Research Paper

 FACTORS INFLUENCING PEOPLE TO HAVE EATING DISORDERS

 Research Paper Presented to

The English Resource Center

School of Multimedia Arts 

Asia Pacific College

Magallanes, Makati City

In Partial Fulfillment 

of the Requirements for the Course

ERESWRT- Research Writing

Gelzalis S. Duque

August 2014

********************************************************************************************************

Chapter 1

INTRODUCTION

A. Background of the Study

Over the past several decades, eating disorders like anorexia nervosa, bulimia nervosa, and compulsive overeating or binge eating disorder have become major health problems that frequently appear during teen years or young adulthood, particularly in women. According to Anorexia Nervosa and Related Eating Disorders, a person with anorexia refuses to maintain normal body weight for age and height and weighs 85% or less than what is expected for age and height. In addition, they have an intense fear of gaining weight or becoming fat, even when they’re severely underweight. Bulimia nervosa is often referred to as “bingeing and purging”. People with this eating disorder go on wild eating binges, consuming between 1,000 and 20,000 calories in one-sitting. They then purge what they have eaten by self-induced vomiting or taking laxatives or diuretics before their bodies can absorb the food. Lastly, a compulsive overeater (binge eater) is an individual who compulsively eats but does not purge and usually becomes overweight. 

Andrew Weil, M.D., an expertise in dealing with health problems wrote an article entitled "Compulsive Overeating". In this article, he discussed about binge eating disorder, which is one of the most common types of eating disorder. 

Weil writes, ""All eating disorders are serious medical conditions that can have a long-lasting impact on health and should be treated by experts in the field. Each may require a slightly different approach (http://www.drweil.com/drw/u/ART00524/compulsive-overeating.html)". 

Eating disorders are serious health problems that have many health consequences. With anorexia nervosa, the patient starve herself and restrict eating foods. Because of self-starvation, she will not get the proper nutrients that her body needs in order to function. The physical impact of anorexia nervosa could cause slow heart rate and blood pressure, bone loss, muscle weakness, and hair and skin problems. With bulimia nervosa, the patient binges and purges, upsetting the digestive system. The physical impact of bulimia could cause intestinal and dental issues. And with binge eating disorder, the patient consumes a lot of calories that could make her become overweight and obese. Obesity is not just being fat or overweight, it has many health consequences such as diabetes, high blood pressure, high cholesterol level, stroke and gallbladder disease.  

Eating disorders are not only health problems that could affect the physical health of a person, they are also considered as mental illnesses and usually associated with other psychological disorder. In an article entitled "Associated Mental Health Conditions and Addictions", the author wrote about all the possible psychological disorders that could co-exist with eating disorders. 

The author said, "Some of the psychological illness that can be (but are not always) found in people suffering with Anorexia, Bulimia and Compulsive Overeating are: Obsessive Compulsive Disorder, Depression, Post Traumatic Stress Disorder, BiPolar and BiPolar II Disorder, Borderline Personality Disorder, Panic Disorders and anxiety, and Dissociative Disorder and Multiple Personality Disorder (http://www.something-fishy.org/isf/mentalhealth.php)". 

Eating disorders are mental illnesses that could become fatal if not treated properly. A new research showed that patients with eating disorders of any type have a significantly increased risk of death, but anorexia nervosa appears to be particularly deadly and linked to the highest mortality and suicide rates. A study also found out that eating disorders have the highest mortality rate of all mental illnesses. The mortality (death) rate for eating disorders is approximately 18% in 20-year studies, and 20% in 30-year follow up studies.

In an article written by Deborah Brauser entitled "All Eating Disorders Can Be Deadly, Anorexia the Worst", the author wrote about some researchers who did a meta-analysis on the mortality rate of people who have eating disorders. The lead author Jon Arcelus, PhD, from the Eating Disorders Service in Leicester and Loughborough University, United Kingdom, told Medscape Medical News that mortality in eating disorders, particularly anorexia, was high. 

Dr. Arcelus added, "This study gives clinicians some information about predictive factors they can use in their day-to-day work. It should also give the primary care doctors and the general population a message that eating disorders are serious and the quicker they are treated the better (http://www.medscape.com/viewarticle/747148)".  

Although there is a lot of information available online about the harmful effects of eating disorders, many organizations like the Eating Disorder Information Service Network who are devoted in preventing eating disorders and the National Eating Disorder Association (NEDA) , are alarmed on the rising population of people with eating disorders. According to NEDA, the rate of development of new cases of eating disorders has been increasing since 1950. There has also been a rise in incidence of anorexia in young women 15-19 in each decade since 1930. In a research by Neumark and Sztainer, they found out that over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives. 

In an article written by Jenifer Goodwin entitled "Rate of Eating Disorders in Kids Keeps Rising", the author discussed about various studies and researches who reported on the rising cases of eating disorders among children.

Dr. David Rosen, a professor of pediatrics, internal medicine and psychiatry at University of Michigan reported, "We are seeing a lot more eating disorders than we used to and we are seeing it in people we didn't associate with eating disorders in the past -- a lot of boys, little kids, people of color and those with lower socioeconomic backgrounds, (http://health.usnews.com/health-news/family-health/brain-and behavior/articles/2010/11/29/rate-of-eating-disorders-in-kids-keeps-rising)". 

In spite of all the organizations who do campaigns and advertisements just to let people be aware of the harmful effects and negative impact of eating disorders, many people still develop this health problem. Women diagnosed with anorexia are having a hard time to recover, and there are cases in which anorexics do not want to cure their illness, and they still want to lose weight. Teenagers who are at risk in developing this illness started to acquire the signs and symptoms of eating disorders. Because of these phenomenon, some people blame certain things and they want to know the factors that may contribute on the growing population of people with eating disorders. Therefore, having background information about the factors that influence people in developing eating disorders will help them to know the reasons behind the unending cases of eating disorders in the society and the causes of the rise on the percentage of teenagers who have these mental illnesses.  

The purpose of this paper is to discuss the factors that could influence people to have eating disorders.     

B. Statement of the Problem

   This study aims to answer this question:

    1. What are the factors that could influence people to have eating disorders? 

C. Significance of the Study

Doctors and Health care Professionals. Doctors who specialized in eating disorders will help their patients easily recover from these health problems. Eating disorder like anorexia nervosa is difficult to treat because this illness is associated with other psychological illness. In addition, some anorexics are secretly members organizations and their illness is being supported by other anorexics. So, knowing the causes of this illness might help doctors find better treatment for their patients.

Teenagers. Nowadays, many teens are at risk of having eating disorders. However, teenagers don't have enough knowledge about this kind of health problem and they do not know the negative effects of this illness to their physical and emotional health. This study will help teenagers be aware of the factors of eating disorders so they can avoid themselves in having this mental illness.

Patients. People who are diagnosed with anorexia, bulimia and binge-eating disorders are struggling to cope up with their health problems. Because of eating disorders, they are experiencing health consequences such as malnutrition, weak bones and muscles, tooth decay, heart disease and others. Some patients are having difficulties in finding solution to their eating disorders because of some factors that hinder them from recovering. Thus, this study will be beneficial to patients in knowing more information about their problems. Having knowledge about the influencing factors of eating disorders can prevent patients from worsening their illness. 

Parents. Eating disorders are health problems that are usually misdiagnosed and mistreated. Many parents are not aware that their children are having eating disorders. They would just figure out the problem if they notice unusual eating habits of their children and big changes on their children's bodies. Parents of children or teens who have eating disorders are largely affected and they want an early treatment for this health problem. However, there are still teens who do not tell their problems to their parents and they kept it among themselves. Thus, this study will be needed by parents so that if they find out that their children have eating disorders, they can guide their children and avoid them from the influencing factors. 

Future Researchers. There are many researchers who have studied about eating disorders. Previous studies have been published and are used by other researchers to examine the causes of eating disorders. Aside from the other studies, this study will also be helpful for other researchers in order to know the current factors of eating disorders that affected many people, particularly teenagers. 


D. Scope and Limitation 

This study focuses on the factors that may influence on the development of eating disorders. According to some scientists, there are no exact causes for eating disorders, there are only contributing factors that influence people to develop anorexia nervosa, bulimia nervosa, and binge-eating disorder. The researcher will identify and explain each factors that mainly affect all the people, particularly teenagers. 

Due to time constraints, this study will no longer conduct a survey on how severe do the factors influence the people. The study will not discuss about the effective treatments for eating disorders, but the researcher will discuss the solutions that people may possibly do to prevent the influencing factors of eating disorders. 


E. Materials and Methods

The sources that are used in this research are articles that focuses on the causes and contributing factors of eating disorders. The researcher also gathered relevant information from previous researches and thesis of doctors that specialized in eating disorders. 

Every piece of information that is being gathered throughout online will be stated here, and for those who wrote the articles and did the previous researches will be given credibility for their work.

The study will analyze all the data by discussing issues about the impact of eating disorders to people and finding out the factors that mostly influence people in developing eating disorders. 


F. Definition of Terms

1. Eating disorder-  condition defined by abnormal eating habits that may involve either insufficient or excessive intake of food. 

2. Anorexia nervosa- eating disorder characterized by an obsessive desire to lose weight by refusing to eat. 

3. Bulimia nervosa- eating disorder characterized by binge eating and purging. 

4. Binge eating disorder- eating disorder characterized by binge eating without purging. 

5. Pro-ana- organization that encourage and promote anorexia. 

Chapter 2

DISCUSSION

What are the factors that could influence people to have eating disorders?

I. Definition and Types of Eating Disorders

Eating disorders are serious, potentially life-threatening conditions that affect a person's emotional and physical health. Eating disorders have many health consequences and medical complications that need to be seriously treated physically and emotionally, as early as possible. The most common types of eating disorders are: Anorexia nervosa, bulimia nervosa, and binge eating disorder. Anorexia nervosa is characterized by self-starvation, a distortion of body image, and refusal to maintain a healthy body weight. Bulimia nervosa is characterized by binge eating and purging, or consuming a large amount of food in a short amount of time, and followed by a self-induced vomiting. The third most common type is binge eating disorder which is like bulimia without purging, so most binge eaters are overweight or obese. 

There is a common misconception that eating disorders only affect women but the reality is that eating disorders affect both men and women. However, eating disorders are primarily diagnosed in women than men. According to statistics provided by the National Association of Anorexia Nervosa and Associated Disorders, 91% of women surveyed on a college campus had attempted to control their weight through dieting, 95% of those who have eating disorders are between the ages of 12 and 25; Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives. 

Since the past several years until now many people develop eating disorders. According to NEDA, the rate of development of new cases of eating disorders has been increasing since 1950. There has also been a rise in incidence of anorexia in young women 15-19 in each decade since 1930. In a research by Neumark and Sztainer, they found out that over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives. 

In an article written by Jenifer Goodwin entitled "Rate of Eating Disorders in Kids Keeps Rising", the author discussed about various studies and researches who reported on the rising cases of eating disorders among children.

Dr. David Rosen, a professor of pediatrics, internal medicine and psychiatry at University of Michigan reported, "We are seeing a lot more eating disorders than we used to and we are seeing it in people we didn't associate with eating disorders in the past -- a lot of boys, little kids, people of color and those with lower socioeconomic backgrounds, (http://health.usnews.com/health-news/family-health/brain-and behavior/articles/2010/11/29/rate-of-eating-disorders-in-kids-keeps-rising)".

Although people already know that eating disorders are serious health problems with many health consequences, there is a large increase in percentage of people developing these illnesses. Teenagers and children are becoming more prone to eating disorders. Because of that, many people want to know the certain causes and factors that mainly contribute to the development of eating disorders. 

II. Factors Influencing the Development of Eating Disorders

Causes of Eating Disorders

No single cause has been identified for eating disorders. Like other psychiatric and health conditions, a combination of several factors may contribute to the development of eating disorders. 

Eating disorders are complex conditions that arise from a combination of long-standing behavioral, biological, emotional, psychological, interpersonal, and social factors. Scientists and researchers are trying to learn more about the underlying causes of these emotionally and physically damaging conditions. However, the National Eating Disorders Association (NEDA) knows some of the general issues that can contribute to the development of eating disorders.

In their article "Factors that May Contribute to Eating Disorders", they said, "While eating disorders may first appear to be solely about food and weight preoccupations, those suffering from them often try to use food and the control of food to cope with feelings and emotions that may otherwise seem overwhelming. For some, dieting, bingeing, and purging may begin as a way to cope with painful emotions and to feel in control of one's life. (https://www.nationaleatingdisorders.org/factors-may-contribute-eating-disorders)".

NEDA said that eating disorders are not just about food and weights, but those who suffer from these disorders often try to use food and control of food as a solution to their emotional problems. 

A. Biological Factors

Many researchers are conducting studies on the possibility of genetics as contributing factors for eating disorders. Recent research found out that inherited biological and genetic factors contribute approximately 56% of the risk for developing an eating disorder. 

In a research by Wade Berrettini, MD, PhD, entitled "The Genetics of Eating Disorders", he found out, "Estimates from the most rigorous studies suggest that greater than 50 percent of the variance in liability to eating disorders and disordered eating behaviors can be accounted for by additive genetic effects (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010958/)". 

Berrettini researched about the heritability of eating disorders in families and twins. Controlled family studies have generally found increased rates of eating disorders in relatives of women with anorexia and bulimia compared to relatives of controls. Findings from the largest and most systematic studies suggest a 7 to 12-fold increase in the prevalence of anorexia and bulimia in relatives. In a twin study, the trait/disorder of identical (MZ) and fraternal twins(DZ) has been compared and correlated with genetics. The study found out that identical twins is more liable in anorexia and bulimia than fraternal twins. Eating disorder symptoms themselves also appear to be moderately heritable. Twin studies of binge eating, self-induced vomiting, and dietary restraint suggest that these behaviors are roughly 46 to 72 percent heritable. 

Research has also focused on abnormalities in the structure or activity of the hypothalamus, a brain structure responsible for regulating eating behaviors. Studies suggest that the hypothalamus of bulimics may not trigger a normal satiation (feeling full or finished) response. So, even after a meal, these individuals do not feel full. A wealth of research suggests that several different neurotransmitters are involved in eating disorders. It has been shown that the neurotransmitters neuroepinephrine and serotonin are severely diminished in patients that are suffering with acute cases of bulimia and anorexia nervosa. These are the same neurotransmitters that function abnormally when individuals are struggling with depression. This correlation has led some researchers to surmise that there could be a link between eating disorders and depression. In addition to creating feelings of emotional and physical satisfaction, the neurotransmitter serotonin also is responsible for feelings of fullness after eating.

B. Environmental Factors

Childhood Adversities

Child Abuse, childhood maltreatment, sexual abuse, as well as neglect has been shown by some studies as factors of various psychiatric disorders, including eating disorders. Children who had been abused when they were young may develop eating disorders in an effort to gain some sense of control or for a sense of comfort. Child abuse and neglect can cause changes in physiological structure and neurochemistry of the developing brain. 

In a study by Jeffrey Johnson Phd, Patricia Cohen Phd, Stephanie Kasen, Phd, and Judith Brook Phd, entitled "Childhood Adversities Associated With Risk for Eating Disorders or Weight Problems During Adolescence or Early Adulthood", they conducted a longitudinal study to investigate the association between childhood adversities and problems with eating or weight during adolescence and early adulthood. They concluded, "Childhood adversities may contribute to greater risk for the development of eating disorders and problems with eating and weight that persist into early adulthood. Maladaptive paternal behavior may play a particularly important role in the development of eating disorders in offspring (http://journals.psychiatryonline.org/article.aspx?articleid=175391)". 

The researchers present findings indicate that a wide range of childhood adversities tend to be associated with elevated risk for development of eating or weight during adolescence or early adulthood after the effects of childhood eating problems, difficult childhood temperament, parental psychopathology, and co-occurring childhood adversities are controlled statistically. The present finding are also consistent with previous cross-sectional research suggesting that childhood maltreatment and maladaptive parental behavior may contribute to the development of eating disorders. 

Parental Influence

Parental influence has been shown as a component in the development of eating disorders in children. This influence is manifested by food choices, food selection, or mother and father's direct comments about a child's body and weight. 

In a study by Robert Klesges, Risa Stein, Linda Eck, Terry Isbell, and Lisa Klesges entitled "Parental influence on food selection in young children and its relationship to childhood obesity", their study evaluated the impact of parental influences on children's food selection and the impact of childhood obesity on these food choices. 

The researchers concluded, "In summary, the current investigation indicated that children do not naturally select foods high in nutrition. Parents have a strong influence on the food selection of young children, largely by reducing the amount of foods low in nutrition (http://ajcn.nutrition.org/content/53/4/859.full.pdf+html)" 

Although parents' have a good influence on their children's choice of foods, there are cases in which parents are the ones who do not have healthy food selections and they are overweight or obese. If a mother or a father is obese and consumes many foods, children might be influenced and they will also eat a lot like their parents. They will adopt their parent's eating behaviors and there will be a possibility that they will develop eating disorder like binge eating disorder. But in some cases, parents are overly restricting junk foods, sweets, and other unhealthy foods to their children. Children who have those kind of parents are likely to develop eating disorders because children might crave for the foods that they want to eat.  

Cultural Pressure

Cultural pressure plays a big role in eating disorders particularly anorexia. In many societies, being extremely thin is the standard of beauty for women and it represents success, happiness, and self-control. In modern Westernized countries, models, magazines, the media, dieting fads currently influence women to be thin as possible. However, the idealized ultra-thin body shape is impossible for women to achieve since it does not fit with the biological and inherited factors that determine natural body weight. And because of that, many women are dissatisfied with their bodies leading them to have abnormal eating habits and do diets and starvation. 

In an article by Bridget Engel entitled "Causes of eating disorders- Cultural Influences", the author wrote about the ways on how the culture influences people to have eating disorders. 

Engel says, "In 1999, a study was published about the effects of exposing a culture to Western television for the first time. Prior to the television viewing, the people of Fiji believed that the ideal body was plump, round, and soft. Interviews after 38 months of exposure to Westernized shows suggested a sharp decrease in self-esteem and an increase in symptoms of eating disorders in teenage girls (http://sevencounties.org/poc/view_doc.php?type=doc&id=11752&cn=46)"

Media is one of the factors that mostly influence people to have eating disorders. Just by viewing the television which shows models with skinny bodies, collar bones, thigh gaps, and ant-size waistlines, even girls from other countries like Fiji who believed that body should be plump and round could still be influenced by Western countries. 

Treating the psychological factors of eating disorders involves reducing or eliminating behaviors or thoughts that originally led to disordered eating, and treating the psychological disorders related to the illness. If a person is exposed to television, in order to avoid dissatisfaction of body and negative self-image, he/she should avoid watching run shows and reading magazines. Refraining oneself from the cultural pressure of bodies should be thin could also help a person to accept his/her own body. 

C. Sociological Factors

Anorexia nervosa and bulimia nervosa are well-known eating disorders especially to girls but boys can also develop these illness. Having anorexia and bulimia can be developed from some reasons. If a girl is being teased or bullied because she was fat or obese when she was young, she could start being body-conscious when she becomes a teen, she would realize that being fat is embarrassing and people will just always tease you. It can also be developed if a girl always sees or watches models, actresses, and celebrities in televisions, magazines, newspapers, and in social media. They will admire those models that have svelte bodies. Since they admire and idolize models, they also want to have a body like theirs. A body with no fats, very thin, and any clothes will fit and look good on them. In order to be thin, these girls start to eat less and search in the Internet some tips on ‘how to lose weight’ or ‘how to be skinny forever’. They would already have clicked all the sites that seem helpful for them and they would have started doing what they had read.

Social Media

Teenagers are the most exposed to social media sites. They like looking at many photos of models and celebrities and comparing themselves is automatic.

In an article by Marcela Rojas entitled "Social media helps fuel some eating disorders", Rojas said, “Social media, where users exchange information and photos and communities from over common interests, has become a bastion for some struggling with eating disorders. Images of spindly legs, concave stomachs and jutting ribs emerge on various sites by searching hashtags like #thinspogram #thighgap or #bonespo (http://www.usatoday.com/story/news/nation/2014/06/01/social-media-helps-fuel-eating-disorders/9817513/)”.

The girls who see those disturbing photos are often accompanied by even more shocking “thinspirational” messages such as “pretty girls don’t eat”, “skip dinner, be thinner”, and “you have to exercise for a week to work of the thigh fat from a single Snickers.” These messages and photos are advocated by people who are known to be “pro-ana” (pro-anorexia) and “pro-mia” (pro-bulimia). Pro-ana and pro-mia websites have existed since the inception of Internet. But social media sites- Facebook, Twitter, Tumblr, Instagram and Pinterest have given the communities a global platform on which to share ideas and photographs. Users promote one another self-destructive behaviors through shared tips and tricks and promote the notion that an eating disorder is a lifestyle choice, not a serious mental illness. 

Another article entitled "Social Networking Sites Promoting Eating Disorders", the author said, "Experts say that social media forces teen girls into adopting unhealthy eating habits that often lead to eating disorders. A latest fad among teen girls is the thigh gap. The impossible weight loss goal is to become so thin that there is a gap between the thighs even when the feet are together. Apparently, the wider the gap is the sexier is the person (http://www.natureworldnews.com/articles/4334/20131005/social-networking-sites-promoting-eating-disorders.htm)".  

According to health experts, social media sites fuel such trends. A person needs to lose a large amount of weight to achieve the kind of thigh gap that is being promoted. The pictures of super-thin models with thigh gaps pressurize young girls into achieving an impossible body shape.  The staff reported also wrote that there is as study conducted by researchers at the University of Haifa reported in 2011 that teen girls who spent more time on social networking sites had higher risk of developing eating disorders, according to the Associated press. But, now social media sites discourage users from posting pictures of self-harm, but the images still get through. 

Pro-ana Movement

Teenagers who have anorexia nervosa or bulimia nervosa and those who want to be anorexics and bulimics are both exposed to social media sites. Most of the girls who have eating disorders have joined a group known as the “pro-ana” and “pro-mia” that is a short term for pro-anorexia and pro-bulimia. 

In an article by Jacqueline Head entitled "Seeking 'thinspiration'", Jacqueline Head said, “Pro-anorexia websites offering tips on extreme dieting are nothing new, but their growth on social networking sites is a disturbing new twist and brings them within reach of a wider audience. (http://news.bbc.co.uk/2/hi/uk_news/magazine/6935768.stm)”. 

The author said that websites that are offering tips on extreme dieting are not new but there is an increase of growth in people who are seeking extreme diet tips to be thin because of the popularity of social networking sites. The pro-anorexia and pro-bulimia websites are advocates of these extreme dieting. Members of such groups are posting pictures of painfully skinny girls for “thinspiration”, comparing dangerously low goal weights and measurements, and are teamed-up to “keep each other strong” in their quest to lose weight. Previously, people on such internet groups remained anonymous, and the groups are sometimes hard to find. Such groups can be found in social networking sites, and the biggest group is found in MySpace named Pro Ana Nation which has more than 1,000 members, and another group is Pro Extreme Dieting, which states: “we are here to support each other in our choices, even if they are to recover, or try to put on, or lose weight.” Facebook includes groups such as “Getting thin or die trying”, “Yes, I have an eating disorder. No, it’s not your problem” and other more groups.

There is an article which also believes that pro-ana websites are seriously affecting a lot of teen girls. It is an article by Sara Song entitled "Health: Starvation on the Web", Song wrote, " “Click on “disclaimer” on the website ceruleanbutterfly.com and instead of the standard fine-print legalese, you get a rant. “If you don’t have an eating disorder, it says at one point, “I wonder what the bloody hell you’re doing here. If you’ve come to yell at us, please realize that it’s pointless- we’re going to ignore your point of view just as you ignore ours.(http://content.time.com/time/magazine/article/0,9171,1081370-2,00.html)”

The creator of Cerulean Butterfly- a site which deals frankly and approves with anorexia and other eating disorder, is an intelligent San Francisco college student who asked to be called Lizzy has been anorexic since 2002 and is candid about her belief that eating disorder is less a disease than a lifestyle choice- a “decision to pursue perfection”. Lizzy says that the mission of her website is to provide support for people who already have eating disorders, not to encourage or promote self-destructive behavior. She said that the term pro-ana is widely misunderstood and misused. For many girls who are struggling with low self-esteem and a negative self-image, the pro-ana sites can be seductive.

III. Conclusion

The researcher found out that there are several factors that contribute to the development of eating disorders. According to studies, biological factor has a high probability that eating disorders can be inherited by a child with parents who have history of eating disorders. Childhood adversities like childhood maltreatment and sexual abuse can also be a factor because a child who was abused when he/she was young can cause him/her to develop disordered eating habits and psychological problems that can be linked to eating disorders. 

Research also said that parental influence and parent's choice of foods can be linked to a child's development of eating disorders. The cultural pressure where in the media, magazines, TV shows and the 'thin as the ideal body size' are big factors of the risk of eating disorders among teenagers. Lastly, social media has the highest influence to people since most people use and visit social networking sites daily. They can see various groups of people there who are promoting eating disorders like anorexia nervosa and because of that there is a chance that some people particularly teenagers will be influenced and they will be joining such groups. Specifically, the groups in social media who are promoting eating disorders particularly anorexia is called pro-ana movement. The pro-ana movement is composed of anorexics who are recovering or finding other people to support their illness. Pro-ana is a big factor of eating disorders because it shows many pictures, stories, and experiences of anorexics which can be adopted by the other girls.

Biological, environmental, and sociological factors affect people differently. Although these factors have different ways of influencing people, eating disorders still need to be treated seriously and properly by consulting to doctors and health care professionals who truly know how to cure eating disorders. Parents should know how to guide their children with their eating habits and food selections. Teenagers should avoid viewing and joining pro-eating disorder groups and sites in social media so that they can lessen the effect of these factors to their self-confidence and body image. Lastly, people should be more aware of their environment because there are many things in eating disorders which can have negative impact to most people. 

Chapter 3

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS

SUMMARY

This paper attempted to determine the factors that could influence people to have eating disorders.

The research design used in this study is the descriptive research method wherein data from documents and articles found in the internet were used to answer the research question posed. The research finding were the following:

1. Eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder have become major health problems that frequently appear during teen years or young adulthood, particularly in women.

2. The rate of development of new cases of eating disorders has been increasing. There has also been a rise of incidence of anorexia in young women in each decade. 

3. Although people already know that eating disorders are serious health problems with many health consequences, many people still develop these illnesses.

4. There are several factors that can influence people to have eating disorders. 


CONCLUSION

Based on the findings of the study, the following conclusions are drawn:

1.  Eating disorders are complex conditions that arise from a combination of long-standing biological, environmental and sociological factors.

2. According to studies, biological factors has a high probability that eating disorders can be inherited by a child with parents who have history of eating disorders.

3. The cultural pressure where in the media, magazines, TV shows, and the 'thin as the ideal body size' are big factors of eating disorders among teenagers.

4. Social media has the highest influence to people since most people nowadays use and visit social networking sites. In social media, several groups who are promoting the eating disorder anorexia nervosa called the 'pro-ana movement' affect a lot of women.


RECOMMENDATIONS

After drawing the conclusions of the study, the researchers hereby make the following suggestions/recommendations:

1. The influencing factors of eating disorders can help the doctors and health care professionals to gain more knowledge about eating disorders. Aside from knowing the factors, doctors should have an in-depth understanding for each factors so that they can easily help their patients to recover.

2. Teenagers who are at risk of eating disorders should be more aware of their environment, should know how to properly use social media and should not join any pro-eating disorder groups so that they can refrain themselves from having these illnesses.

3. For the future researchers who will study more on eating disorders, they should research about the possible treatments and solutions for each influencing factors so that they can help people from developing eating disorders. 


References:

Berrettini W. M.D. (2004, November) The Genetics of Eating Disorders. Retrieved August 11, 2014 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010958/

Brauser, D. (2011, January 5) All Eating Disorders Can Be Deadly Anorexia the Worst. Retrieved August 7, 2014 from http://www.medscape.com/viewarticle/747148

Engel B. (n.d.) Causes of eating disorders- Cultural Influences. Retrieved August 11, 2014 from http://sevencounties.org/poc/view_doc.php?type=doc&id=11752&cn=46
  
Goodwin, J. (2010, November 29) Rate of Eating Disorders in Kids Keeps Rising. Retrieved August 7, 2014 from http://health.usnews.com/health-news/family-health/brain-and behavior/articles/2010/11/29/rate-of-eating-disorders-in-kids-keeps-rising

Head, J. (2007, August 8) Seeking 'thinspiration'. Retrieved August 11, 2014 from http://news.bbc.co.uk/2/hi/uk_news/magazine/6935768.stm

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Blog Post #8: Anti-Fat Acceptance

Why can't society just accept fat people for who they are? They're human beings too. They have feelings and emotions, but, they have different body size compared to most of the people we always see in our everyday life. Since they also feel the way we feel, if they are judged, criticized, teased, and bullied, they become so emotional that sometimes lead them to have depression, anxiety, stress, etc. and their stress can become stress-eating so they will become fatter! Being fat, overweight, or obese is very stressful not only for people who are truly fat, but also to those who feel like they're fat even though they are literally not. For those who are 'truly fat' and 'feeling fat', they have something in common when they encounter the word 'acceptance'. Most of the obese people find it very difficult to lose weight and cope up with their current body size. Some think it would be better if the society will just accept fat people for who they are and for what body size they have so, they invented a community where every fat people in the world is accepted and understood- and that is the 'Fat Acceptance movement'.

The first event of Fat Acceptance movement started in New York City in 1967. After that event, there comes an organization which was called the National Association For The Advancement of Fat People (NAAFA). Then, the NAAFA was followed by the Fat Underground in 1980's. And today, there are now several fat acceptance groups online typically found in social media. Many obese people now who want justice for fat discrimination joined the fat acceptance movement. They joined such groups simply because like the pro-ana and pro-mia, these certain kinds of people want to have a big family where they are wholly accepted and understood, they want to be a part of a large community who are struggling to fight for their rights in the society, and they want to change people's minds and opinions about them. But, obviously, there are many people who disagree with the fat acceptance. Some think that fat acceptance is a ridiculous, unacceptable, and a 'bullshit' idea.

I read an article entitled Fit Pride Isn't Hate Speech written by Maria Kang from the site ideas.time.com. The author of the article Maria Kang is a freelance writer and founder of Fitness Without Borders, so she is an advocate of fitness and a healthy lifestyle. In her article, Maria says, "In the age of Photoshop, plastic surgery and celebrity idolatry, it seems women are constantly debating what is considered a "real" woman. And, as I found out recently when I posted a picture of myself looking fit and healthy in workout clothes with my three sons (playfully asking the question "Whats your excuse?"), apparently I don't count."

Maria Kang posted a picture of herself in Facebook wearing workout clothes together with her three sons. She posted that picture because she was encouraging fat women to also post pictures of themselves only wearing bikinis. Her intention for posting that was to say that 'being overweight is normal'.  But, Facebook banned her temporarily and even shut down her account for almost three days because she had supposedly violated the site's term of service- after a number of users flagged her post as a damaging and offensive post for fat acceptance. And also, someone said that her post is a "hate speech". In her article, she well-written her own view about her issue. She was disturbed about today's culture for labeling a disliked speech as something hateful. For her, she was asking that since the fat-acceptance movement is growing, should the promotion for 'fit pride' and a healthy and fit body should be countervailed? Another statement from her article, she said that 'being overweight is now normal; being at a healthy weight is not.' She asked if one's body defines how healthy he/she is, and she answered "not always but in most circumstances yes". She said that according to a study, "metabolically, healthy obese participants had a higher risk of dying earlier or having heart-related problems than those who were normal weight and also metabolically healthy." 

"When people shame fit and healthy individuals for perpetuating an "unattainable" body image, they're also dismissing the real health benefits that fit bodies represent. After all, healthy people breed healthy children, and healthy children create a healthier future. Why shouldn't that be celebrated?" Maria Kang says. 

To summarize what Maria Kang wants to say in her article, she quite disagree with the fat-acceptance movement because of the hazardous effects of it in our health. She was also disturbed and irritated about the people today who don't understand the good intention she wants to convey to them specifically to the fat people. Some fat people could have hated her because she has a physically fit body, that's why some labelled her post as a hate speech. For the site Facebook, they banned her because Facebook thought that she hates fat people and the fat acceptance movement. But for her, she was shocked to know today's standard for being healthy and as an advocate of fitness, she still wants to see fat women who are stepping out of their shadows just to show to the world that they can be successful in attaining fit and healthy bodies. She also wants to say that all women are "real" women and they should be proud of themselves.

The second article I read is entitled Unacceptably Fat by Jim Goad from the site takimag.com. Jim Goad says, "The results are in: fat people overeat because our fat-fearing society "fat-shames" them, which then causes them to overeat. This doesn't explain how they got in the first place, but let's not get picky."

In his article, Jim Goad talked about a new study called "The ironing effects of weight stigma" from the Journal of Experimental Social Psychology. The study said that, "Exposure to weight-stigmatizing news article caused self-perceived overweight women, but not women who did not perceive themselves as overweight, to consume more calories and feel less capable of controlling their eating than exposure to non-stigmatizing articles." Simply saying, women who feel they have been discriminated against based on their weight are prone to put on some pounds. He also said in his article that some of the people who are members in fat acceptance movement deny the health risks of being fat. He mentioned that the CDC claims that being a porker increases one's risk of heart disease, liver disease, gallbladder disease, diabetes, stroke, breast and colon cancer, sleep apnea, and osteoarthritis. According to a 2006 study, Obesity is clearly associated with increased risk for mortality and it's also called "morbid" obesity or as called by children "deathfat". 

"What I don't understand is that if you're truly A-OK with being fat, why would you need "acceptance" from others? ... The fact the you appear to need my acceptance only makes me think you don't accept yourself, which in turn makes me less likely to accept you. Why can't you accept that?" Jim Goad says.

According to the author, he found fat acceptance movement unacceptable because aside from the many health risks that an obese person can get from his/her own obesity, people who are overweight or obese blame the people who had fat-shamed them. They usually blame them as the reason for their overeating. The author doesn't want to accept fat people if they force him to accept them for their size and for their personality because he thinks that fat people don't need an acceptance from the society if they already accepted the way they look and if they already knew the reasons why were they fat.

The third article that I read is entitled Size Matters: Oh, the horror written by Tasha Fierce from the site bitchmagazine.org. Tasha Fierce said, "Continuing the conversation about respecting and accepting fatness as a choice, I thought I'd examine some of the reaction to a recent sensationalist story about a fat woman in New Jersey named Donna Simpson, who expressed her fantasy of adding 385 lbs. to her current 604 pound weight in order to be named in the Guinness Book of World Records as the heaviest woman alive." 

Tasha was struck about the cognitive dissonance of the commenters on the thread on a NY post article about the issue. Some said that they had supported her goal to be the heaviest woman alive. Others acted concerned for her health and for the welfare of her daughter. While others are disgusted and often would express a desire to see her dead. The author mentioned a question, what is it about this woman's acceptance of herself at such a large size that triggers such emotional response? Other, smaller fat people also expressed disgust at her size and many stated that they were fat but would "never give up trying" to lose weight. Fat people are attempting to get skinny but in the case of Donna Simpson she never attempt to lose weight but instead to put more weight. 

"The drama over Donna Simpson is less about health and more about choice- respecting the choices others make for their own bodies and protecting the right to make that choice and not be penalized for it by society." Tasha Fierce says.

For Donna Simpson, she has some good points why she wants to be in the Guinness Book of World Record. I think she really fantasizes to be 1000 lbs, she loves to eat, she is not dissatisfied with her body, and she enjoys her body. Although, she knew to herself that she has a binge-eating disorder, she's suicidal and she has a lot of health problems, she still pursues her dream. For Tasha, I think she respects the choice of Donna because Donna is enjoying the body and life that she has. But, for me, it's also okay to have a strong fighting spirit if you want to be the heaviest woman alive. The only problem for me is that, if other fat people would know about her goal, they might admire her and maybe someday in the future, fat people will also be competing with one another in order to be heavier than her, and if that happens, I can't imagine how will the world would weigh about.

As we can observe in our society today, the population of fat and obese people are increasing and their kind is becoming stronger and more confident because of the emergence of the fat acceptance movement organizations and online groups. They are becoming powerful in a way that they have been forcing other people to accept them, to not hurt them in personal or in social media, to not fat-shame them, and to respect the choice that they want to remain fat until they die. Many fat people now are overreacting and becoming compulsive when it comes to their rights and acceptance in the society. And because of that, they are making other people discriminate and criticize them more instead of respecting and understanding them. 

Blog Post #7: Anti-ana

Pro-ana as a short form for pro-anorexia is a term for people who think that it’s their choice to have an eating disorder. There are Pro-ana websites where people are talking about their own tips on ‘how to be thinner’ or ‘how to have anorexia nervosa’, and these sites are more common in women. Seriously, are these pro-ana websites encouraging people to have eating disorders? Or are they just supporting and giving love and acceptance for people who have anorexia? From the point of view of pro-ana sites, they don’t encourage people to develop an eating disorder. They said that it is a person’s choice to go into those kinds of online community. They are just offering a place where a person’s condition is wholly accepted and understood if she is not being treated the way she wants. But, from the opinion of other people, they think that pro-ana is unacceptable because it can affect many teenage girls and younger children to be thin or have anorexia nervosa than to have a healthy body.

Franca Sozzani (right) editor-in-chief of Vogue Italia

There may be a lot of people who are against pro-ana because of the obviousness that it is not a healthy lifestyle choice to be adapted by people especially women. There is an article I had read entitled Vogue campaign takes on pro-anorexia websites written by John Hooper from the site theguardian.com wherein the author wrote about the Italian Vogue editor Franca Sozzani who launched a petition calling for law against sites that promote eating disorder.

“There are thousands of these sites and blogs which don’t just support this evil, but push young people into competition over the physical shape,” said Franca Sozzani.

In Franca’s blog, in which she announced a petition calling for legislation to close down such sites, she said that pro-ana sites should prove a kind of open confessional and support for those who are unable to carry on by themselves along a road can only lead to death. The Vogue editor-in-chief are really against pro-ana because of a tragic consequence last November 2007, wherein a French model named Isabelle Caro had died at the age of 28 because of anorexia nervosa. It is also not Vogue’s first campaign in the area of eating disorder. In 2009, the Editor of Vogue, Alexandra Shulman, had written to designers accusing them of sending fashion magazines smaller garments for photo-shoots, thus forcing them to hire models with jutting bones and no breasts or lips. Some commentators criticized Vogue’s publication because they argue that those models’ images were the reason for the spread of anorexia, bulimia, and similar disorders.

“Sozzani said fashion devotees failed to understand that “models in most cases are naturally slender because they are still very young and not yet fully developed.” John Hooper said.

What I think Sozzani wants for young people to know about pro-ana is that Anorexia is a harmful activity and she doesn’t encourage this activity. She doesn’t want to see young girls developing an eating disorder and considering those conditions as their friend. She also wants to ban Pro-Ana’s thinspiration advices like, “tape/tack up pictures of your favorite models and always carry one around with you. When you are hungry, pull out the picture.” Sozzani said that most models are naturally-born slender so girls don’t need to have eating disorder like anorexia nervosa if they want to be like their supermodel idols. 

There is another article I read wherein the writer talked about a campaign for anti-anorexia, this article is entitled Powerful anti-anorexia ad campaign tells women 'you are not a sketch' using models with fashion illustration proportions written by a daily mail reporter from dailymail.co.uk. The writer wrote, "Star models, a modeling agency based in Brazil has released a graphic new anti-anorexia ad campaign, using Photoshop to turn models into life-size fashion illustrations."  

The ads which run with a tag line saying 'Say not to anorexia' showed fashion illustrations with exaggerated proportions next to a model wearing the same outfits and the same measurements. The graphic ad-campaign has been used to as a powerful ad which is hopeful that it will send an effective anti-anorexia message against thinspiration blogs and pro-anorexia websites. A commentator named Adam Green liked the ads because according to him they address the issue that anorexia seemed to stem from the inability for people to distinguish reality from fiction. Another one named Liz Osborne-Leavell said that it sends a powerful message because it's a literal visualization of what the fashion industry sets the standards at. However, one commenter wrote, 'Unfortunately I think some women could look to these images for thinspiration'. Another one stated 'It is a good campaign for young girls who have not yet succumbed to the thin culture of our country, but for those who are already truly anorexic, these models are their goal'.

"I've seen models regularly in magazines as thin as the ones shown in this ad. Nothing is going to change until models who are not skeleton thin are hired and photographed in fashion magazines and fashion shows." one commentator said. 

The graphic ad is a brilliant idea to promote anti-anorexia but I don't think that it will be very powerful for those people who are in the pro-ana community. Like what the other commentator said, they will find this ad as an inspiration rather than a warning. They will think that they might look better if their bodies are like sketch of models. And for the last commentator who said that he had seen many models in magazines who are as thin like the sketch, I somewhat agree to his statement that nothing is going to change if models in fashion magazines and fashion shows are still like skeleton thin. They should now start hiring models that are not anorexic and naturally thin. 

Pro-ana and pro-mia sites are only accessible in the Internet and Social media is one of its hosts. From the thousands of people who are now having pleasure in Social media, I don't think think at no one never see any pictures and images when they are opening their accounts. They always see a lot of pictures from these social media and those who have anorexia nervosa may find images and quotes that can be helpful for them, they may be looking for thinspiration for those who wants to join pro-ana or recovery quotes for those who don't want to be anorexic anymore. I read an article entitled Social media sites need to do more to eliminate pro-anorexia messages, but they aren't behind the rise in eating disorder by Ilona Burton from the site independent.co.uk, Ilona says "It may sound far-fetched to hear that a bunch of photographs blogged and hash-tagged alongside 'motivational' quotes on social websites aimed at young people are actually easily accessible breeding grounds for a whole host of dangerous beliefs and behaviors such as starvation, depression, loneliness, self-harm and suicidal ideation, but sadly, it's true".

Ilona Burton is not talking about catwalk models or airbrushed celebrities and some slogans saying 'Nothing tastes like skinny feels', she wants to talk about the emaciated bodies on the brink of death. For many, social websites are the only place that young people feel they can openly express the way they feel, where they can gain immediate acceptance and support; it's a safe place for them but sometimes it can be extremely addictive. The Independent on Sunday revealed that number of children and teenagers seeking help for eating disorders has risen by 110 percent in the past three years. The headline attributed this dramatic increase to the social media, but there is no scapegoat for eating disorders. There is no one person, group of people, movement, motion or thing at which they we can point the figure and say "That's why this happens" or "This is why the numbers are increasing". It belittles those who suffer from the fact that an eating disorder is a mental illness and a deadly one. In 2012, some leading social media platform took action against pro-anorexia and pro self-harm. Instagram says "Any account found encouraging or urging users to embrace anorexia, bulimia, or other eating disorders... will result in a disabled account with a warning." Facebook says "Facebook takes threats of self-harm very seriously. We remove any promotion or encouragement or eating disorders." Aside from Instagram and Facebook, Twitter, Pinterest and Tumblr also participated in the anti-anorexia.

"In the main, they have each failed miserably. Part of the problem is that if one hashtag is blocked, another similar shortened or misspelled version appears and the same material is replicated there instead. The alternative hashtag will be listed alongside those that are accepted and bam, it grows into its own." Burton says.

Many people wants to inspire others so they like to share something substantial to the public. In Instagram, people upload their photos and put hashtag captions with it. But, according to Burton's opinion, she have realized that Instagram, Facebook, Tumblr, etc. have miserably failed to communicate to the social media users the dark side of eating disorders. She said that in Instagram, although #thinspiration and #pro-ana will be blocked in the public, there will be a chance for naughty people to make an alternative hashtag, shortened or misspelled versions for it. Therefore, pro-anorexia will still remain in the social media.

Pro-anorexia is becoming widely-known and they are continually influencing teenagers because of social factors like fashion magazines, fashion shows, and the social media. Fashion magazine's editor-in-chief, article writers, commentators, and social media users are bashing and sharing their best comments and reactions for pro-anorexia. Although, a lot of people are against pro-ana community, other people think that is hard to eliminate them especially in the social media because of the adamant people involved in those kind of community, but it doesn't mean that those people who are against will give up to fight for their arguments. If you don't want to live in a place where all of the people you see are like skeleton thin, then don't try to be a pro-ana but instead be someone that can change a pro-ana.