Eating Disorders in Adolescents
The eating disorders anorexia nervosa and bulimia nervosa are complex psychosomatic illnesses. Underlying biological diatheses related to the regulation of mood, hunger, satiety, weight control, and metabolism, combined with psychological and sociocultural vulnerabilities, place an individual at risk for developing an eating disorder (Kaplan and Garfinkel, 1993).
The American Anorexia Nervosa Association defines anorexia as a serious illness of deliberate self-starvation with profound psychiatric and physical components. It is a complex emotional disorder that initiates its victims on a course of unsettled dieting in pursuit of excessive thinness (Neuman and Halvorson, 1983).
The intense fear of obesity that anorexics experience takes on the qualities of an obsession. Anorexics seem to have a greater fear of getting fat than of dying from the effects of their self-imposed starvation (Neuman and Halvorson, 1983). Another unusual twist occurs in relation to this fear of growing fat. The average person concerned about weight gain will feel a sense of relief as he/she loses weight. However, the anorexic is unlike other people in this respect: for them, the fear does not diminish (Neuman and Halvorson, 1983).
The disturbance of body image in anorexia is an unclear circumstance. Most anorexics have distorted perceptions of themselves. Some insist that their wasted bodies are repulsively over-fleshed. According to some researchers, however, the more distortion present, the worse the prognosis (Neuman and Halvorson, 1983).
Weight loss of at least 25 percent of original body weight or, if under 18 years of age, weight loss from original body weight plus projected weight gain expected from growth charts may be combined to make 25 percent (Neuman and Halvorson, 1983). The primary symptom of anorexia nervosa is severe weight loss. While this is one of the major criteria for making the diagnosis, it is believed the 25 percent reduction to be misleading (Neuman, 1983). It is often incorrectly assumed that anorexics were previously obese. While the disorder is often preceded by normal dieting, only one-third of anorexics have been overweight and most of these only mildly so. Two-thirds have never been overweight, although they may have been the targets of comments regarding their physical development (Neuman, 1983).
Anorexia is often preceded by a stressful life situa...