1. Describe how eating disorders can be viewed as multi-determined disorders.
It is challenging to outline what causes anorexia nervosa and bulimia nervosa as both eating disorders are multi-determined, this means that there is are a combination of societal, individual, and family factors which all play a role in the development and continuation of an eating disorder. Rather than interpreting these as distinct causal factors, it is best to see them as factors which make a person vulnerable to the development of an eating disorder. Eating disorders are not solely disorders of eating. Rather, they develop as a result of multi-determined and self- perpetuating problems” in the perception and expression of how an individual sees herself in the world” (Palmer, 2000). Some individuals are unable to effectively deal with the stresses and challenges which accompany life, the individual may turn to dieting as a “solution” to the problems and challenges she faces. In summary, a person is prone, or made vulnerable, to the development of an eating disorder as a result of a combination of factors such as societal, individual, and family. The eating disorder is caused by a stressful event or time of life and prolonged by many of the original casual factors, as well as the effects of the eating disorder itself. In reference to module two power point anorexia may be viewed as a multi-determined disorder with individual, family and possible cultural predisposing factors. (Module, Two). There is an interaction between ‘mounting concerns with shape’ and psychopathology which pushes certainly vulnerable adolescents to behaviors which lead to anorexia. It could be hypothesized that groups in which hold the pressure to be slim and diet are dominant which may give rise to a greater expression of anorexia in vulnerable adolescents.
2. Describe the reasons why dieting usually precedes binge eating (in other words, describe how dieting can lead to binge eating).
Dieting usually precedes binging, chronologically. It has been proposed that dieting causes binging by promoting the adoption of a cognitively regulated eating style. The behavioral reaction of binge eating is best understood in cognitive, not physiological, terms. By ousting the physiological regulatory controls with the cognitive controls, dieting thus makes the dieter vulnerable to disinhibition and consequent over eating. In other words, dieting trains the person to eat with their mind and not their body. There is considerable evidence that dieting and binging co-occur. Some people with anorexia (binge-eating type) tend to practice dramatic dietary restrictions when they are not actually binging. Bingers, in short, tend to be dieters. It does seem only natural for people who binge to diet afterward in order to compensate for their excessive eating. Many people do not believe that binge eating “causes” dieting, however. They believe dieting causes binging. However, even in bulimic clients who do not suffer from anorexia, dieting of some sort seems generally to have preceded the onset of binge eating. Thus, prior denial produced a penchant to overeat subsequently, even after the weight lost during the deprivation phase had been regained.
Dieters have consistently exhibited a counter-regulation pattern in which they eat little as one pleases food thus maintaining their diets after no preload or a small forced preload, but eat a great deal of food ad lib after being forced to consume a lot. Dieters, however, eat small, diet-maintaining amounts when calm, but eat somewhat more when distressed.
3. Describe some of the broad areas of a person’s life that a nutrition counselor or therapist might pay attention to.
A nutrition counselor or a therapist is a responsible for special training in nutrition help people create healthy eating habits. A registered dietitian is used to provide nutrition therapy for the whole range of disordered eating. Their job is to help people recognize the fact that disordered eating may meet their need for safety or the relief of pain. Nutrition counseling guides patients in identifying problematic behaviors and setting realistic and achievable nutrition-related goals to support clients in making behavior changes. They focus on food intake, supplement use, compensatory behaviors, physical activity, and lastly the person’s relationship with their body as was stated in module 6. (Module Six) .The nutrition therapist assesses the factors that affect food intake: lifestyle and socioeconomic factors, personal values, interpersonal relationships and skills, trauma history, body image, self-esteem, substance abuse, and participation in sports. They may pay attention to family traits, education, physiological and physical traits. Dietary habits including avoidance of specific foods or food groups, picky eating. Sociocultural values, including the perception of health or beauty, that influence drive for thinness, negative body image, and/or body dissatisfaction. Psychological factors, including temperament, anxiety disorders, low self-esteem, self-regulation, attachment issues, and the history of abuse. Eating disorders are thought to arise from the interplay of genetics, biology, and psycho-sociocultural factors.
4. Explain some of the ways that the family of an individual might impact or lead to eating disorders in that person. You can reference the past and current theories.
Parents influence the development of eating, immensely. In a child’s life, there are many decisions which include the types of foods the child consumes and the availability of foods as well. As was noted in the module power point that parents, especially mothers, may contribute to their children’s (particularly daughters’) decision to lose weight. (Module, Six). One important note is how the family functions if the family is dysfunctional, this can lead to the creation of bulimia in the child. Children absorb everything they see at home and from their parents, they follow their parent’s behaviors. If the parent has unhealthy eating behaviors, the child will ultimately follow with a similar behavior. As well if mothers keep pushing their child to be thin, as this is the case for many perfectionistic mothers, putting importance on being thin proves to show bulimic symptoms and beliefs.
There were many references made to psychosomatic families which hold four different problems which enmeshment, conflict avoidance, overprotectiveness, and rigidity. (Minuchin et al. 1978). Enmeshment can be defined as a failure to keep proper personal boundaries amongst family members, which can lead to the dysfunctional families. As Minuchin’s approach to anorexia is found in his book Psychosomatic Families: Anorexia Nervosa in Context (Minuchin et al. 1978) There is an attempt to modify structural problems that result largely from enmeshment by challenging inappropriate alliances between a parent and a child. Overprotectiveness and rigidity also come from this. These parents have an overly protective attitude and set of behaviors toward their children. Thus, resulting in the development of anorexia. Perfectionistic parents see their own imperfections in their children, and they try to push their child to be “perfect”, but in reality, it affects the child’s self-esteem and pushing them to develop various eating disorders.