Anorexia Nervosa Development in a College Student

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Table of Contents

Introduction
Challenges Posed by Anorexia Nervosa
Pressures to be Thin and Attractive
Possibility of Parents’ Alternative Interventions
Reasons for Overlooking Initial Suspicions
Ways for Educational Institutions to Identify Eating Disorders
Lived Experience and Wrap-Around Support
Conclusion
References

Introduction

This paper will discuss the case of Charlotte, an 18-year-old female showing symptoms of anorexia nervosa (AN). She demonstrated early signs of this mental disorder in her first year of the university when she was under pressure to continue running and maintain her credit grade average. By the end of the year, she weighed about 40 kg, and her body mass index was low. This paper will explore the impact of AN on family relationships, review some aspects of the disease development and early detection, and provide a critical reflection on the influence of lived experience and a wrap-around support approach.

Challenges Posed by Anorexia Nervosa

Mental disorders pose significant challenges to family relationships, and AN is no exception. AN puts considerable pressure on the family members who have to take an active role in treating their relatives with AN and maintain the whole family functioning at the same time. As one study shows, this pressure is especially felt during mealtimes because individuals with AN may demonstrate abusive behaviors toward their caregivers (Williams et al., 2020). For instance, a person with AN can throw plates and smash the house during mealtime (Williams et al., 2020). Another challenge is finding a new trade-off between engaging in paid work and caring for a person with this mental disorder. As Williams et al. (2020) discovered, individuals who had to take care of their relatives with AN felt increased stress most of the time: at home, they worried about paid work, and at work, they worried about their situation at home. In addition, AN poses challenges to maintaining relationships with extended family members because caregivers of the person with AN often do not have time for meaningful connections with other people.

AN negatively affects individuals in their roles as parents, spouses, and children. The disease is most common among individuals aged 15-19, who usually live with their parents (Williams et al., 2020). It implies that it significantly influences parents who play a key role in treating their children with AN. Parents may experience fear for their children or denial of their children’s disease; they may also feel guilt, pain, and shame (Williams et al., 2020). Children whose parents have AN may also feel stressed or guilty. Individuals whose spouses have AN often experience caregiver burden and challenges in providing support and communicating effectively, which may lead them to become avoidant or critical and blame (Sadeh‐Sharvit et al., 2020). In the case study, the influence of AN on family is evident from Charlotte’s mother’s reaction, who became worried when she saw negative changes in her daughter’s appearance and began searching for information and help.

Pressures to be Thin and Attractive

Eating disorders like AN usually affect young women or adolescent girls. Females are disproportionately at risk of these mental illnesses because of pressures imposed on them by society and reinforced by the media. For example, Åberg et al. (2020) found that female users of social media websites experienced more appearance-related pressure than their male counterparts, and this pressure was greater for those with larger numbers of friends and followers. Likewise, Mckay et al. (2018) discovered that young women experienced pressures in terms of weight and overall appearance. For example, in trying to look like women in advertisements, they could engage in restrictive eating and excessive exercising (Mckay et al., 2018). In terms of overall pressure for attractiveness, Mckay et al. (2018) found that young women felt forced to fit in the beauty ideals of other people, use cosmetics, and struggle between succeeding in studying, working, and meeting Western beauty standards. These findings show that young women experience pressures to be thin and attractive.

However, there is some disagreement on the role of media in reinforcing these pressures and leading to eating disorders. For example, Ferguson (2018) argues that media does not cause eating disorders in young women because its influence is smaller than that of peers and because it only reflects the attitudes and standards already existing in society. According to Ferguson (2018), media can be associated with the development of eating disorders in people predisposed to these mental health issues. The findings of Aparicio-Martinez et al. (2019) support this argument, showing that young women with eating disorders are often dissatisfied with their body image. It implies that improving young women’s perceptions of their bodies can be a viable strategy to decrease their risk of developing eating disorders and form their resistance to beauty standards reinforced by the media.

Possibility of Parents’ Alternative Interventions

When Charlotte’s mother saw negative changes in her daughter, she intervened by commenting on Charlotte’s looking too thin and suggesting going to a doctor, but these interventions did not work. Eventually, Charlotte’s mother spoke to her daughter’s roommate and, after confirming her suspicions, contacted the dean, who forbade Charlotte to engage in sports until she saw a doctor. Charlotte’s mother’s intervention was not the most effective of possible alternatives. For example, one study investigated adolescents’ and parents’ perspectives on the early detection of and response to eating disorders and found that parents should be proactive, assertive, supportive, and understanding when intervening in their children’s changing eating behaviors (Ciao et al., 2022). It means that parents should address eating disorders early, right after they notice the first symptoms, to avoid the situation worsening, and they should directly confront changing eating patterns (Ciao et al., 2022). Hence, Charlotte’s mother could get better results if she intervened as soon as she noticed her daughter’s avoidance of family dinners and reduced portion sizes. She also should have shown her understanding of the severity of the disease that Charlotte was starting to develop.

Reasons for Overlooking Initial Suspicions

Eating disorders are difficult to notice at early stages, which is why Karen, Charlotte’s roommate, tended to overlook her initial suspicions about Charlotte’s condition. Research shows that even family members often cannot detect the onset of eating disorders; it may take them 11-20 months from symptom onset to identify the disease and seek treatment (Ciao et al., 2022). Moreover, Karen seemed to justify Charlotte’s behavior by stress from balancing studies and training and by the necessity to adhere to a diet and training regimen suggested by the coach. Finally, it may be assumed that Karen was unaware of how eating disorders start and what to do when suspicions arise. A better way for Karen to intervene was to communicate her suspicions to Charlotte’s mother or ask the dean or the coach to speak to Charlotte’s parents as soon as Karen noticed negative changes. Parents are primary responders to eating disorders and have the authority to seek treatment for their children (Ciao et al., 2022). Therefore, informing Charlotte’s parents earlier would help avoid the progression of the disease.

Ways for Educational Institutions to Identify Eating Disorders

Since eating disorders primarily affect adolescents and young women, educational institutions are well-positioned to prevent and detect eating disorders in students. They should create an environment where the prevention and detection of eating disorders would be facilitated. This can be done through education, which aims to promote positive body image and healthy relationships with food, reduce stigma, inform students about the health consequences of eating disorders, and teach optimal nutritional strategies (Wells et al., 2020). In such an environment, identifying individuals with eating disorders would be easier because peers would be able to notice negative changes in their counterparts early and would not tend to overlook their suspicions as Karen in the case study did.

Another way for schools and universities to identify individuals with eating disorders is by using screening tools. These instruments usually have the form of a questionnaire that can be administered to students online and intends to assess students’ eating attitudes or behaviors. Some useful screening tools are the EAT-26, the EDE-Q, the SCOFF, and the SWED, each of which assesses ED behaviors (Fitzsimmons-Craft et al., 2019). Using these questionnaires in the online format may help educational institutions regularly assess eating behaviors in many students.

In my school, the primary mechanism for identifying individuals with eating disorders is through mental health counseling provided by the institution. The school counselor is trained in detecting the signs of these mental diseases and making the necessary referrals. In addition, the school sometimes organizes workshops, the aim of which is to educate students about the symptoms of eating disorders, promote positive body image, and develop media literacy.

Lived Experience and Wrap-Around Support

If I were a counselor treating a university student with AN, I could use lived experience and a wrap-around support approach. Lived experiences of individuals with eating disorders demonstrate that, to facilitate recovery, they need supportive relationships, meaning and purpose, self-compassion, empowerment, and self-discovery (Wetzler et al., 2020). Hence, I realize that, in order to treat a client with the condition, I would need to address the individual’s self-perception, especially body image and internalized appearance standards, and provide the necessary support and understanding to validate the person’s experiences. Further, wrap-around support is a philosophy of care that addresses all aspects of human life because it assumes that each domain can contribute to the functioning of the person as a whole (Erdman, 2019). The wrap-around approach to treating eating disorders usually involves a multidisciplinary team that meets different individual needs, including therapy, medications, finances, schooling, and others (Savaglio et al., 2022). Lived experience and wrap-around support would assist me in treating anorexia nervosa by helping me identify the psychological, social, and physical needs of clients with this mental illness and address them in a complex.

Conclusion

To sum up, anorexia nervosa, along with other eating disorders, is a mental illness resulting from body dissatisfaction and is the most common among adolescent girls and young women. The disease can be overlooked easily, and interventions may be delayed because of a lack of awareness of eating disorders. Hence, there is a need for education about these mental disorders, especially in high schools and universities.

References

Åberg, E., Koivula, A., & Kukkonen, I. (2020). A feminine burden of perfection? Appearance-related pressures on social networking sites. Telematics and Informatics, 46, 101319. Web.

Aparicio-Martinez, P., Perea-Moreno, A. J., Martinez-Jimenez, M. P., Redel-Macías, M. D., Pagliari, C., & Vaquero-Abellan, M. (2019). Social media, thin-ideal, body dissatisfaction and disordered eating attitudes: An exploratory analysis. International Journal of Environmental Research and Public Health, 16(21), 1–16. Web.

Ciao, A. C., Lebow, J., VandenLangenberg, E., Ohls, O., & Berg, K. C. (2022). A qualitative examination of adolescent and parent perspectives on early identification and early response to eating disorders. Eating Disorders, 30(3), 249–266. Web.

Erdman, P. (2019). Wraparound services: Children and families. In C. Brown, V. Stoffel, & J. P. Muñoz (Eds.), Occupational therapy in mental health: A vision for participation (2^nd ed.; pp. 691–703). F.A. Davis Company.

Ferguson, C. J. (2018). The devil wears stata: Thin-ideal media’s minimal contribution to our understanding of body dissatisfaction and eating disorders. Archives of Scientific Psychology, 6(1), 70–79. Web.

Fitzsimmons-Craft, E. E., Karam, A. M., Monterubio, G. E., Taylor, C. B., & Wilfley, D. E. (2019). Screening for eating disorders on college campuses: A review of the recent literature. Current Psychiatry Reports, 21(10), 1–17. Web.

Mckay, A., Moore, S., & Kubik, W. (2018). Western beauty pressures and their impact on young university women. International Journal of Gender and Women’s Studies, 6(2), 1-11. Web.

Sadeh‐Sharvit, S., Sacks, M. R., Runfola, C. D., Bulik, C. M., & Lock, J. D. (2020). Interventions to empower adults with eating disorders and their partners around the transition to parenthood. Family Process, 59(4), 1407–1422.

Savaglio, M., O’Donnell, R., Hatzikiriakidis, K., Vicary, D., & Skouteris, H. (2022). The impact of community mental health programs for Australian youth: A systematic review. Clinical Child and Family Psychology Review, 25, 573–590. Web.

Wells, K. R., Jeacocke, N. A., Appaneal, R., Smith, H. D., Vlahovich, N., Burke, L. M., & Hughes, D. (2020). The Australian Institute of Sport (AIS) and National Eating Disorders Collaboration (NEDC) position statement on disordered eating in high performance sport. British Journal of Sports Medicine, 54(21), 1247–1258. Web.

Wetzler, S., Hackmann, C., Peryer, G., Clayman, K., Friedman, D., Saffran, K., Silver, J., Swarbrick, M., Magill, E., van Furth, E. F., & Pike, K. M. (2020). A framework to conceptualize personal recovery from eating disorders: A systematic review and qualitative meta‐synthesis of perspectives from individuals with lived experience. International Journal of Eating Disorders, 53(8), 1188–1203. Web.

Williams, L. T., Wood, C., & Plath, D. (2020). Parents’ experiences of family therapy for adolescent anorexia nervosa. Australian Social Work, 73(4), 408–419. Web.

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