctional behaviour, no matter how painful it is.
After this exercise, as Burns teaches, the person would make a parallel
chart of "rational response" in which they would answer every distorted thought.
To "I ate a hot dog today" the person would write, alongside it: "That is ok, it is
good and healthy to eat." To "now I will get fat", she would write: "Well, not
necessarily because I am already underweight and even if I was, I only ate one
hot dog." The next step would be the hardest ground to start working one, since
the problem of this person is rooted in distorted thinking. To "Well, because then
I would be worthless and no one would like me" she would have to start
considering the issues of whether her weight was connected to her self-worth.
She would have to start understanding that self-worth was based on something
intrinsic, not on something external. In this step and process lurks the greatest
healing process, for so many of these illnesses are based on illogical thought
patterns. To "Then I would be alone and would have no reason to live" she could
start seeing the ridiculous nature of this underlying belief. She could write down
all the friends she has that would not care less how much she weighed. She
could write down how she would never be alone anyway and that being alone
might not be the end of the world.
This is just an example of course, and it is not to suggest that this writing
process of "cognitive distortion" and "positive response" is the solution to all
these serious problems. But what is important in dealing with eating disorders,
and this is the point, is that the person who is suffering must be made to start
thinking properly before anything else is done. Medication is not going to help a
young girl who is convinced that looking like a skeleton is the only way to get
men to like her, and that her life would not be worth living if men did not find her
sexually attractive. Obviously these ideas and beliefs would have to be dealt
with before any other approach is taken. The point here is that many young girls
suffering from eating disorders are fighting something and it is connected to a
distortion in the process of thinking. David Burns argues, with much success,
that this thinking pattern must change before anything else. He also shows the
tremendous success that it can provide in healing all kind of psychological
disorders. (Burns, pp.383-405)
To be sure, eating disorders are very serious illnesses; they do not have
easily detectable causes and they do not have easily related cures. But we do
know several things that can be done. Along with making a young girl aware of
her thinking, and making her be honest with herself and about her past, it is also
important to clarify to her the social pressures that are sending her false
messages. Education, therefore, is a must in the context of teaching that the
social ideal of thinness perpetuated in Western society is distorted and flawed. It
is not connected to human nature and it is not connected to reality. Once young
women become aware that there is nothing wrong with their own personal body
image, a significant amount can be done on this issue.
More than anything else, we need to find compassion and understanding
for the victims of eating disorders. While we work on helping these individuals,
we must also fight the social forces that objectify and exploit female body image
to the disadvantage of not only women, but of all humanity. No one profits if one
half of the human race is being held under attack by socially constructed body
images that are rooted in morbid intent and infantile fantasy.
Bibliography
Attie, Ilana and Brooks-Gunn, J. "Development of Eating Problems in Adolescent
Girls: A Longitudinal Study," Developmental Psychology, 1989, vol. 25, no.1,
7O-79.
Burns, David. Feeling Good. The New Mood Therapy (New York: Avon Books,
1980)
Cauffman, Elizabeth, and Steinberg, Laurence. "Interactive Effects of
Menarcheal Status and Dating on Dieting and Disordered Eating Among
Adolescent Girls," Developmental Psychology, 1996, vol. 32, no.4, 631-635.
Graber, Julia, Brooks-Gunn, J., Paikoff, Roberta, and Warren, Michelle.
"Prediction of Eating Problems: An 8-Year Study of Adolescent Girls,"
Developmental Psychology, 1994, vol.3O, No.6, 823-834.
Wolf, Naomi. The Beauty Myth (Toronto: Random House, 1991)