Eating Disorders in Adolescence
Eating disorders are mentally influenced ailments that are characterized by irregular eating patterns. They are most prevalent among adolescents, as they are more engrossed in the foods they consume and their weight compared to other age groups. The obsession with body image creates feelings of inadequacy in an individual’s subconscious. Mentally, they ‘feel fat’ or think they are overweight and may often check their weight or skip meals. The individual with a negative body image experiences low self-esteem and may be withdrawn from other peers, overly sensitive, hostile, anxious, fatigued, or often ill. These inadequacy feelings bring an irrational fear of getting fat that preoccupies their mind making it difficult to concentrate on other things. Early exposure to online media and peer influence aggravates risk factors in the occurrence of eating disorders in adolescent girls.
Eating disorders are severe and potentially life-threatening conditions that affect a person’s emotional and physical health. They also are compound and devastating conditions that can have severe consequences for health, productivity, and relationships. Eating disorders can affect every organ system in the body, including skeletal development, and people struggling with an eating disorder need to seek professional help. The earlier a person with an eating disorder seeks treatment, the higher the likelihood of physical and emotional recovery (National Eating Disorder Association, 2018)
There are a variety of eating disorders; however, anorexia nervosa (self-starvation), bulimia nervosa (binge/purge), and binge eating disorder (bingeing) are the most common.
Anorexia nervosa and bulimia, two eating disorders, are conceptualized as exposing the social tensions, particularly affecting young girls, and more frequently. The disorders overlap with standard practices and concerns around weight control (Scodellaro, C., Pan Ké Shon, J., Legleye, S., & Hamilton, P., 2017). If not addressed in time, eating disorders may lead to severe health conditions that affect the physical growth of adolescents. The risk factors predisposing adolescent girls to these disorders include having relatives with eating disorders or mental illness, Type 1 diabetes, perfectionism, teasing, body dissatisfaction, ideal appearance opinions, and weight stigma, among others.
Unfortunately, many of these risk factors are magnified in this age of social media. Ideal body types, usually thin and glowing, were celebrated in physical magazines. Now, all these misconceptions can be found at one’s fingertips. Furthermore, there are applications accessible to users that enable them to alter their bodies to fit the socially accepted beauty standards (Mage et al., 2014). A study conducted by Florida State University found that Facebook reinforced false body images through likes, commenting on likable photos, and sharing them (Mage et al., 2014). There are not stringent measures that check the registration and use of these platforms. An adolescent who is suddenly bombarded with these accepted ideas may react by not eating and develop Anorexia (Mage et al., 2014).
Anorexia nervosa is an eating disorder characterized by weight loss, a struggle to maintain appropriate body weight, and a biased body image. It is also listed as having the highest mortality rate among eating disorders. Exposing adolescent girls who may already be shy about their bodies to ideal thin bodies is harmful (Mage et al., 2014). A typical response is restricting the number of calories and the types of food eaten to attain the desired bodies in order to be considered physically attractive. Social media presents innumerable avenues for potential harm.
A study by Heiman and Shemesh on cyberbullying found that victimization caused low body esteem for adolescents (2016). Peer influences in a tie with other risk factors push adolescents to excessive exercise, which may lead to Anorexia. It is essential to have a comprehensive assessment and treatment program that can address risk factors and influence outcomes because anorexia nervosa leads to serious illnesses if left unchecked (Scodellaro, C., Pan Ké Shon, J., Legleye, S., & Hamilton, P., 2017).
Another study showed that above 50 percent of high school adolescents experienced cyberbullying online through their mobile phones (Gkiomisi et al. 2017). More than half of the cyberbullying incidences were perpetrated by strangers and did not seek outside help to deal with it. A negligible percentage of the population developed sleep and eating disorders or psychological changes as a result of the encounter Gkiomisi et al. 2017). Even though the co-relation between cyberbullying and eating disorders is indirect, it was found to begin depressive episodes (Gkiomisi et al. 2017). Likewise, exposure to thin-ideal body images resulted in increased body dissatisfaction and a deterioration in mood.
At the same time, mostly females who have obsessive and perfectionist personality traits are more likely to have the risk of bulimia nervosa. Bulimia Nervosa involves frequency and periods of binge eating, frequency of purging behaviors, and associated mental disorders. People with this type of personality trait will binge by consuming large amounts of calories in a restricted period. Often they try to undo the binge by purging. The most common is self-induced vomiting. Other risk factors for anorexia are these anxiety symptoms may emerge in any ages, race, middle- to upper-class socioeconomic status, and maybe demonstrated in social situations where the child or adolescent may be hypersensitive to the evaluation and scrutiny of others.
An investigation by Grimm & Steinle (2011), showed that people with eating disorders often experience rejection due to their physical appearance and also suffer as a result of negative stereotypes. There is a directly proportional relationship between the stigma band and the emotional health of many adolescents. Those with obesity often will identify adaptive coping strategies and includes the use of diet restraints that leads to eating disorders in the end.
Some adolescents have biological factors that impact their eating patterns, which may lead to disorders in extreme cases. Genetics inherited within the family lineage are critical contributors to the risk of developing eating disorders. Families with a history of the condition, therefore, are likely to have more cases happening in the coming days. It has been proved through identical twin studies in which they are likely to experience eating disorders as compared to fraternal twins (Beaver, K., Flores, T., Boutwell, B., & Gibson, C., (2012).
The family environment where an adolescent exists also influences eating habits. Adolescents from families that experience disagreements between guardians, financial constraints, or families going through a divorce process are prone to abnormal feeding habits. A vast percentage of these adolescents will spend time online as a distraction to the happenings in their home life (Ramos, 2017). They are more susceptible to trying pro-anorexic practices in a bid to fit in with the crowd (Ramos, 2017). Anorexia nervosa and bulimia were higher among the family environment that had been diagnosed with the condition before.
Individual
temperaments are associated with eating disorders. The personality traits of individuals and especially teens, in this case, predispose them to develop eating disorders as compared to the other people. Among the common characteristics that have been linked with this condition include overthinking, perfectionism, high sensitivity to reward and punishment, emotional imbalances, and hyperactive individuals. Such personalities often tend to trigger high levels of stress in the individual hence causing them to either withdraw or indulge in too much eating. Depression and anxiety also trigger obsessive behavior by influencing the neural pathway and reward inhibition (Cook & Hausenblas, 2011). These risk factors predispose the individual to harmful eating practices.
Moreover, environmental factors that influence the life of an individual contribute significantly to the progression of eating disorders among adolescents. One of these is the culture that dictates how people respond to many things, including their interaction with food. Some cultures have developed poor eating habits that tend to influence the way adolescents are likely to behave around food. While the majority of the African American women are curvaceous, their men counterparts mark slender bodies as ideal. It is part of a body-shaming practice that encourages individuals to lose weight.
The intense socialization that takes place at school also is responsible for developing inadequacies leading to eating disorders. Cohrdes, Goebel, Schlack & Hoelling, (2019), observed that the adolescent who is teased more frequently are likely to suffer from eating disorders as compared to those that are not.
On the other hand, the adolescents will often adopt the eating patterns of the peers they spend time with most. As illustrated by Rosen (2010), the socio-cultural factors associated with body image and weight are responsible for spreading unrealistic standards that may not be reasonable for most of the adolescents to attain and maintain. The influence of peers on the overall perception of a perfect body image also influences eating patterns for adolescents. In this case, once a friendship shares the same concerned relating to dietary restrain, weight concerns, and also extreme weight control practices, there is pressure to become like them. Thus, this is among the key reasons why this condition is most prevalent in adolescent girls.
Gender and ethnicity also influence the eating perceptions of teens. Most of the people from the minority racial and ethnic groups, especially those undergoing stigmatization, are more likely to suffer from eating disorders. Some women, who were previously comfortable with their weight, once they move to new environments, may be affected by the new culture, especially westernization, which in return leads to eating disorders. Generally, African Americans are judged more harshly in the media. For the longest time, lean, white women’s bodies were the accepted beauty standard, and the barrier is still there today. According to Cook & Hausenblas, (2011), most of the teen that are bullied or teased about their weight tend to try out different measures to remedy it.
While dieting may be similar to rates among other racial groups, or even less prevalent among American Indian adolescents, other restrictive eating practices may be more apparent. Buser et al. (2010) reported that American Indian females had the highest prevalence (47.6%) of fasting or skipping meals in the past year compared to White (43%), Black (30.7%), Hispanic (40.2%), and Asian (38%) females. More American Indian males (18.2%) also reported fasting or skipping meals compared to White (13.9%), Black (12.1%), Hispanic (16.6%), and Asian (13.4%) males. Buser et al. (2010) found that Native American male adolescents reported higher rates than White males for behaviors such as fasting (14.5% vs. 7.4%) and eating very little food (28.2% vs. 13.7%) in the past year. Similarly, these researchers found that 22.7% of American Indian female adolescents reported fasting, compared to 19.3% of White females; 48.2% of American Indian females reported eating very little food, compared to 42.6% of White females.
Eating disorders can happen to anyone at any age, gender, or socio-economic level. However, eating disorders are a common occurrence among adolescents, and they lead to extreme disturbances in the eating behaviors of individuals. Rosen (2010) looks into the intersection of gender and eating disorders, and the results show that they are much familiar in women as compared to men, and most eating disorders are a common phenomenon in adolescents between 15-19 years; however, most of the symptoms begin to show pre-adolescent.
Furthermore, young girls are known to be more concerned about their weight and shape because most of the girls between 15-16 years old were prone to eating disturbances. More specifically, heavier girls found it hard to cope in school, and hence they were determined to look into their weight further. Similarly, Martinsen & Sundgot-Borgen (2013) conducted another study among adolescent athletes, and his finding concluded that the prevalence of eating disorders was high among adolescent elite athletes than other controls in the study.
Touchette et al. (2011) report that binge eating had the highest prevalence among adolescents with a prevalence of 10.8% for subclinical binge eating, while bulimia nervosa was the second with a prevalence of 3.8% and lastly anorexia nervosa 3.5%. As Lock (2015) shows, eating disorders are highly frequent and also have severe psychological effects, and mostly they begin to show up during adolescence. An overall frequency of 0.48% and 1.7% in adolescent women is highly prevalent, and more so, he reports a limited number of studies covering the male. From the study, girls that had subclinical anorexia nervosa also had other significant depressive symptoms and more so anxious as compared to those with no eating disorders. There is a directly proportional relationship between eating disorders and mood and anxiety among young girls.
Wentz, Björk, & Dahlgren, (2019) shows that most of the adolescents may lack the ability to express some of the emotional components they possess such as self-awareness, enthusiasm related to factors such as weight loss and sometimes a feeling of depression. In puberty, it may be observed that there is a delay in development or complete growth retardation among the youths. Rigorous epidemiology study found out that the higher proportion of eating disorders was among adolescents, and between the ages 12 and 17, anorexia and bulimia are overwhelmingly feminine (Scodellaro, Pan Ké Shon, Legleye & Hamilton, 2017).
As stated by Benowitz-Fredericks et al. (2012) cognitively, there is an increased sense of awareness concerning the norm and values of the society in adolescence, and this is also those affecting the physical appearance and relationships. The hormonal changes that take place in the body are known to increase sexual interest, which affects the body image perception of the teens. Rigorous epidemiology study found out that the higher proportion of eating disorders were among adolescents. The majority of individuals that are known to suffer from eating disorders are adolescents, and it is the third prevalent condition among, especially females at adolescents. These conditions bring along various biological, mental, and sociological illnesses, and sometimes it leads to mortality (Scodellaro, C., Pan Ké Shon, J., Legleye, S., & Hamilton, P, 2017).
To sum up, both nature and nurture play a significant role in the development of eating disorders. Some of the critical factors in nature that result in eating disturbances are the genetic variations that will determine the eating habits of a particular generation. The hormonal imbalance in most people also may result in an eating disorder. In nurture, there are various environmental factors such as culture, parenting, and peer pressure that cause individuals to engage in eating disorders. In most cases, it has been witnessed that adolescents starting from 12 years old are more prone to eating disorders as compared to other age groups. It is linked to their cognitive development, the school environment, and hence they are likely to practice poor eating habits. Overall, these risk factors mixed in pro-anorexia media messages pose considerable potential harm to adolescent girls.
References
Beaver, K., Flores, T., Boutwell, B., & Gibson, C. (2012). Genetic Influences on Adolescent Eating Habits. Health Education & Behavior, 39(2), 142-151. Retrieved April 9, 2020, from www.jstor.org/stable/45056780
Benowitz-Fredericks, C. A., Garcia, K., Massey, M., Vasagar, B., & Borzekowski, D. L. (2012, June). Body image, eating disorders, and the relationship to adolescent media use. Pediatric Clinics of North America, 59(3), 693.
Buser, J. (2010). American Indian Adolescents and Disordered Eating. Professional School Counseling, 14(2), 146-155. Retrieved April 9, 2020, from www.jstor.org/stable/42732943
Cohrdes, C., Goebel, K., Schlack, R., & Hoelling, H. (2019). Symptoms of eating disorders in children and adolescents: frequencies and risk factors: Results from KiGGS Wave 2 and trends. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz.
Cook, B., & Hausenblas, H. (2011). Eating disorder-specific health-related quality of life and exercise in college females. Quality of Life Research, 20(9), 1385-1390. Retrieved April 12, 2020, from www.jstor.org/stable/41488202
Gkiomisi, A., Gkrizioti, M., Gkiomisi, A., Anastasilakis, D., & Kardaras, P. (2017). Cyberbullying Among Greek High School Adolescents. Retrieved 15 April 2020, from https://doi.org/10.1007/s12098-016-2256-2
Grimm, E. R., & Steinle, N. I. (2011). Genetics of eating behavior: established and emerging concepts. Nutrition reviews, 69(1), 52-60.
Krauth, C., Buser, K., & Vogel, H. (2002). How High Are the Costs of Eating Disorders – Anorexia Nervosa and Bulimia Nervosa – for German Society? The European Journal of Health Economics, 3(4), 244–250. Retrieved from www.jstor.org/stable/3570016
Lock, J. (2015). Update on evidence-based psychosocial treatments for eating disorders in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 44(5), 707-721.
Mage, A., Forney, K., & Keel, P. K. (2014). Do you “like” my photo?: Facebook use maintains an eating disorder risk. International Journal Of Eating Disorders. Retrieved from http://dx.doi.org/10.1002/eat.22254
Martinsen, M., & Sundgot-Borgen, J. (2013, June). Higher prevalence of eating disorders among adolescent elite athletes than controls. Medicine & Science in Sports & Exercise, 45(6), 1188-1197.
Ramos Salazar, L. (2017). Cyberbullying Victimization as a Predictor of Cyberbullying Perpetration, Body Image Dissatisfaction, Healthy Eating, and Dieting Behaviors, and Life Satisfaction. Journal of Interpersonal Violence. https://doi.org/10.1177/0886260517725737
Rosen, D. S. (2010). Identification and management of eating disorders in children and adolescents. Pediatrics, 126(6), 1240-1253.
Samantha Hajna, Paul J. LeBlanc, Brent E. Faught, Anwar T. Merchant, John Cairney, John Hay, & Jian Liu. (2014). Associations between family eating behaviors and body composition measures in peri-adolescents: Results from a community-based study of school-aged children. Canadian Journal of Public Health / Revue Canadienne De Santé Publique,105(1), E15-E21. Retrieved April 12, 2020, from www.jstor.org/stable/canajpublheal.105.1.0e15
Scodellaro, C., Pan Ké Shon, J., Legleye, S., & Hamilton, P. (2017). Disorders in Social Relationships: The Case of Anorexia and Bulimia. Revue Française De Sociologie (English Edition),58(1), 1-30. Retrieved April 12, 2020, from www.jstor.org/stable/26605190
Shemesh, D., & Heiman, T. (2016). Cyberbullying Victimization in Adolescents as Related to Body Esteem, Social Support, and Social Self-Efficacy. Retrieved 15 April 2020, from https://www.tandfonline.com/doi/abs/10.1080/00221325.2016.1195331
Touchette, E., Henegar, A., Godart, N. T., Pryor, L., Falissard, B., Tremblay, R. E., & Côté, S. M. (2011, January 30). Subclinical eating disorders and their comorbidity with mood and anxiety disorders in adolescent girls. Psychiatry Research, 185(1-2), 185-192.