Eating Disorder Case Study
Info: 1289 words (5 pages) Nursing Case Study
Published: 12th Feb 2020
‘When normal eating becomes abnormal’
Eating is a crucial activity for humans, as the food we consume acts to provide us with the fuel we need to keep our bodies running, and to live our daily lives. Normal levels of eating can be characterised as consuming just enough calories (of energy) to allow us to function as we require, and not to have so much left over that is not used and subsequently stored as fat cells. Exactly what level is characterised will vary on an individual-to-individual basis, as ‘normal’ will be subject to individual differences such as activity levels, age and metabolic rate, which can all affect the rate at which energy is used or stored by the body. Abnormal eating can thus be seen to occur when we either consume too much or too little energy (food) for what we need, and forms the basis of negative eating behaviour, classed as eating disorders.
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There are two main eating disorders; anorexia nervosa, and bulimia. Anorexia is perhaps the most well-known of the disorders, and attracts a great deal of media coverage and celebrity profiles associated with the condition such as Victoria Beckham, Calistra Flockheart and the Olsen twins (Mary-Kate and Ashley). Characterised by deliberate and extreme weight loss through the withholding of hold – often to the point of emaciation, anorexics will constantly worry about food, with such cognitions visible through behaviours such as obsessive weighing and calorie counting and abnormal levels of control in regards to food. Self-image is chronically out of touch with reality, with individuals at the later stages of the condition still seeing their body as fat, despite being seriously underweight. Through this self-inflicted starvation, the anorexic will start to experience physical symptoms and problems such as stomach pains, growth stunting, osteoporosis and reproduction problems such as the stopping of periods in women, or infertility in men. In the long term, lack of food can be serious to health, with the possibility of leading to kidney, liver and even heart damage, and thus the condition can be fatal.
Bulimia is a more common disorder than anorexia and in contrast to the strict self-control of eating regulated by anorexics, bulimia can occur as a result of a lack of control over eating. Bulimics do not starve themselves, instead will binge massive amounts of food (often secretly), and with some cases reported as ingesting as much as 15,000 calories in 1 – 2 hours. After eating until they feel ill, bulimics will then use methods such as vomiting or laxatives to purge themselves of the calories that they have ingested. Physical effects of bulimia can be harder to detect as there is usually no dramatic weight loss, and in many cases is simply the maintenance of weight despite the food binges they have. Associated physical problems include sore and inflamed throat as a result of induced vomiting, which may eventually lead to a difficulty in swallowing. Stomach acid brought up along with food will also cause problems such as burning of the oesophagus and the damaging of tooth enamel. Intestine function can break down when forced repeatedly to expel food; dehydration can occur due to loss of fluids, and when to a serious enough degree can upset the balance of chemicals within the blood with minor consequences including dizziness, and the most serious being heart failure.
Bulimia is a condition that is intricately linked with emotions and psychological well-being. Anxiety and unhappiness can binges which then cause guilt and further unhappiness until alleviated by purging. The sufferer is thus trapped in a vicious circle. One of the most high profile cases of bulimia is likely to be that of Princess Diana. Quoted as saying the bulimia was “a symptom of what was going on in my marriage. I was crying out for help, but giving the wrong signals,” (Panorma, BBC TV, 1995) such a comment is a prime example of the psychological nature of the condition. The difficulty in treatment of bulimia is that emotionally the action of purging is reinforcing by alleviating the guilt and unhappiness felt after a binging session, and thus makes the cycle far harder to break.
Most cases of these eating disorders will start during adolescence or early adulthood, and are strongly linked in the literature and media as associated to psychological issues. Personal aspects such as perfectionism, identity and sexuality and self-esteem are strongly correlated factors, with control issues – whether in regards to excessive restraint, or in loss of control over eating, also have a predominant role. Along side these personality traits, the concept of body image, and how it is portrayed is felt to play a major contributing factor to the continued existence and rise of eating disorders. Weight is often seen as a measure of self-worth, attractiveness and sexuality, and subsequently this is modelled by the rich and famous that many adolescents look up to. Whether modelled in movies such as Demi Moore in Charlie’s Angels, or in fashion and celebrity magazines such as Vogue or Heat, young people are surrounded by visual media with images of the perfect body and what it means to be attractive and (subsequently associated) successful, and will unsurprisingly want to achieve this. When younger people do not feel that they match up to this notion of beauty, this can act as the psychological trigger to any of the conditions mentioned. The spread of eating disorders across the world alongside Westernisation to continents once free of such conditions, has further demonstrated the role that culture exerts over these diseases. Communication technologies such as the internet have also made the transfer of information such as tricks and tips between sufferers easier by connecting a once hidden and isolated population, the so called ‘Pro-ana (Anorexia) and Pro-mia (Bulimia)’ websites and chat rooms, which may also reinforce sufferer through the social support system such ‘societies and groups’ entail. Role of the media in the message it send out about eating disorders is thus mixed – articles in the written press appear to be condoning the behaviour, and yet reading behind the lines often eludes to something else – A profile article on Calistra Flockhart in Hello! Magazine describes her anorexia, and yet in the same sentence tells how her ‘look’ is what landed her the role in the TV series Ally McBeal. Men’s magazines such as FHM and Loaded run annual ratings of the most attractive women, and subsequently reinforce the male attitude of thinness as attractive, and women see this as further example of how they believe they are expected to look.
However there is evidence for optimism that that there is a shift in the ideology of beauty previously characterised in the 1990’s as the ‘waif supermodel look’ of Kate Moss and Jodie Kidd. Stars such as Beyonce and Jenifer Lopez are beginning to change the boundaries of attractiveness, reinventing the look of the womanly figure and curves.
Abraham, S & Llewellyn-Jones, D (1992) Eating Disorders: The Facts Oxford University Press
Bryan, J (1999) Talking Points: Eating Disorders Wayland Publishers Ltd
Carlson, N () Physiology of behaviour (4th Ed) Allyn & Bacon
Donnellan, C (2001) Confronting eating disorders Volume 24 Independence
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