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RESEARCH PROJECTThe Rise in Eating Disorders and What Can Cause Them(anorexia nervosa & bulimia): August 2007: Hayley: (Graduate of the Diploma in Holistic Stress Management with Complementary Healthcare)
INTRODUCTION This research project will look at the rise in cases of anorexia and bulimia and what causes these eating disorders and treatment options. The amount of cases for anorexia and bulimia has risen over the past 30 years and according to The Eating Disorders Association an estimated one million people in the UK are affected. The incidence of new cases each year has been estimated by BEAT (Beating Eating Disorders) as; Anorexia up to 11 new cases per 100,000 population per year and Bulimia up to 18 new cases per 100,000 populations per year. Anorexia and bulimia are eating disorders which boys and girls, women and men can get however, according to the Royal College of Psychiatrist girls and women are 10 times more likely than boys and men to suffer from anorexia or bulimia. However eating disorders do seem to be on the increase in boys and men.
Historical Background Anorexia Nervosa and Bulimia Nervosa have existed for a very long time. The very first incident which was like Anorexia was written in 1669 by Physician and Minister John Reynolds and again in 1688 by Philosopher Thomas Hobbes. A more accurate description was written by Richard Mortonin 1694 regarding a case he had seen in 1684. The recognition of the disorder as a clinical condition dates from work in London and Paris in 1873. Bulimia was not recognised as a clinical condition until Gerald Russell’s paper was published in the UK in 1979.
EXPLANATION OF ANOREXIA NERVOSA AND BULIMIA
Anorexia Nervosa Someone with anorexia nervosa will constantly worry about being fat and the amount of food that they eat which is very little. They loose weight very quickly. They often think that they are fat when they are actually skinny. They can constantly exercise; smoke more to suppress their appetite, loose interest in sex, and their periods are irregular and can stop. Often people with anorexia start lying about the amount they have eaten and possibly use slimming pills. The consequences for someone with anorexia are;
Also, anorexia nervosa presents itself as having one of the highest rates of mortality for any psychiatric condition, estimated to run at around 13-20 per cent per annum. (Howlett et al. 1995) 2. Anorexia often starts around the teenage years and can affect around 1 fifteen year old girl in every 150 and 1 fifteen year old boy in every 1000. Around four out of ten people with fully established anorexia make a full recovery, and others improve. Only about three in ten continue to have major long-term illness. Untreated, about 15 per cent of all sufferers will die from the disorder within 20 years of its onset.
Bulimia Someone with bulimia also worries about their weight and avoids eating with others or disappears to the toilet after every meal to vomit the food they have eaten. They alternate between eating nothing and binging when they gorge themselves. They then vomit or take laxatives to control their weight and have an intense dread of gaining weight. Their weight fluctuates and is preoccupied with thoughts of food or cravings. They can become obsessed with exercise and feel tired and guilty and girls/women can stop their periods. 3. Bulimia often starts in mid teens but people don’t usually seek advice or help until their early to mid-twenties because they are able to hide it. It will affect their social and work life but will often seek help when their life changes – they start a new relationship or having to live with other people for the first time. The consequences of someone with bulimia are;
About 4 out of every 100 women suffers from bulimia at some time in their lives, rather fewer men. A person with an eating disorder can recover within five years providing they receive appropriate treatment, but in some cases, the illness will persist throughout life.
STATISTICS AND EVIDENCE At least 1.1 million people in the Here are
some statistics from various Mind: The The Independent on Sunday: Beat:
Beat currently
believes the number of people receiving treatment for anorexia
or bulimia to be near to 90,000, while many more people have
eating disorders undiagnosed, in particular those with bulimia
nervosa. Liberal Democrats: In the same
year more girls aged below 18 years were treated in NHS hospitals
for eating disorders than at any other time over the past decade. A
recent study showed that a total of 673 cases of children 18
and under were recorded in 2005/06, up from 486 in 1996/97, the
figures showed. The breakdown showed there were 562 cases of
girls aged 18 and under being admitted to hospital - the highest
figure for girls in the last decade - and 111 cases of boys. The following
table shows the number of diagnosed and admitted cases of eating
disorders in NHS hospitals,
THE STRESSFUL SITUATIONS WHICH CAN CAUSE AN EATING DISORDER When we feel as though we are faced with pressure, challenge or danger we need to react quickly and our body releases hormones such as cortisol and adrenaline to aid this. These hormones are part of the ‘flight or fight’ response and affect the heart rate, blood pressure and metabolic rate. Very often we are faced with stresses which do no call for either flight or fight however our bodies still release these hormones as part of the reaction and this reaction can damage health and reduce the ability to cope. When we feel stressed we can loose our appetite or crave foods plus a whole raft of other things such as frequent crying, biting our nails and feeling tired. There are many reasons why a person can develop anorexia nervosa or bulimia and they are mainly due to that person feeling a pressure, challenge or danger which causes them stress. These are some of the reasons why a person may develop anorexia or bulimia;
Evidence: As seen below there is evidence to prove that stress can drive you to eat and stress can come in a variety of forms as seen above.
Eating Disorders Association We surveyed (Time to tell) 1,000 young people with personal experience of an eating disorder, and asked them key questions about who they could tell; how long it took to seek help; and what change they would wish for in the world to make a difference to eating disorders. The results showed that;
Exeter University A 1998 survey done by Exeter University included 37,500 young women between twelve and fifteen;
THERAPY FOR EATING DISORDERS The type of treatment/therapy that the person receives will depend upon the severity of the eating disorder and the length of time that they have had the disorder. It will also depend of the persons preferences.
MY OWN OPINION AND PERSONAL EXPERIENCE OF ANOREXIA AND BULEMIA I had always had an idea of some of the factors which could have triggered my anorexia and bulimia such as moving away from home at an early age, loss of control over my life and someone commenting on my figure which I found very hurtful and painful. My personal experience of anorexia and bulimia When I was 17 I moved to Germany to be a nanny for a family of 6 to get away from the boredom of life on the Isle of Wight. This was a huge step for me and one in which I had my heart set on. On reflection I can see that the experience was a very stressful one, in that I was away from my family and friends, didn’t speak the language, had no idea of their culture, and had never had the responsibility of 4 young children and the housework. I used food as a comforter and would find that I would wake in the middle of night and sneak downstairs to eat huge bowls of ice cream and cake. Obviously I put on loads of weight (3 stone) and when I went home I remember walking through town in my new outfit to get a comment from a group of boys who whistled and said “Hey footballers legs”, and started laughing. I was absolutely devastated and remembered feeling so fat an awful as I took it that they were saying they were ‘fat’. From then on I ate hardly anything and remember reading that on average we eat around 2000 calories a day so I decided to half that and eat even less. When I returned to Germany my main focus was on my weight but this time on how much I could loose and I wrote everything down and the calorie count and some days would eat as less as 100 calories. When I returned to England I weighed under 7 stone. My parents had just told me that my dad was having an affair and that’s when it became worse because I was so hurt and confused about my dad having an affair and had to try and been strong for my mum and brother. I tried counselling but didn’t respond to it as I was numb to any feelings and thoughts and found it hard answering the questions the counsellor asked. I didn’t go back and this is when I decided that I couldn’t take it any longer and got a job in America, away from it all! This is where my bulimia began. One night I was sick after eating chicken and something struck me that this was the answer; I could have a great time in America eating all the great food but just vomit afterwards to get rid of it. I still had control. This carried on for 8 years and got progressively worse where I was sometimes vomiting 30+ times a day. I started to get a lot of headaches, palpitations and my skin became really dry. I would on occasions pass out and my teeth started to decay. I would live my life around food and plan how and when I could eat loads of food. I gave me a sense of fulfilment and great achievement when I would vomit it all back up. I remember meeting another nanny like me who would take laxatives which I tried once, but didn’t like the pain it caused so I didn’t carry on. I finally got better when I meet and American man who was very strong, confident and wealthy. When we moved in together I remember this feeling of relief that I had some stability, security and love. I was also scared, embarrassed and ashamed of my eating disorders and would have been absolutely mortified if he had found out. I knew it would all go away and I started to eat normally without feeling guilty. Since this time I have had a couple of relapses and been sick twice! On reflection I can see that I lost control of my life when I was 17 and became stressed with a great deal of pressure, challenges and even danger to deal with. The next 8 years I found that the only aspect of my life I could control was my food intake. Having someone comment on my figure just highlighted the fact that I had lost control and therefore I took control with my eating. When I look back I cannot believe that I did this for so long and didn’t do more damage to myself- I was lucky! My experience has been one in which I can now use and I always knew that I would. I hope to work with people with eating disorders and help them find a way out too. To do this I will gain a qualification in CBT, nutrition and eating disorders and use my Holistic Stress Management Diploma and own personal experience to help with recovery and healing. CONCLUSION It is evident that the amount of cases for anorexia and bulimia has risen over the past 30 years. The incidence of new cases each year has been estimated by BEAT (Beating Eating Disorders) as; Anorexia up to 11 new cases per 100,000 population per year and Bulimia up to 18 new cases per 100,000 populations per year. It is also evident that the younger generation have eating disorders and as seen in a study a total of 673 cases of children 18 and under were recorded in 2005/06, up from 486 in 1996/97. There is no real definitive reason as to why a person would become anorexic or bulimic but a whole raft of very stressful situations. From my own personal experience I can agree that leaving home, divorce and low self esteem played a big part in my life. The media portraying the so called ‘perfect woman’ is also a big issue as seen in several studies. There have been several studies that have shown ‘appearance’ as being the biggest concern in their lives and people wanting the media to show more ‘real’ bodies. It has also been highlighted that young people have felt that they couldn’t tell anyone about their eating disorder. There has also been new research to suggest that there is a biological link between stress and the drive to eat. Comfort foods -- high in sugar, fat, and calories -- seem to calm the body's response to chronic stress. In addition, hormones produced when one is under stress encourage the formation of fat cells. These eating disorders are very serious and people can die from them and can affect children, women and men of all ages. It is evident that stressful situations can be the cause of eating disorders and therefore it seems that support is needed more in the beginning of these stressful times which would hopefully minimise the risk of having an eating disorder. The very young need to understand that support is there for them when they are experiencing troublesome times from both their families and professionally. The media also needs to address the fact that everyone is beautiful irrespective of their size, shape and appearance and start to use models etc of all shapes and sizes. I will aim to be one of the people to help these people recover and regain their lives, health and happiness.
Bibliography: Helping People with Eating Disorders. Bob Palmer. Wiley Publication. 2003.
References: 1. Royal College of Psychiatrists 2. Royal College of Psychiatrists 3. Royal College of Psychiatrists
Internet sites: www.nimh.nih.gov/publicat/eatingdisorders.cfm#ed5 www.datehookup.com/content-beyond-physical-appearances-a-guide-to-anorexia.htm www.netdoctor.co.uk/diseases/facts/anorexianervosa.htm www.anxiety-and-depression-solutions.com/articles/news/stress_perfectionism_0707.php www.rcpsych.ac.uk/mentalhealthinformation/mentalhealthandgrowingup/24eatingdisordersinyoung.aspx www.nhsdirect.nhs.uk/articles/article.aspx?articleId=350&PrintPage=1 www.mentalhealth.org.uk/information/news/?EntryId=47560 www.cks.library.nhs.uk/search/0/anorexia www.clinicalevidence.com/ceweb/SearchServlet?searchTerm=anorexia&x=0&y=0 www.disordered-eating.co.uk/eating-disorders-statistics/eating-disorders-statistics-uk.html
APPENDIX 1 Influence of the media
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