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Comm 1312: Writing and Research
Section # 202, Dr. Runna Alghazo
Name:
ID:
Major: Finance
Assignment #3: Literature Review
Topic: Anorexia Nervosa
Introduction:
Anorexia Nervosa, a disease that is caused by the obsession of losing weight, is
increasing at a high rate day by day. Anorexia was not yet known as a disease until it
increased and became more well-known to physicians in the later part of the nineteenth
century and throughout the twentieth century. Anorexia was first discovered by a London
doctor called Sir William Gull in 1874. According to Lucas (2004), a professional researcher
in the field of eating disorders, anorexia was found to be the third most common chronic
illness among teenage girls (Lucas 2004). However, anorexia is also common among adult
women and men. Many people die from anorexia nervosa, either from suicides caused from
the depression that anorexia leads to or due to the medical problems it causes. Curtis (1999)
states in his book: "Anorexia nervosa originally indicates a ‘loss of appetite through nervous
causes’" (Curtis 1999). Anorexia Nervosa is considered to be partly genetic but mostly a
psychological disorder. It comes along with a range of changes in behavior, emotions,
thinking, perceptions, and social interactions. Anorexia is believed to be just another sign of
destroying oneself like cutting one's wrist. Since anorexia is a major disease worldwide, it is
important to consider its causes, negative effects, symptoms, how is it diagnosed, who is
more prone to anorexia, and its treatments.
Causes:
There are many causes that are suggested by different doctors for anorexia since the
significant cause is still uncertain till now. A couple of the most probable causes are the
pressure from the media and the society, and from a particular failure often seen in families
of anorexic patients. Passer et al. (2005) and Stoppler (2007), professional psychologists,
state that the cause of anorexia usually lies in a combination of environmental, psychological,
and biological factors. Many women who immigrate to Western countries from non-western
countries usually end up with anorexia since there are variations in the beauty standards
among different cultural groups. Anorexics are perfectionists since they strive to live up to
superior self-standards. Therefore, since they think that being thin makes people seem
attractive, they try to be even thinner than normal people which causes them to be anorexic.
This is caused by the pressure from the media and the society. Therefore, the poor self image
that they have starts the problem of anorexia and losing weight for them becomes like a battle
for success and control. (Passer et al, 2005; Stoppler, 2007)
Passer et al. (2005) and Stoppler (2007) also state that biologically, anorexia can also be
passed on genetically when the neurotransmitter levels in the brain are imbalanced. In
addition, families also play an important role in causing their children to become anorexic.
When the family is overprotective and rigid having high parental expectations, poor
communications skills, and frequent problems, the children usually end up becoming
anorexic (Passer et al., 2005; Stoppler, 2007). Brunch (2001) indicated that observant parents
should offer food to their children even if they do not want to and take care of their children.
The families should talk to their children and they should not leave them alone. The parents
should try to help their children as much as possible to boost their self esteem. Therefore,
when their self esteem increases, they would be happy with the way they look keeping them
away from being anorexic (Brunch, 2001).
Passer et al. (2005) also points out that in children, especially girls, part of this
malfunction includes a fear of growing up and the desire to be perfect to impress their family.
Treating anorexia, like all the other eating disorders, is difficult and may take years since they
have to change the way they eat, think, and act. (Passer et al, 2005)
Symptoms of anorexia:
According to Strober and Scheider (2005), there are three stages that a person goes
through before being anorexic. These three stages are called the slippery slope. The first stage
is the innocent but rigid dieter where the person thinks that he or she needs to lose a little
weight; therefore, he or she picks a diet and sticks to it. The person also starts exercising
every day. The second stage is the exhilarated dieter where the person starts receiving many
complements about losing weight; therefore, she or he starts studying carbohydrate and
calorie charts. The last stage is the obsessed and preoccupied dieter where the person starts
thinking all the time that he or she is really fat. At this time the person get tired so he or she
start sitting on their own all the time because they think no one is understanding the. The
symptoms of anorexia start to appear. (Strober & Schneider 2005)
According to the EhealthMD organization (2004), some of the warning signs or
symptoms of anorexia are the denial of hunger, isolation, obsession in losing weight,
menstruation stops, repeatedly weighing oneself, excessive exercising, guilt after eating,
mood swings, depression, skipping meals, use of diet pills, body dissatisfaction, low self
esteem, eating low fat foods, vomiting, sleep difficulties, fatigue and changes in relationships
with families and friends (EhealthMD, 2004). Another symptom is when the person starts to
claim to feel fat when obviously not over-weight and wearing baggy clothes to hide their
body.
Anorexics are usually sad, angry, stubborn, aggressive, and secretive. They like to be
isolated from everyone even their family and friends. Individuals are hard to be diagnosed as
anorexics since they deny the fact that they are losing weight so fast.
Negative effects

Physical Changes:
EhealthMD organization (2004) states that many physical changes can occur to an
anorexic person. Some of these physical changes are a pale face color, teeth cavities, swollen
ankles, dryness of hair, and reduced sleep hours. Another physical change is the growth of
lanugo hairs on the back, arms, and face. Lanugo hairs are the fine, silky hairs found on the
fetus. It also grows on grown people as a sign of starvation since the body tries to protect
itself when too much weight is lost (EhealthMD, 2004).

Medical Problems:
In addition, there are a lot of medical problems that are caused by anorexia such as
osteoporosis which is the loss of bone density, low breathing rate, low body temperature,
fainting, weakness, swollen salivary glands and constipation. Michel (2003), an expert on the
study of anorexia, states that the anorexics' blood pressure, heart rate lower due to the fact
that the body responds to starvation by slowing down to preserve calories. Anxiety disorders
become more common as the studies show that 60 to 83 percent of the anorexics had an
anxiety disorder at some point in their lives (Michel, 2003). Anorexics also take diet and
diuretic pills by a higher dosage than required and more frequent times leading to dangerous
outcomes.
Even though anorexic people usually weigh less than 85% of the normal weight, they still
view themselves as being fat. Crisp (1995) points out that there are many metabolic
abnormalities due to anorexia such as levels of the lipid in the blood may be very high or very
low, high levels of insulin, and low levels of glucose (Crisp 1995). Anorexia causes
menstruation to stop for females; it damages the heart. It also increases the risk in death since
it causes many diseases and because it causes depression and isolation; therefore, anorexics
might commit suicide. (Passer et al., 2005)
Who is more prone to anorexia?
According to Shuriquie (1999), traditionally in numerous non-Western countries,
chubbiness is considered to be attractive unlike the western countries where slenderness is
considered to be attractive. An experiment was made using a sample of 420 students in Egypt
to see if anorexia is a common disease in Egypt and the result was that the traditional values
of Egyptian society do not value a thin body too highly; rather they join the importance of a
women's fertility with being an ideal mother. Being slim and fit is preferred in Western
cultures where being thin apparently represents social acceptance, self-discipline, selfcontrol, competitiveness and class. In non-Western cultures eating disorders have been
considered rare and plumpness is the ideal for feminine beauty (Shuriquie, 1999).
According to EhealthMD organization (2004), anorexia nervosa occurs in 1% to 5% of
the population, it is most common in the white upper and middle class, and it is most
common within the people whose jobs require them to stay thin such as dancers, models, and
gymnasts (EhealthMD, 2004). Curtis (1999) indicated that females are twenty times more
likely to develop anorexia than males; however, anorexia is occurring in males more often
than before. (Curtis, 1999)
Types of families that the anorexics come from and what should those families do?
Strobber and Schneider (2005) state that there are three types of families that their
children have a possibility of being anorexic and each family has a different way of helping
their anorexic child. The three types of families are the conflict-avoidant family, the high
achieving family and the chaotic family. The conflict- avoidant family is the type of family
which has limited emotional breadth and is tightly controlled. They may seem peaceful in the
outside but there is always a sense of resentment and isolation, unhappiness and anger. This
type of family should start to be honest with each other and talking more about their problems
and emotions. They should also sit together for meals. The second type of family is the high
achieving family where their standards are too high. This family pressures the children to be
perfect; therefore, their children can turn out to be anorexic thinking that the perfect body
image is to be skinny. This family should redefine for their children what being successful is.
When the parents see that their child is trying too hard to be the best, the family should tell
her that it is not necessary and should not put too much pressure on him or her. The third type
of family is the chaotic family. This family has many faces; they share a number of qualities.
Therefore, they should be clear about their boundaries, and they should talk about the chaos
instead of pretending that there isn't any. In all the cases the families can help their anorexic
child to return to his or her healthy lifestyle (Strober & Schneider, 2005).
Treatments:
The Capital Health Eating Disorders Clinic in Canada follows the following steps for
treating the people with the signs of anorexic (Capital Health Eating Disorder Clinic, 2009).
The first step in the treatment of a person with signs of anorexia is the physician referral
process where the family doctor has to refer the patient to the Eating Disorder Clinic at the
hospital. Once the referral is sent to the hospital, the patient will be asked to complete a
survey and to attend an interview to assess the person’s individual condition. The patient then
attends a Stages Group which is a four-session group which helps the person to get to know
the program and its services and to learn more about his or her readiness to engage in
treatment. Finally, once the person is ready, a treatment will be designed specifically for
them.
Outpatient treatment is usually sufficient for people with mild symptoms of anorexia.
They undergo group treatments only in the Eating Disorder Clinic but most of their treatment
is at home where they have to follow strict eating schedules. However, those that are anorexic
and develop severe symptoms are sent by the Clinic treatment team to a mental health
inpatient unit close to the person’s home. These people’s condition is too serious and requires
constant supervision in a hospital setting. This step becomes necessary when the person’s
condition worsens even after intensive outpatient treatment or they have entered into a
serious state of depression which is affecting their way of life and their self esteem.
Specifically, patients with BMI (Body Mass Index) below 18 absolutely need to undergo
inpatient treatment until they are stable enough to go back to outpatient group treatments.
Some clinic groups under the eating disorder program include eating experiences,
assertiveness, body image, and psychotherapy. (Capital Health Eating Disorders Clinic,
2009).
Conclusion:
In conclusion, Anorexia is a serious problem that is increasing throughout the world.
Stoppler (2007) states that anorexia is among the conditions with the highest death rate, with
an estimated 6% of anorexia victims dying from complications of the disease and another
cause of death is suicide (Stoppler, 2007). According to Lucas (2004), there are many rumors
regarding anorexia. One of the rumors is that anorexia strikes a million American women and
150000 of them die every year. Nevertheless, this is not possible since if this was true,
anorexia would be the fourth most common cause of death, after heart disease, cancer, and
stroke (Lucas 2004).
Although research mostly blames the media for such disease since they make the people
misunderstand the idea of a good body image, families should also be blamed since the
parents fail to make their children feel the sense of confidence and self value. In fact,
according to Schwarz (2009), some lawmakers want to forbid skinny models so that people
would not be affected by them (Schwarz 2009).
Anorexics should not think of losing weight as a battle for success and control. People
should be satisfied with the way they look and they should not be affected by the media or the
celebrities they see. They should thank God on the way they look and they should remember
that being skinny is not the perfect body image.