Running Head: Eating Disorders

Eating Disorders
Kathleen Wallace
Wayne State University

Eating Disorders

I look so fat! I need to lose like 15 pounds! I heard this comment while walking passed
a group of teenagers on the street. I also overheard a similar conversation in the fitting room, and
know of young people who tell themselves this via their own psyche. A judgment such as this,
often stems from low self-esteem, and is a key ingredient for the development of eating
disorders. Throughout the United States, amongst both females and males, 1 or 2 out of every
100 students are suffering from an eating disorder (New, 2011, pp.1). This has become an
increasing epidemic that lacks the essential attention it needs throughout society to inspire any
sense of change. Yet, I wish to become a social worker to provide assistance in tackling this
social problem through increasing awareness, services and supports to address it
Demographics
Teenagers are impacted greatly on this issue. Considering individuals at this age are
going through many changes during puberty, teens are vulnerable to comparing themselves with
others and creating a depressive self-image because of their maturing body alterations. Studies
have found, when a child hits puberty, his or her brains socio-emotional system changes and
this is seen as an increased concern in being socially accepted (Thompson, 2014, pp.2). With
the combination of physical body changes and the struggle to keep up with the impractical
appearances of the models on the covers of magazines, this often leads young teenagers to fixate
on their weight; therefore, leading to unhealthy eating habits. In order to fit in and fit the
illusion of a perfect body, females become victimized to eating disorders as quick fixes to
become societys understanding of attractive. Thus, in the United States, as many as 10 in 100
young women suffer from an eating disorder (AACAP, 2008, p.1). Hence, in order to reach
societal perfection and mend the feeling of unacceptance, many teens turn to eating disorders
such as Bulimia and Anorexia as a solution.

Eating Disorders

Bulimia Nervosa and Anorexia Nervosa are two eating disorders that work hand in hand
together. If a teenager is suffering from an eating disorder, she may exhibit symptoms of both
Bulimia and Anorexia simultaneously. A common characteristic of Bulimia is binge eating
followed by vomiting. Additionally, these episodes of binge-eating are hard to control and many
times the patient will hide their evidence, such as food wrappers, to conceal their actions (NEDA
Communications Team, 2013). A common symptom of Anorexia is starvation. Young girls will
refuse to eat because of the fear of gaining weight, in combination with exercising obsessively
(Anorexia Nervosa and Associated Disorders, 2014). No matter how much weight is lost, there
always seems to be more to lose; it is a never ending cycle of dissatisfaction. Interestingly, both
disorders share very similar characteristics. Patients suffering from both disorders experience
rapid and extreme weight loss, hair loss, abnormal menstruation cycles, withdrawal from their
peers and family, and unpredictable emotional states. These disorders affect the physical, mental,
and emotional state of a person.
Additionally, eating disorders often lead to Body Dysmorphic Disorder (BDD). This
mental health disorder is associated with the fixation of ones flaws. Poor self-esteem and the
unacceptance of ones physical appearance are two characteristics found in both Body
Dysmorphic Disorder and eating disorders. Likewise, similar to eating disorders, BDD is
commonly found throughout the adolescent and teenage population. However, often times BDD
goes undiagnosed because doctors commonly mistake it to be other mental health conditions
such as Obsessive-Compulsive Disorder or an eating disorder, considering they share such strong
similarities. It is believed that one percent of the population in the United States suffers from
Body Dysmorphic Disorder (Anxiety and Depression Association of America, 2010).
History of treatment

Eating Disorders

The first identified eating disorder was during the time of Caesar around 700 B.C. It was
common for Romans to overeat at their festivals and vomit so they could continue to eat more.
Also, during the time of the Renaissance, women would fast to reach closeness to God and
anorexia was respected as a way to cleanse the womans spirit. Today, eating disorders share the
same characteristics from the past. Although the reasoning for the involvement with the disease
may be different, the same symptoms of vomiting, fasting, binging, weight loss, and an
emaciated physical appearance remains. Yet, in the past, it was more common for eating
disorders to be spiritual and a way of life verses eating disorders today, which are a common
consequence of young women being unhappy with their weight. However, the first formal
diagnosis of anorexia was in the 1680s by Dr. Richard Morton in London, England with his 22
year old patient. He concluded that her eating disorder was caused by unhappiness; believing she
was being eaten away by the emotion. In 1873, Sir William Gull, a physician to the Royal Family
in England, changed the name of Anorexia Hysteria, to Anorexia Nervosa. He believed that
this disorder was not caused by religious hysteria or biology, like many physicians believed prior
to his study, but was a consequence of a certain mental state. This disorder was treated by Gull
with his practice of changing his patients environment, constructing moral teachings, and force
feedings. He was the first physician to recognize this social problem as a mental illness (Engal,
2007).
Anorexia was first recognized in the United States by Dr. Hilde Bruch. Bruch was a
professor of psychiatry at the Baylor College of Medicine in Houston, Texas. She worked with
girls suffering from eating disorders that looked like walking skeletons. One of her patients
was 59 and weighed only 62lbs. Bruchs strategy for treat her patients was by to convince them
they could achieve attention in healthy ways, such as their intelligence and unique abilities,

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rather than starving themselves (Demaret, 1978). Today, policy solutions such as My Plate,
have been introduced to address this problem. On June 2, 2011 Michelle Obama and Tom
Vilsack, USDA Secretary, created MyPlate to help individuals make healthier food choices. This
program provides consumers with tools to build a healthy diet and receive nutrition education.
Likewise, in 1994 the organization of the U.S. Department of Agriculture created the Center for
Nutrition Policy and Promotion to improve the nutrition of citizens by focusing on dietary
guidance and conducting research in nutrition and consumer economics (USDA, 2014).
Services to alleviate eating disorders
Today, there are many services offered to alleviate the problem of eating disorders. There
is a range of treatments such as counseling, group therapy, mental institutions, anti-depressant
medication, 24 hour hotlines, and psychologists that specialize in the treatment of eating
disorders. There are numerous bills that are waiting to be passed to raise awareness, prevent
images in the media from using Photoshop, grant programs, and insurance coverage for medical
care to provide assistance for medical treatment (National Eating Disorder Association, 2008).
Congresswoman Judy Biggert introduced the Eating Disorders Awareness, Prevention, and
Education Act to create programs to educate and bring awareness to eating disorders. Federal
Response to Eliminating Eating Disorders Act, is a piece of legislation that addresses research
and treatment to those suffering from eating disorders (Anorexia Nervosa and Associated
Disorders, 2014). Additionally, New York and New Jersey have passed important legislation to
bring awareness to eating disorders. In September of this year, Governor Cuomo in New York
signed S2530/A5294 into law, which required the public health law to create the Eating Disorder
Awareness and Prevention Program (Dolan, 2014). Likewise, New Jerseys Governor Chris
Christie established a program that covers the cost of the treatment for people suffering from

Eating Disorders

eating disorders (NEDA Communications Team, 2013). This enables populations unable to
afford the mental health treatment to receive support. Thus, as time goes on, the prospects for
humanity to enforce bills that focus on assisting patients suffering from eating disorders and
bringing awareness to the issue continues to increase.
The most common form of therapy for individuals suffering from eating disorders is
Cognitive-Behavioral Therapy. This specific type of therapy is based on the idea that the
individuals behavior, feelings, and thoughts work together and can be recreated with optimism
for a safe and healthy lifestyle. A patients negative thoughts are the cognitive portion of therapy,
whereas their actions, such as binge eating, are classified as the behavioral attribute. This
particular type of therapy can be classified into three phases. The first phase is the Behavioral
Phase in which the therapist and patient work in unison to create a plan to tackle the harmful
behavior and practice new behaviors by managing their feelings. The second phase is the
Cognitive Phase where the negative thoughts are replaced with new perspectives and a main
focus is placed on recognizing underlying issues. The final stage is Maintenance and Relapse
Prevention, this is important for long term recovery because it focuses on eliminating the
triggers that cause patients to begin experiencing symptoms of eating disorders and returning to a
happy, healthy life (Sheppard Pratt Health System,2014).
Ordinarily, the population that receives the services offered to treat eating disorders are
those from urban districts. Although there are free hotlines and non-profit organizations, the most
effective treatment is by working with a physiatrist for rigorous mental health treatment, for an
extensive amount of time. Considering up to half of all people suffering from eating disorders are
clinically depressed, it is essential to see a professional to cure with the underlying mental health
issues. Furthermore, when a teenager suffers from this condition living in rural areas, it is harder

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to treat based on their limited resources. Thus, populations from poor neighborhoods are not able
to receive the same adequate assistance as populations of the upper class. Consequently, with
female teenagers already vulnerable to feelings of insecurity based on their physical appearances,
it only makes matter worse when they are also living in poverty. Hence, a poor social status often
lowers their self-esteem further and this is the population unable to receive adequate assistance.
However, there are policies being introduced to the government that can help this situation. If the
government takes this problem into consideration and offers medical assistance for those unable
to afford treatment, this can begin to lower the outstanding 50% of teenage girls suffering from
eating disorders (Anorexia nervosa and associated disorders, 2014).
Although there is a stereotype that eating disorders occur in the female, upper class,
Caucasian community, research has found that is not the case. Minnesota Adolescent Health
Study found that feelings associated with dissatisfaction and low self-esteem is equal among all
ethnicities. Similarly, through of a survey of 6,504 adolescents from individuals from various
race such as Asian, Black, Hispanic and Caucasian, all reported losing weight at similar rates.
Interestingly, in a study of 6th and 7th grade female students, Asians and Hispanic females
reported being more dissatisfied with their body image than Caucasians. Hence, the belief that
eating disorders occur primarily in the Caucasian community is incorrect. Consequently, many
different communities of people different backgrounds are being affected equally (NEDA
Communications Team, 2013).
Social Stigma
Social stigma and discrimination affects the definition and policy solutions in a major
way. Eating disorders are created from distorted social norms from a negative stigma of being

Eating Disorders

overweight. Society views individuals that are overweight as shameful and often times these
individuals are discriminated against because of their physical appearance. For teenage girls,
there are many discriminatory actions taken by their peers against females that weight more,
such as bullying, cyber bullying, and gossip. It is believed that the skinnier girls are more
attractive and receive more attention from the opposite sex. Thus, being skinny to look the part
of a flawless popular girl, is the goal for most teenagers. They are striving to become beautiful
based on their waistline and the media is only strengthening their distorted beliefs. The media
portrays women on covers of magazines and television to be flawless, yet in reality, these images
are edited to look the way they do. These images are created like a painting; unrealistic and
intangible. These image burn into the heads of young women as reality and they desire to look
like these models to achieve the same attention and glamorous lifestyle, beginning with shrinking
their number on the scale.
Media is the evil villain to change. The policy solutions are affected by the media
because the most valued aspect to society; money. We live in a world that revolves around a
competitive market that is always on the chase to make more money. Thus, it is a tough position
for the government to intervene when there are magazines, television shows, and music videos
that showcase these perfect looking women, creating revenue by luring teenagers to purchase
their products and watch their shows. The teenage population is a strong target for believing that
if they buy a models perfume or clothing line, they will transform to become more like them.
Likewise, these young women are buying miracle diet pills to try and lose weight to help fit the
image. However, besides for being dangerous, these pills normally produce little, if any, results.
Thus, desperate to lose more weight, young teenagers take this issue with their own hands and
begin experiencing symptoms of Anorexia or Bulimia as a guaranteed fix to their problem.

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My personal belief
My personal belief on the issue of eating disorders amongst teenage girls is that a low
self-image, which enables eating disorders, is a major consequence of a negative environment. If
a teenager grows up in a household with parents, siblings, and friends that discuss her
insecurities in a humorous manner by taunts and jokes, it will create extreme self-consciousness.
Likewise, school is another negative environment filled with clichs of females that are
constantly comparing themselves to their peers and complaining about their imperfections.
Similarly, I believe the mother and daughter relationship is a huge contributor to eating disorders.
Little girls grow up, striving to be like their mother one day. If a childs role model is someone
that distills a belief system that places an importance on physical appearance, she will remember
that notion throughout life. Presumed jokes that their daughter needs to wear more makeup or
is beginning to appear fuller in the waistline, is a common remark made in households around
the world that does extreme damage to someones self-esteem; especially coming from a mother
that is supposed to love you unconditionally. Children living through these types of environments
enter their teenage years and adulthood, with a poor self-image because of their unsupportive
past.
Social Work values and ethics
The treatment of eating disorders is related to Social Works values and ethics by the
promotion of social justice to provide services such as counseling and a nutritionist to encourage
a healthy lifestyle to patients. The importance of human relationships is essential for the
treatment of individuals living with this disorder because a positive, self-loving environment can
hold the key to success. It is important to have a strong support system comprised of positivity

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and self-respect, rather than focusing on ones flaws. An attribute that often leads young
teenagers to eating disorders, is the negative environment at school based on the consequences
they face from their peers, such as bullying and isolation due to their physical appearances.
Additionally, the media also generates a negative environment for vulnerable, young teens. It is
impossible for anyone to go to the store and not see magazines promoting flawless pictures of
models and weight loss advertisements. Similarly, television plays shows such as Americas Next
Top Model that showcases an emphasis on women competing to look the best. Throughout our
daily lives, there is no escape from the constant reminder of how important physical appearances
are. (Code of Ethics, 2008)
An ethical principle that is essential to treatment for females suffering from eating
disorders is self-determination. It is important for social workers to distill self-determination into
females in order for real change. A client may feel determined and ready for change while in
session, however, once they are on their own, they may begin fixating on their weight again and
put themselves down. Social workers have the responsibility of giving their clients the tools to
continue the ambition by being their own cheerleader when a social worker is not around. This is
a practical method because a social worker cannot be around a client all day, every day. The
client has to learn to take control of their life instead of letting their disorder have the power.
Hence, their self-determination to learn new behaviors, such as breaking the cycle of the
dissatisfaction by constantly comparing themselves to other and remembering the impractical
images in the media, their self-confidence will. It is important to enforce the value of the Dignity
and Worth of the person to the client. Individuals must recognize, as well as the social worker,
the respect they deserve; not only from others but themselves. Everyone offers something to the
world and eating disorders distort this feeling of value. Thus, effective treatment can be achieved

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by learning healthy lifestyle changes and practicing them independently; thus, making healthy
habits for every day life (Code of Ethics, 2008).
Eating disorders are impacting a great majority of our youth. It is important for society to
stop the negative attitude about imperfections. Media can play a huge role in doing so by
promoting self-acceptance and embracing differences. Our world is full of people of all shapes,
sizes, color, ethnicities, and religion, and that is what makes our country so great. We are
described as a country that promotes independence and freedom; however, young females are
prisoned by the hands of unrealistic ideals. I wish to become a social worker that can make a
difference in the lives on young teens and promote healthy lifestyles to increase their self-esteem
and prove the beauty of being different.

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References
AACAP. (2008, May 1). Teenagers with eating disorders. Retrieved, from
http://www.rosestreet.org/pdfs/Teenagers and Eating Disorders.pdf
Anorexia Nervosa and Associated Disorders. (2014, January 1). Eating disorder statistics.
Retrieved, from http://www.anad.org/get-information/about-eating-disorders/eatingdisorders-statistics/
Anxiety and Depression Association of America. (2010, January 1). Body Dysmorphic Disorder.
Retrieved, from http://www.adaa.org/understanding-anxiety/related-illnesses/otherrelated-conditions/body-dysmorphic-disorder-bdd
Code of Ethics. (2008, January 1). Code of Ethics. Retrieved, from
http://www.naswdc.org/pubs/code/code.asp
Demaret, K. (1978, June 26). Psychiatrist Hilde Bruch Saves Anorexia Nervosa Patients from
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Dolan, K. (2014, September 25). Victory for eating disorders awareness & prevention in New
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Eating Disorders Coaltion for Research, Policy & Action. (2008, January 1). Influencing policy.

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Retrieved, from http://www.eatingdisorderscoalition.org/influency-policy.htm

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National Eating Disorder Association. (2014, January 1). Legislation. Retrieved, from
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Thompson, C., Muhlheim, L., & Farrar, T. (2014, January 1). Eating disorders in teenagers.
Retrieved, from http://www.mirror-mirror.org/teens.htm#sthash.JbcJeKUj.dpuf

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USDA. (2014, January 1). MyPlate. Retrieved November 12, 2014, from
http://www.choosemyplate.gov/about.html

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