With the progress of globalization and industrialization, the development of eating disorders is also on the increase. The two main types of eating disorder are anorexia nervosa and bulimia nervosa. Anorexia is when a person has an intense fear of being fat and is hence unable to maintain normal body weight. On the other hand, bulimia involves a person who consumes large amount of food and then compensates it by vomiting, fasting or over-exercising to avoid gaining weight. The causes and the subsequent treatments of anorexia and bulimia can be classified into various factors, some of which are: biological factors which are treated with medication, environmental factors which are treated through brief-out psychotherapy, family environment factor which is treated through family therapy and lastly the psychological factors which are treated by hospitalization and cognitive-behavioral treatment.
Genetics and biological factors play a vital role in the development of anorexia and bulimia. The involvement of biochemical factors feed the existence of these disorders. Serotonin is a chemical found in the brain which increases serotonin activity in the brain causing anorexia while decreased activity causes bulimia. Hypothalamus is also a part of the brain which controls the autonomic nervous system and the endocrinal system. Damage to the hypothalamus can also cause either anorexia or bulimia (Cardwell and Flanagan, 151). Treating biological factors of the disorders involve the use of drugs such as anti-depressants but they are more efficient in treating bulimia as compared to anorexia (Davison and Neale, 236).
The involvement of social and environmental factors also has a major share of contribution towards abnormal eating patterns of people. The media image of women is becoming thinner and thinner, which contradicts with the average women’s weight in an industrialized society. The study by Stice refers to the concept that women who eat less food and have thin body shapes are more feminine (Swain, 162). This results in the development of body dissatisfaction and comparison of oneself with the “ideal image” presented by the media. The behavioral approach of psychology explains the procedure of media learning in terms of classical and operant conditioning which involves the process of learning an action and its reinforcement. Through classical conditioning, the person learns to associate thinness with admiration which is further reinforced by operant conditioning involving encouragements by others (Cardwell and Flanagan, 149). Treatment in this regard involves brief-out psychotherapy and family encouragement (Bourke, Castle and Cameron, 134) in which the person is familiarized with various positive aspects about them and taught to resolve their personal issues.
The influence of a troubled or over-dominant family can also result in the development of eating disorders which gives the adolescents a technique of drawing attention of their parents or family members towards themselves (B.Sadock, Kaplan and V. Sadock, 728). The four factors in the family system that trigger and boost the occurrence of eating disorders are enmeshment (speaking up for the children), over protectiveness, rigidity and lack of conflict resolution (Davison and Neale, 231). As the psychodynamic approach of psychology state, such family environment generates psychological problems in the children and their psychological needs are then fulfilled by the development of disorders like anorexia and bulimia, which provides them a psychological sense of control. Family therapy is extremely important in this regard. According to Moorey, the family follows certain patterns of interaction in the relationship which enhances the development of anorexia and bulimia. The therapist has to “identify the role of function that the eating disorder has within this complex pattern of relationships” and to “discover ways in which particular aspects of family behavior and communication can be adjusted in order to provide a context in which the eating disorder can be given up” (137).
The psychological factors highlight the major difference between the causes of anorexia and bulimia. The environmental factors, which include the ideal image given by the media or the over dominant and troubled families cause different psychological judgments amongst the people. People with anorexia become perfectionists who set up extremely high standards for themselves (of being exceptionally thin) and indulge in lack of eating, which can also be a way to punish their parents (Passer and Smith, 360). On the other hand, Passer and Smith also refers to the work of Strober and Humphrey, and state that people with bulimia “tend to be depressed and anxious, exhibit low impulse control and seem to lack a stable sense of personal identity” (360-61). Bulimics tend to binge and purge to reduce the level of anxiety and stress that is caused by their craving for food (Passer and Smith, 361). Analogous to difference in psychological cause, anorexia and bulimia also differ in terms of the treatment for these psychological causes. In anorexia, the patient is usually hospitalized and the aim is to help the person to gain weight and then to maintain that weight using motivational methods like ego-analytic psychotherapy (Davison and Neale, 237). In contrast, people with bulimia are treated with the standard approach of cognitive/ behavior therapy in which the person’s unrealistic ideas about body weight and self image are changed and they are motivated to eat reasonably (Davison and Neale, 237).
When analyzing the underlying reasons behind the development of anorexia and bulimia, a holistic approach is required. Through this, evaluation on these disorders can be made by considering all the various causes of development which are generally interlinked and fueling each other which, in turn, provide an efficient way to plan the treatment process for these disorders accordingly.