TOO SKINNY – Anorexia Nervosa and Eating Disorders
What ethnic groups are affected by anorexia?
Until recently, eating disorders were thought of as illnesses that disproportionately affected Caucasian females. However, several recent studies suggest that the risk for anorexia across ethnic groups may be similar. For example, a recent report published in the Psychological Bulletin compiled the results of nearly 100 studies that examined body dissatisfaction among women of different ethnicities. Researchers found that body dissatisfaction was a strong predictor of eating disorders across each of the ethnic groups. Studies report that in the U.S., disordered eating patterns do appear to be equally common among Caucasian and Hispanic females and slightly less common among Black and Asian females (although studies show that the risk among Asian females is increasing), and slightly more common among Native Americans. Other studies indicate that the risk of eating disorders in ethnic minority populations is higher when the degree of acculturation is higher.
It appears that no ethnic group is immune to the dangers of developing anorexia. Of special concern, however, is that studies in North America indicate ethnic minority women are less likely to be sought out for eating disorders research, less likely to seek care, and less likely to receive treatment for an eating disorder. These findings are disquieting and mark the need for increased efforts at prevention and treatment for underserved populations.
No ethnic group is immune to the dangers of developing anorexia.
Term:
Acculturation – Adapting to another culture or modification of one’s culture through contact with another culture.
I really want to become pregnant, but I’m afraid to because I’m just beginning my journey of recovery. What are some of the effects of pregnancy on women with anorexia?
First, you should know that anorexia and other eating disorders have recently been implicated as a cause of infertility in women of childbearing age. As many as 5-15% of women treated for infertility have a history of eating disorder symptoms, and anorexia patients are particularly susceptible to low rates of fertility. Poor nutrition, endocrine changes caused by low body weight, and excessive exercise can affect fertility. Your doctor will help you determine if your history of anorexia may affect your ability to conceive. However, if you are currently experiencing any symptoms of anorexia, it is better that you continue with your progress in recovery rather than try to enhance fertility when you are underweight or at risk for medical complications. For reasons that will affect both you and your baby, you should wait until you, your doctor, and your treatment
team are sure that you are ready to become pregnant. Issues of fertility aside, pregnancy can be a serious challenge for someone with a history of anorexia and can pose risks to an expectant mother. For example, someone not fully recovered, or not ready for pregnancy, risks a return of eating disorder behaviors, both while pregnant and after giving birth. Therefore, monitoring your symptoms, even if you have been in recovery for some time, is important throughout the duration of your pregnancy as well as postpartum. Some of the potential maternal complications associated with eating disorders include hypertension, vaginal bleeding, cesarean deliveries, anemia, and postpartum depression. In addition, failure to maintain adequate body weight and nutrition during pregnancy can result in the need for hospitalization and intravenous feeding.
Anorexia in an expectant mother can also increase the risk of complications to a developing fetus; complications that can affect a child long after birth. Risk of fetal and infant complications include higher rates of miscarriage, infant mortality, premature birth, low birth-weight, low APGAR scores, malformations (including cleft lip and palate), respiratory problems, failure to thrive, and delayed development. Abuse of caffeine, diet pills, diuretics, and/or laxatives is particularly dangerous to a fetus. In addition, low maternal weight, purging, and poor nutrition can lead to cognitive, sensory, and physical defects in children. Maternal anorexia is also associated with more disturbed feeding behaviors and a higher rate of depression in children. Mothers with a history of eating disorders may have increased difficulty with breastfeeding and may be excessively concerned with their children’s eating behaviors and body weight. For all of these reasons, it is very important that mothers with a history of anorexia receive ongoing collaboration and monitoring from their treatment team throughout the duration of their pregnancy. Mothers should be sure to share their eating disorder symptoms with their gynecologist/obstetrician in order to receive the best prenatal and perinatal care. Additionally, mothers should discuss their infants’ food plan with a doctor in order to ensure that their children receive adequate nutrition.
Term:
APGAR – A test to determine the physical health of a newborn baby. The total score is based on five categories: color, cry, muscle tone, respiration, and reflexes
I have read that people with anorexia have low self-esteem. Is this true?
Of the personality factors reported among patients with anorexia, poor self-image and low self-esteem are often an issue. Specifically, many anorexia patients report that they lack a personal sense of self-worth or value and see themselves as “inadequate.” Although not everyone with self-esteem concerns develops anorexia, low self-esteem is known to be one of the factors that can serve to increase overall eating disorders risk. Even healthy individuals commonly report that body shape, weight, and appearance affect the way that they feel about themselves. For individuals with anorexia, however, these factors play an exaggerated role in determining their sense of self-worth and self-esteem. For the person at risk, restrictive dieting and weight loss may begin as an attempt to compensate for feelings of low self-worth. The pursuit of thinness, then, becomes a means of attaining acceptance from others and increasing personal self-esteem. The body shape and weight pursued by those with anorexia usually represent the quest of an unattainable ideal, an endless pursuit that actually serves to decrease, rather than enhance, self-esteem and self-image.
As a result, a cycle of personal shame, self-defeat, and diminished self-worth often ensues. Given the link between self-esteem and eating disorder symptoms, recovery from anorexia often includes learning ways of developing a healthier sense of self-worth and personal value. Indeed, expanding self-esteem to include more than just issues of personal appearance is key for any healthy individual, let alone one who has struggled with an eating disorder.
Self-Esteem Quick Test
Choose the statement that best describes you. Most of the time does you:
a) Accept compliments? b) Negate them?
a) Consider the total picture of who you are and what you have accomplished? b) Look for the blemishes (errors) in the total picture and dwell on them?
a) Like things about your physical self? b) Look for and point out your own shortcomings?
a) Reach a goal and savor it? b) Reach a goal and think you should have done better or should have done more?
a) Prefer the company of others? b) Prefer solitude and isolation?
a) Like your friends and seek them out? b) Tolerate your friends or try to avoid them?
If you chose all of the answers in the “a” column, you likely have a strong sense of self-esteem and base your self-image on a broad variety of factors. On the other hand, if you chose answers mainly from the “b” column, you may need to spend time strengthening your self-esteem and expand the number and type of qualities you consider when determining your own self-worth.
Terms:
Self-image – An individual’s perception of his or her own self.
Self-esteem – Personal opinions, judgments, or feelings about oneself.
