The Eating Disorder – Bulimia among Teens By Susan Kong #23, Alison Nguyen # 31, and Jenny Thay #37
Defining the Problem • Characterized by recurrent and frequent episodes of eating (usually large amounts) of food during which a person feels a lack of control over eating, followed by purging behavior such as vomiting, dating, use of diuretics, or excessive exercise • Prevalence among female between the ages 12- 20 • Median age 18 • Lifetime prevalence of bulimia nervosa among women is 1-3% • 0 to 3% of women with bulimia eventually die from complications of the disease
Causative Agent • Social Values • Low self-esteem • Admiring thinness • Society • Social Media – TV, magazines and social networks
Causative Agent continued • Family History • Disorder may come from family history with psychological disorders • Paternal criticism for weight • Family history of addictions or emotional disorders • History of abuse or obesity • Stressful Life • Abnormal life events, out of their control • Sense of control
Condition • Damaged tooth enamel • Weakens and erodes teeth often causing cavities • Sores • Heart problems • Abnormally low potassium levels in the blood can lead to irregular heartbeats also known as heart arrhythmias • Arrhythmias leads to heart attacks, heart failure, heart rupture and heart muscle damage, and ultimately, death
Condition • Gastrointestinal problems • Due to the repeated over-stretching of the stomach • repeated exposure to stomach acid from vomiting • Others • Damaged hands • Broken blood vessels
Host Characteristics • Age ranges from 12 to 25.8 • Highly influenced by others • Sex – mainly influenced on female • Pressures of appearances set by society • Nativity and Ethnic group – non-Hispanic whites, African American, Asian – American, Hispanics and foreign born
Environmental Attributes • Body Image set by Society • Results from environmental pressures encouraging unrealistic body shapes • Medial influences • Family • Grows in families that place stress and the desire to be perfect • Often families are controlling and so the bulimic teen learns to control their food intake as a coping mechanism to stress • Being praised for losing weight • Individual begins to feel accepted and continue to purge
Environmental Attributes continued • Health Status • Poor or fair health • 51% of teens reporting poor or fair health were dissatisfied with their body • Adolescents with chronic illnesses and poorer health are more likely to be dissatisfied
Temporal Variation • Secular and longitudinal trends • Appears to be seasonal • Cases of bulimia appears to peak during summer • Less clothing • Bikini season
Current Hypothesis • Can be controlled • Through education, redefining public image of beauty • Cognitive behavioral therapy • Changing an individuals’ attitudes toward their shape and weight as central to maintaining the disorder • Seeks to change individuals’ dysfunctional attitudes in order to facilitate recovery • Fluoxetine (Prozac) • Antidepressant that help balance the serotonin levels, one of the causes of bulimia
Additional Characteristics of the agent • Cultural/Society • Obsession with thinness and beauty • Social Networks that spread standards of the way beauty is defined in our society. • Celebrities, music artists and other people that adolescent girls look up too as a role model mainly based on their appearance. • Biological, genetic • Of particular importance to eating disorders is the chemical messenger serotonin which is thought to be related to well-being, anxiety and appetite. • A deficiency in serotonin is thought to be one of the causes of bulimia development • Psychological • Many people become bulimic, in part, due to a psychological disorder such as body dysmorphic disorder, depression or a personality disorder (causes of bulimia).
Gaps in Knowledge of the Distribution of the Causative Agent • Failing to educate adolescents • Regarding the cause and effects of purging • Long term problems • Physical and mental consequences that can come with bulimia. • Individuals who do not see it as a problem • Does not harm anybody else • Close and loved ones don’t address problem right away. • Lack of knowledge for long term consequences. • Lack of Research • Lack of standardized instruments to assess initial behavior • Follow-up assessment • Few studies have involved comprehensive outcome measures related to a wide range of variables. • Number of adolescent treatments are small.
Suggested Research • Psychological factors that influence the development and maintenance of anorexia nervosa and bulimia; • Cognitive and psychological dysfunction that may be the result of prolonged starvation; • The influence of cultural factors and the family on an individual's eating habits and food beliefs. • Further exploration of different pharmacological approaches used in thetreatment of bulimia. • Evaluation of interventions to improve motivation and adherence to treatment are particularly required in the younger population
Data Appraisal • References Hospitalizations for Eating Disorders Up Over Last Decade (2011, September 12). Mental Health, Depression, Anxiety, Wellness, Family & Relationship Issues, Sexual Disorders & ADHD Medications. Retrieved April 16, 2012, from http://www.mentalhelp.net/poc/view_doc.php?type=news&id=140391 Tracy, N. (2012, March 23). Bulimia Facts and Bulimia Statistics. HealthyPlace. Retrieved April 16, 2012, from http://www.healthyplace.com/eating-disorders/bulimia-nervosa/bulimia-facts-and-bulimia-statistics/ Autry, J. H., Stover, E. S., & Reatig, N. (1986). Anorexia nervosa and bulimia. Annual Reviews Public Health, 7, 535-543. Retrieved from http://www.annualreviews.org/doi/pdf/10.1146/annurev.pu.07.050186.002535 Gower, S., & Bryant-Waugh, R. (2004). Management of child and adolescent eating base and future directions. Journal of Child Psychology and Psychiatry, 45(1), 63-83. Retrieved from http://www.satsanga.buffalo.edu/docs/Guidelines_Psychology_and_Psychiatry.pdf
Data Appraisal • References Berger, F. K. (2011, April 18). Bulimia. Retrieved from PubMed Health website: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001381/ (2009, June 15). Bulimia nervosa. Retrieved from Women's Health website: http://www.womenshealth.gov/publications/our-publications/fact-sheet/bulimia-nervosa.cfm Schoenstadt, A. (2012, ). Bulimia statistics. Retrieved from eMedTV Health Information Brought to Life website: http://bulimia.emedtv.com/bulimia/bulimia-statistics.html (n.d.). Eating disorder statistics. Retrieved from National Association of Anorexia Nervosa and Associated Disorder website: http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/