Eating disorders are conditions resulting from long-term behavioral, social, emotional, biological and interpersonal factors. Although researchers and scientists have not conclusively settled on the underlying causes of eating disorders, some general issues have been cited as key contributors to the development of this condition. It has also been established that many people and especially the adolescents use food and the control of food in an attempt to compensate for emotions and feelings that seem over-whelming (Gianna, 1992).
Psychological factors that are seen to lead to eating disorders may include low self-esteem, depression, anxiety, anger, loneliness, and feeling of inadequacy or lack of control of life. Interpersonal factors cited above may include troubled family, personal relationships, history of sexual or physical abuse, history of being ridiculed based on ones weight or size, difficulty in expressing feelings and emotions.
Social factors that may lead to eating disorders comprise of cultural pressures that mystify either thinness as a place value of obtaining a perfect body, narrow definitions of beauty as persons with specific physical appearances and not the inner qualities. Scientists have noted that some of the biological factors that contribute to eating disorders constitute of imbalance of the chemicals in the brain that control digestion, appetite, hunger and digestion.
This paper examines eating disorders in adolescents with a focus on the types of eating disorders, diagnosis, medical complications, nutritional disturbances, treatment and the barriers to care. There are four major types of eating disorders although it has been established that not every one (adolescent) fits in a type (Gianna, 1992). These subgroups include the compulsive overeating, Bulimia, chronic dieting and Anorexia. 1. Compulsive Overeating Compulsive overeaters usually eat foods for emotional rather than nutritional but do not necessarily purge.
Therefore binge may include a feeling of loss of control or not being good at eating large quantities or forbidden foods. This implies that this type of eating disorders involves a preoccupation with food for comfort when stressed. Many persons found to be compulsive overeaters are usually overweight and may appear obese although not all people who are obese suffer from this condition. 2. Bulimia This condition involves binge-eating followed by attempts to minimize the effect of overeating by either vomiting or fasting.
Bulimia may not be easily identified because it persons with condition appear to be within the normal weight range. The physical symptoms include dental problems, swelling of the parotid glands, digestive tract problems as well as electrolyte imbalances. Bulimics have a low self-esteem, negative self thoughts, depressed feelings, a sense of shame as well as extreme concerns with body weight and shape. 3. Chronic Dieting Chronic dieting interrupts healthy eating patterns which eventually results to a lapse, renewed vows to diet and feelings of failure.
Chronic dieters tend to avoid social activities because they often have negative thought about themselves. This is because self-esteem is not experienced as an internal feeling but instead appear to be weighed on a scale. 4. Anorexia This condition is characterized by extreme weight loss due to very restrictive eating or fasting. Symptoms of starvation, sensitivity to cold, dehydration and even protein deficiency occur and may as well be life threatening. It has also been noted that people with anorexia are perfectionists with unrealistic high expectations and therefore turn to restrictive eating as a way of feeling in control.
Since eating disorders are associated with biological, psychological and sociological factors, it is very important to put into considerations the developmental processes of adolescence in their determining the diagnosis, treatment and the results of this illness. 5. Diagnosis Majority of the adolescents lack capacity to express abstract ideas such self-awareness, motivation to lose weight and feeling of depression to due to their stage of cognitive development (Gianna, 1992).
Younger patients may show problems in eating, body image, and weight control without meeting the criteria of any of the above mentioned group of eating disorders. It is therefore important to eating disorders in terms of in the context of varied features of normal pubertal growth, adolescent development as well as the eventual attainment of a healthy adulthood instead of applying some formalized criteria that may have been laid down. 6. Medical complications Most of the adolescents with eating disorder with display the effects of weight-control behaviors as well as malnutrition.
This implies that majority of the medical complications in adolescents suffering from eating disorder will improve with nutritional rehabilitation and recovery although some may appear irreversible (Gianna, 1992). Experts have noted that adolescents who demonstrate any of the features stated are dire need of treatment even if they do not meet all the formal criteria of any of the eating disorders. 7. Nutritional Disturbances These are characterized by the deprivation of energy (calories) as well as protein which are very critical to growth.
Adolescents with eating disorders usually lose critical tissue components for instance muscle mass, bone mineral and body yet this is usually the stage of development when increases in these elements should be occurring. This indicates that continued assessment of nutritional status forms the basis of management of adolescents with this complex illness. 8. Psychological Disturbances Eating disorders that occur during adolescence tend to interfere with the copying up with the pubertal development and consequently the developmental tasks so as to become a healthy adult.
In many cases, isolation and family conflicts occur at a time when both the families and peers should be providing maximum support to development (Gianna, 1992). This also shows that at this point, issues associated to self-concept, depression, anxiety, the capacity of intimacy as well as separation from families should be addressed appropriately. One needs to thoroughly explore the role of families during both evaluation and treatment because adolescents usually interact with their families on daily basis.
However, mental health interventions for these adolescents with eating disorders should address the psychopathology characteristics of the condition, accomplishment of the developmental tasks of adolescence as well as the specific psychosocial issues prescribed for this age group. It is therefore established that for most adolescents, family therapy is the most recommended part of treatment. Treatment The complexity of the eating disorders requires that assessment and management of these conditions is done by a team comprising of professionals from medical, nursing, nutritional and mental health disciplines.
Usually, physical and occupational therapy is seen as a remedy to treatment. This implies that health care providers should have solid experience in managing eating disorders and also be experts in working with adolescents and their families. This is because their knowledge on the normal adolescent physical and emotional development is very critical as it will facilitate both the in-patient and out-patient treatment (Gianna, 1992). The objective of both the in medical in-patient or out-patient settings in treatment is usually to assist the adolescents with eating disorders to acquire and sustain physical and psychological health.
Nevertheless, the success of the treatment offered to adolescents with eating disorders does not necessarily depend the particular setting but rather the expertise and dedication of the members of the professional team who work specifically for peers and their families. It is evident that if not treated, eating disorders may eventually lead to the development of psychiatric disorders and therefore for effective intervention, treatment should be of sufficient in terms of duration, intensity and frequency.
Barriers to Care of Adolescents with Eating Disorders The above discussion has shown that interdisciplinary approach to assessment and management of eating disorders is the commonly used treatment strategy. However, interdisciplinary treatment of adolescents with eating disorders is seen to be time-consuming, prolonged and very expensive (Gianna, 1992). Again, lack of interdisciplinary teams and consequently inadequate treatment may lead to chronicity, psychiatric or social morbidity and worse still death. Conclusion
This paper has examined eating disorders in adolescents and has shown that the condition consists of eating behaviors that range from chronic dieting to compulsive overeating to cycles of binging and purging to self starvation. It has been noted that chronic dieting is the most frequent among adolescents followed compulsive overeating, bulimia then anorexia. It is therefore important to advocate for health care reforms that will ensure the provision of services to adolescents with eating disorders.
Reference
Gianna P. W (1992). Exploring Eating Disorders in Adolescents. London: Karnac Books.