Adolescent Eating Disorders: Summary Overview, Common Causes, and Counseling Methods

Eating disorders have plagued society for many centuries. Since the ancient times of Saint Catherine of Siena and Julius Caesar to the modern era of the late Princess Diana of Wales and singing phenomenon Karen Carpenter, men and women have used food as a way to control the human physique. In the eyes of many people, it is believed that by achieving the perfect body, through any means necessary, one can achieve the acceptance of others and ultimately one’s own happiness. Typically, eating disorders are characterized by severe disturbances in eating behavior. When many people think of eating disorders, they traditionally think of anorexia nervosa and bulimia nervosa. The DSM-IV-TR lists anorexia nervosa and bulimia nervosa and also binge eating disorder. The even more recent orthorexic nervosa, which is the obsessive focus on only eating healthy foods, is not in the current DSM. In some situations, multiple eating disorders can occur simultaneously within an individual and if continued can lead to multiple health problems such as malnutrition, heart failure, electrolyte imbalances, seizures, and numerous other problems.

Anorexia Nervosa

Anorexia nervosa is often identified as the starvation disease. People who suffer from this disease usually follow strict diets that consist of little to no food. Anorexics experience an intense fear of gaining weight, even the minimal amount of weight that is normal for their height and age. A client can be diagnosed with anorexia nervosa if the client weighs less than eighty-five percent of their expected or normal weight or fifteen percent under their normal weight (Bergs, 1997). There are two categories of anorexia nervosa and they include restricting type and the binge eating/purging type. The restricting type of anorexia involves severely limiting food without the use of binging or purging. The binge eating/ purging type of anorexia is defined by one who severely limits food, but then uses methods such as purging in order to expel the small amount of food from the body. Symptoms of anorexia nervosa include changes in mood, decreased amounts of energy, emaciated appearance, dry, yellow colored skin, low body temperature and pulse, and fine hair and nails. The consequences of depriving the body from nourishment due to anorexia nervosa include suicidal thoughts, prolonged disturbances of one’s metabolism, heart problems, and diminished abilities in one’s psychomotor skills. In severe circumstances hospitalization may be required.

Bulimia Nervosa

Individuals who suffer from bulimia nervosa often will go on with their disorder longer because bulimia nervosa is hard to detect by using observations on the initial appearance alone. Bulimics can usually maintain average weight. Bulimia nervosa often includes the occurrence of binge eating and is then followed by a method that is used to expel the food from the body. Like anorexia nervosa, bulimia nervosa can be categorized into two different types, such as the purging type or the non-purging type. The purging type of bulimia nervosa involves one using methods to expel the food and nutrients from the body. These methods include vomiting, diuretics, or laxatives. The non-purging type of bulimia nervosa involves other methods such as over exercising, or fasting for a long period of time. The criteria needed for a client to be diagnosed with bulimia nervosa include experiencing two or more binge eating episodes per week, using a method in order to compensate for binge eating, and involves the individual feeling as if they were influenced by the shape of their body and weight. Symptoms of bulimia include alexithymia (Hayaki, 2009), or the inability to identify or describe one’s emotions, heart problems, electrolyte imbalance, acidic burns in the esophagus, degradation of enamel on the teeth, and anxiety.

Binge Eating Disorder

Binge eating disorder has often been referred to as compulsive eating. Binge eating disorder is characterized by eating in excess despite not experiencing hunger. Individuals who experience a binge eating disorder often experience a sense of lack of control about their eating. Binge eating differs from bulimia nervosa in the sense that it is not followed by compensatory behaviors, such as vomiting or over exercising. In order for a client to be diagnosed with a binge eating disorder the client would have had to have experienced recurrent binge eating episodes for at least two days a week for a minimum of six months. Symptoms associated with binge eating disorder include the rapid consumption of food, the inability to control the amount one eats, feeling emotionally numb while eating, feelings of disgust with oneself, and continuously eating throughout the day or night.

Orthorexia Nervosa

Orthorexia nervosa is an eating disorder that is characterized by an obsession with healthy eating. Until recently, orthorexia nervosa had been categorized as a miscellaneous eating disorder. Orthorexia nervosa became acknowledged by the public in an article of Utne Reader (1998) by Dr. Steven Bratman. Many people have been starting to experience this eating disorder and that led to orthorexia nervosa being established as a separate type of eating disorder. Orthorexics tend to establish strict rules involving what they can eat. This disorder often starts off as an individual eating a healthy diet. However, it soon escalates to the point where individuals become obsessive about their eating habits and then they restrict many types of food which leads to the individual becoming malnourished. Symptoms of orthorexia nervosa may include obsession, emaciation, feelings of guilt about food consumption, mood swings, or depression.

Common Eating Disorder Causes

Biologically Induced

Eating disorders are often more common for adolescents because shortly after an individual has reached the point of adolescence their body begins to mature in preparation for adulthood. From an individual’s perspective, they witness how their body changes in front of their eyes as they slowly mature into adults after the occurrence of menarche (Abraham, Boyd, Lal, Luscombe, & Taylor, 2009). Young girls are more likely to have difficult with this change. As part of the maturation into adulthood, young girls generally gain weight in order to accommodate the possibility of reproduction in the future and to allow the body to undergo its normal biochemistry and function. Despite this being a normal aspect of human development, many young girls do not see the weight gain as part of growing up, but instead an aspect that is plagued with disdain, frustration, and self-consciousness. This is an important area to address because one must be able to accept this asset of nature and human development. By not accepting this, the problem could escalate to an individual who is constantly trying to fight with the way the body wishes and is designed to operate.

Social and Media-Induced

In some cases eating disorders can be caused by something as simple as seeing a model on the cover of a fashion magazine or listening to friends talk about how they hate their bodies or think they are fat. Images in the media or an ultra-thin appearance or hearing a friend discuss their own body issues can lead to one thinking about one’s own body. These thoughts are often lead to negative conclusions about their own body image. A thought process can be experienced when looking at something as simple as a model on a magazine. The basic thought pattern starts with noticing the model on the cover of a magazine. Then the individual notices that the model appears to be happy and thin. This can lead to the individual to come up with the conclusion that if they could be as thin as the model then they too can achieve happiness. McNicholas, Lydon, Lennon, & Dooley (2009) believe this to be true after conducting a study in Ireland that showed media exposure promoting an unhealthy thin look was more likely to influence adolescents into developing an eating disorder than adults. After an individual starts and attempts to lose weight in any way possible. After the individual has lost a certain amount of weight, their friends may notice and could be likely to compliment the weight loss. This would allow the individual to realize that they are receiving positive attention which could reinforce the behavior to continue. This is an important area to address because in a typical situation an adolescent is likely to be more influenced by peers rather than family members (Scoffier, Maiano, & d’Arripe-Longueville, 2010).

Professionally Induced

For a selected few individuals the way they wish to make a living is by performing with their bodies as their primary tool. Careers in fields such as gymnastics, ballet, or other physically demanding sports place a pressure on the individuals in order to maintain the ideal body for the sport. This demand to maintain the ideal body is also enforced upon men as well in fields such as wrestling or horse racing. These athletes or artists are often pressured to perform or compete at nothing less than perfection. This can cause the athletes or artists to become extremely critical of their performance. In their eyes the perfect gymnast or perfect ballerina can perform all of their moves in a manner of high precision only while maintaining a very small physique. This allows the young individuals to develop a sense of perfectionism that is applied to the most important aspect of their careers, their bodies. This is an important area because as athletes and artists, who have given up many things in order to fully achieve their goals, must realize that if they are physically working harder than other individuals and they need to supply their bodies, which is their primary tool for their chosen careers, with the proper amounts of nutrients.

Vulnerability to an Eating Disorder

An eating disorder is developed due to many different factors and not just one occurrence of a factor. These factors can include not having a positive self-image of their appearance or body, poor relationships with others, have eating and exercise habits, or high expectations of themselves. Those who are vulnerable to an eating disorder are likely to experience some of these factors and maybe additional factors. The possibility of these factors being effective to vulnerable individuals could be because the vulnerable individuals are more sensitive to the factors around them and would try to create a change in their lives. Other people who experience one or more of these factors might not interpret the factors in a manner that would cause them to experience the need to lose weight unhealthily.Continued on Next Page »