Causes of anorexia and bulimia: biological constituent

Why people prefer to starve, driving themselves almost to exhaustion, or eat so little that soon come on the verge of illness? Serious consequences of physical and mental well-being of anorexia and bulimia have brought to life a number of theories. It is not possible to allocate any single factor as the principal cause of anorexia and bulimia. More than that, such search is complicated by the hen-and-egg causality problem. Are disorders of patterns of nutrition are caused by neurobiological processes or it is eating disorders that cause changes of neurobiology?

In order to explain the gradual degenerative process of development of this or that eating disorder, it is necessary to recognize all three basic etiological constituents: biological, sociocultural (including family and peers) and psychological. They may act alone or together, causing derangements of person's self-control.

We shall start with the biological constituent. Practically there are no objections, that neurobiological factors play rather an insignificant role in occurrence of anorexia and bulimia. However such factors can maintain these disorders, as they influence on appetite, mood, perception and energy regulation.

It is logical to assume, that biological mechanisms (genes, neurochemical processes), acting together or apart bear responsibility for derangements of regulatory functions. A person with an insignificant deviation undermines normal regulatory processes by unreasoned attempts to reach purposes connected with weight or dieting. In its turn it can cause universal changes in central nervous and neuroendocrine systems, which, in their turn, can cause new derangements and so on. Thus, it is also logical to admit, that ability to control such important reactions of the organism as hunger and appetite can result in unnatural habits in nutrition, which can result in unhealthy patterns of food consumption.

Rate of development of anorexia and bulimia

Anorexia and bulimia usually occur in youth at the age of 14-18. Though sometimes women and men of older age as well as children who have not reached sexual maturity also may fall victim to them. The occurrence of anorexia and bulimia is usually connected with some stressful and frustrating event, such as a divorce of parents and drastic changes within the family or in school.

Though symptoms anorexia nervosa are rather specific and easily determined, the rate and outcome of it vary greatly. Recurrences and chronic development are quite typical. Here are the statistics that characterize the outcome of anorexia nervosa on average:

Good - 52%
Satisfactory - 29%
Bad - 19%

The unstable pattern (returning of normal weight followed by the recurrence of the disorder) is the most prevalent. When the patient loses weight significantly and starts to suffer from heavy dystrophy, he is immediately hospitalized. A large number of patients (from 6 to 10%) die from medical complications or commit suicide.

The unstable pattern is also typical of patients with bulimia nervosa when periods of remission are interchanged with periods of binges and purges, or the disorder can take the chronic and more homogeneous form.

The recent study of patients suffering from anorexia and bulimia has showed that bulimics have more chances to recover than anorexics - from 50 up to 75%. It's also important to note bulimia nervosa is treated more effectively and its cyclic character is often easily disturbed.

Thus, anorexia and bulimia have a similar rate and character of development but presuppose different approaches to their treatment. I will write about it next time.

Anorexia and bulimia: cross-cultural comparison

Eating disorders are culturally conditioned to a considerable degree. For example, in North America anorexia and bulimia are much more rare among immigrants and minority groups. These cultural distinctions are peculiarly evident when teenagers from other cultures get acquainted with American ideals of weight and beauty. And after a little while the number and the extent of eating disorders among them grows significantly.

Teenagers from minority groups, that belong to upper middle class, are exposed to a greater risk because of their aspiration to be accepted in the dominating culture, or because they come under critical influence of two different (and sometimes contradictory) systems of cultural values. As it was already said, patterns of food consumptions and, consequently, eating disorders are closely connected with upbringing and cultural values. Such cultural favors as thinness and self-restraint are predominant in the North-American culture.

If we take into account statistics, it turns out that anorexia and bulimia are 5 times more prevalent in big cities than in the countryside. Probably, it's the impact of urbanization. Hustles and bustles of city life, stresses and frustrations tell on the state of health of the urban population and lead to anorexia and bulimia.

Some subgroups of teenagers are subjected to these disorders to a greater extent. Among them are girls with high socio-economic status or those who aspire to make a good career in certain fields.

Anorexia and bulimia victimize women of all ages

Anorexia and bulimia are abnormalities of nutritional behaviour that are typical mainly of women. According to western psychiatrists about 4% of young women aged 14 to 20 suffer from these eating disorders. And it is quite natural as at teenage age young girls pay a special attention to their appearance and are very sensitive to others opinion about their looks. The standards of beauty also play a great role. The image of a fragile, air and graceful woman has become a standard of beauty in the second half XX and the beginning of the XXI century. There is nothing bad when a young girl watches her body weight and keeps fit but only if it goes within the reasonable norm. But quite often young ladies take it to extremes. Sometimes only a slight stoutness or wide cheekbones bring great dissatisfaction and distorted image of one's looks. They begin to regard their own appearance as defective. As a result their are depressed about it, their mood is often low and they have a feeling that people pay heed to their "ugliness" and laugh about them. It all leads to the dysmorphophobic syndrome when young girls start feeling keenly about their (often thought-out) "physical defects". They come to the conclusion about necessity of growing thin and begin to strive against their "extra-kilos" in different ways and to different extent. And it is very often that this struggle turns to psychologically conditioned diseases known as anorexia and bulimia. Sad but true:(

Recent studies showed that it is not only teenage ladies that pay such an excessive attention to their look what leads to abnormalities of nutritional behaviour. Even quite elderly women can be very worried about their appearance. Statistics say that about 60% of women aged 60 to 70 are dissatisfied with their body weight and "extra-kilos". 4% of them have the diagnosis of anorexia and bulimia. So women of any age can fall victim of the disease.

Anorexia and bulimia: how different are they?

Anorexia and bulimia are eating diaorders that can have both psychological and somatic basis that stands for abnormal nutritional behaviour. Anorexia and bulimia are accompanied by a great attention of the person to his weight.

It is established that anorexia and bulimia are mostly women's diseases. They may first appear in the juvenile age and last for long years.

Still as regards pathological behaviour, physiological signs and change of character, anorexia and bulimia are quite different. In case of bulimia there isn't such a considerable loss of weight. If anorexia where loss of weight finally becomes inevitably obvious for people around, the bulimic sufferers can hide their disease for a long time since their weight keeps normal.

Lets' consider how different anorexia and bulimia are.

Pathological behaviour

Anorexia: restricted food consumptions, diets; rituals connected with eating, such as calculation of calories, shattering of meal, preparation of food for others and eating by oneself; strong fear to put on weight, constant struggle to keep one's weight lower than the norm; fear to be obliged to eat in public (during parties, at restaurants, etc.); hyperactivity (usually exessive sports excercises); hiding one's body under wide hanging clothes.
Bulimia: constant concern in food (conversations about weight, calories and diets); overeating , cumpulsive food consumption, inclination to hide food; fear to put on weight; avoiding paties, restaurants, etc.; visitings of a toilet right after meal; use of pharmacological means to grow thin, compulsive vomitting, use of laxatives; strict diets.

Physiological signs

Anorexia: progressive loss of weight (in short periods of time); absence or delays of menses; palenesslor, loss of hair, sensation of cold, blue fingers.
Bulimia: swelling of the parotid gland; haemorrhages of fine blood vessels on the face and under the eyes; chronic irritation of the throat; weariness and pain in muscles; dropout of teeth; wieght fluctuation (5-10 kg upwards and downwards).

Change of character

Anorexia: irritability, anger; depression, diffidence; feeling of guilt during starvation and food consumption.
Bulimia: depression; feeling of guilt and hatred to oneself, absence of self-control; severe self-criticism; seeking for approval of one's deeds and actions; changing opinion concerning body weight.

Thus, anorexia and bulimia are quite different in terms of behaviour, physiological signs and changes of character.