Eating Disorder In Adolescents: Causes

Abstract

Eating disorder is one among the common chronic conditions in the world today especially among adolescents. Eating disorder (ED) describe sicknesses that are represented by constant disturbance of eating patterns and extreme unhappiness or worry about body weight/shape which leads to poor physical and/or mental health. There is a huge misconception among some adolescents about “what is eating healthy” and they tend to skip meals and consume fad diets in order to be healthy and start developing eating disorder symptoms. Adolescents wanting to have a perfect body shape by following fashion models and celebrities pushes them to go into dieting, excessing exercises which intern leads to the development of eating disorders. Initially it starts just weight losing which in future transforms into excessive dieting, skipping meals and taking dietary pills or laxatives. Today, social media has become very common and easily accessible to everyone due to the technology. The internet is filled with pictures of ideal body shapes and youngsters without realising the digital alteration done in the pictures, compare them with their self-pictures and develop body dissatisfaction. The other reasons for developing eating disorders include, prenatal and early life stress, parental care and weight talks among friends/peers. This paper focuses on elaborating the above-mentioned causes that relate to the development of eating disorders.

Introduction

Eating disorder (ED) describe sicknesses that are represented by constant disturbance of eating patterns and extreme unhappiness or worry about body weight/shape which leads to poor physical and/or mental health. Over the past few decades there has been an increase in the prevalence of eating disorder especially among adolescents. Among young children below 12 years of age, eating disorders rose by 119% from 1999 to 2006 in the United States (Golden, et al., 2016). Around 3% of the world's population is affected by eating disorder and it exists majorly among females than compared to males. Eating disorder is one among the most common chronic conditions among young youths after obesity and asthma. Eating disorder in teens and young youths is linked with high mortality risks, comparable with schizophrenia, bipolar disorder and autism spectrum disorders. There are several factors or reasons which leads young people to develop eating disorders, the most common being the social media like Facebook, Instagram, Twitter and Pinterest. The other reasons are parental care, prenatal stress, acute maternal stress, overvaluation or dissatisfaction of one's body shape/weight and weight talks among companions. The problem being quite common among young people and seeing the problem up-close among relatives makes it an interesting topic.

Adolescence is a period where one develops from a child to an adult. It is the phase where there are a lot of changes occurring both physically and psychologically in the body. As the adolescents are highly sensitive, media displaying beauty ideals impacts the young mind and they start developing a dissatisfaction about their shape/weight. “Some adolescents may misinterpret what “healthy eating” is and engage in unhealthy behaviors, such as skipping meals or using fad diets in an attempt to “be healthier, ” the result of which could be the development of an ED” (Golden, et al., 2016).

Body image dissatisfaction

Weight/body dissatisfaction is found to be judging requirement for identifying anorexia nervosa and overvaluation of body shape/weight is found to be a solid criterion for diagnosing bulimia nervosa. Overvaluation is giving excessive importance to body weight/shape in determining self-worth on the contrary dissatisfaction is negative feedback on body weight/shape. Overvaluation is associated with gaining more muscles and dissatisfaction is associated with weight loss among adolescents. When compared, overvaluation has gained greater attention for body image disturbance indication while dissatisfaction is considered to be more “normative” than overvaluation. This comparison is found to be truer among females and studies have shown dissatisfaction (15% in men, 40% in women) is indeed more common than overvaluation (14% in men, 23% in women). However, both dissatisfaction and overvaluation are found to have significant effect on the quality of life. Studies have shown that dissatisfaction associating the quality of life impairment more in males than females and overvaluation is more in females than males (Mitchison et al., 2016).

An investigation by Mitchison et al., 2016 showed the significance of body weight/ shape dissatisfaction and overvaluation on eating disorders. 1749 students between the age 12 to 18 years of age attending schools in Australian capital territory were recruited as participants. They were handed out to fill a questionnaire including questions on eating disorder symptoms, psychological distress, dietary eating, objective binge eating and demographic information like age, first language, country of birth, height and weight. A total of 1666 students completed the survey and their data was used for the investigation. It was found that constant thoughts about weight and shape is the main source of distress and eating disorders in females and dietary restraints in males (Mitchison et al., 2016).

Prenatal and Early Life Stress

Studies have also shown that prenatal stress and acute maternal stress is also involved in developing eating disorders. Prenatal stress due to losing a close relative can develop psychiatric disorders and increased chance of eating disorder in offspring’s (Su et al., 2016).

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A study by Su et al., 2016 showed a correlation between parental and early life stress and the chances of eating disorders in young and adolescent females in Denmark and Sweden. “Data from the Danish Civil Registry System and the Swedish Multi-generation Register to identify girls born in Denmark from 1970 to 2000 (N = 1,034,539) and girls born in Sweden from 1973 to 1997 (N = 1,246,560)” (Su et al., 2016) was used. These participants were followed from the age of 10 years until they either reached 26 years old , death or developed an eating disorder. A division was done on the basis of prenatal and postnatal exposure to stress among young females who lost a close relative. Prenatal exposure refers stress during pregnancy till the birth of the child due to the loss of older child, partner or other close relatives and postnatal exposure refers to stress from birth until 10 years of age due to the same reasons. The information obtained was categorised into three sub types namely anorexia nervosa, bulimia nervosa and mixed eating disorders. The results of the study were that there was an increased chance of eating disorders in adolescent girls who were exposed to stress either prenatal or postnatal type due to death of a close relative. Bulimia nervosa and mixed Eating disorder were found to be prominent among the young females due to maternal bereavement than compared to anorexia nervosa.

Parental Care and Weight Talks

Most adolescents who develop eating disorders were not initially overweight or underweight and it is very common for eating disorder to develop with a teenager trying to eat healthy. There is a misinterpretation among some teens and parents about obesity prevention and they start to eliminate foods which they believe to be “bad/unhealthy” and in this process of losing weight they may adopt behaviours of eating disorder (Golden et al., 2016). The start with tries to lose weight further develops to extreme dieting, skipping suppers, lengthy period of starvation, use of self-induced vomiting, diet pills and laxatives. Few studies in the past have showed, dieting was related to increase in weight gain and increase in the attitude of binge eating among both boys and girls during adolescence period. A study showed that among girls who dieted in 9th grade were 3 times more likely to be overweight by the time they were in 12th grade and students who restricted their food intake were 18 times more likely to develop an eating disorder (Golden et al., 2016). It was also found that family meals showed an improvement of dietary intake when compared to the food chosen by teens themselves as parents made healthier choice in food. Also, initial attempts to do physical exercises to burn the calories may turn to into compulsive and excessive exercising. The companions and family members also have a hand in developing eating disorders. Weight talk by family members and friends can encourage adolescents into the path of weight loss/gain. Girls who were teased or bullied during adolescence were 2 times likely to be overweight in a span of 5 years. Also, approximately 50% of the girls and one third of the boys in teenage were dissatisfied by their body image. Dissatisfaction of body image are majorly linked with excess dieting and unhealthy weight control behaviours, less physical activity and more binge eating among both boys and girls.

Social Media

One of the major reasons for body image dissatisfaction and eating disorders is the excessive use of social media. Social media can be described as an electronic platform where users create online networks to share data, thoughts, individual messages, and other content. The use of social media has become very popular and around two thirds of the internet users and one third of the whole population actively use social media (Kircaburun et al., 2019). Many researches have been done to show that social media is the major cause for developing an eating disorder. Adolescents wanting to be popular and trending keeps them actively participated in the social media. The newer social networking sites are coming up with constant updates and features and this enhances the active participation. In social media, interaction with people and interest takes place through likes which is seen as an indicator for popularity. These assist transmitting ideals about beauty and body shapes in adolescents. Adolescents understand the pictures with more likes and comments as socially accepted and compare the pictures which in turn leads to body dissatisfaction (Santarossa & Woodruff et al., 2017). The body dissatisfaction makes adolescents turn towards dieting or improper eating patterns which intern leads to eating disorder. A recent study showed that individuals receiving higher number of likes and comments in negative feedback style on Facebook were reported with higher attitudes of eating disorder and weight/shape concerns. A study in Australia showed the relation between Facebook usage and body image concerns is majorly due to appearance comparisons. Today the internet is filled with pictures of celebrities and the negative comparisons occur when the users start comparing their pictures to them without having any idea whether the pictures have been digitally altered (Santarossa & Woodruff et al., 2017).

Sociocultural model (Santarossa & Woodruff et al., 2017) says that media, companions and family are the roots through which messages about beauty, body shape/weight is transmitted. The model describes that the desire to be thin is the cause for body image disturbances among females and ideal body structure to be tall and muscular are the main causes in males. As per the model, social networking sites are the platform for transmitting the messages about appearances as one can easily interact with friends, family, members of the media (celebrities, athletes and models) which further encourages body dissatisfaction. Studies in the past have found significant correlation between body appearance concern and the number of friends of a social media user.

An investigation in this regard was done by Santarossa & Woodruff et al., 2017 which showed the effects of social networking sites on body image and eating disorders. A total of 212 first year undergraduate students from a Canadian university were chosen as participants for the investigation. The participants were asked to bring Wi-Fi enabled devices to class and were provided with the access to Wi-Fi. The participants had to fill an online survey which took around 30 minutes to complete. Out of the ones who completed the survey and after removing the outliers a total of 147 students between the ages 18 to 19 years were considered for the studies among which 55% were females. The questionnaire had questions relating to body image, self-esteem, eating disorder attitudes and use of social media. The findings of the investigation suggested that greater use of problematic social networking sites is associated with low body image and self-esteem and increase in eating disorder symptoms (Santarossa & Woodruff et al., 2017).

Another study in Turkey by Kircaburun et al., 2019 showed a correlation between excessive social media usage and body image dissatisfaction among adolescents. A total of 385 adolescent participants from a high school, aged between 14 and 18 years, being active in social media were chosen for the study. They were handed out questionnaires with questions relating to childhood trauma, body image dissatisfaction, social media usage and eating disorders. The results showed that problematic social media use is directly or indirectly related to body dissatisfaction among adolescents (Kircaburun et al., 2019).

Conclusion

This paper focussed on the causes that are responsible for developing eating disorders in adolescents. From the discussions so far, it is evident that social media/networking sites, body image/shape dissatisfaction or overvaluation, weight talks, parental care and prenatal stress are the major reasons for the development of eating disorders may it be anorexia nervosa or bulimia nervosa. Social media portraying ideal beauty and body shape though digital alteration has led to high level of body dissatisfaction in young adolescents especially among females and increases eating disorder symptoms. Various new websites and applications are entering into the market and also continues updates of these media further encourages the body image dissatisfaction. Today, there are common scenarios of bullying and weight talks among families and friends which are pushing the adolescents to develop habits leading to eating disorders. Prenatal and postnatal stress followed by tragic shock of losing a close personal is found to be related with risk of eating disorders mainly bulimia nervosa among young adolescents. The current studies were based on self-reported data and future studies should examine in a more mediational way and should include adolescents from all around the world to see if eating disorder development accounts for regional changes. The critique would be whether eating disorder is a genetic component which passes from generation to generation which can also be taken as a future scope of work.

References

1. Golden, N. H, et al., (2017). Preventing Obesity and Eating Disorders in Adolescents. Pediatrics 2016;138 DOI: 10.1542/peds.2016-1649
2. Kircaburun, K, et al., (2019). Childhood Emotional Maltreatment and Problematic Social Media Use Among Adolescents: The Mediating Role of Body Image Dissatisfaction. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-019-0054-6
3. Mitchison, D. et al., (2017). Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents. International Journal of Eating Disorders, 50(2), 118– 126.
4. Santarossa, S., & Woodruff, S. J. (2017). #SocialMedia: Exploring the Relationship of Social Networking Sites on Body Image, Self-Esteem, and Eating Disorders. Social Media + Society. https://doi.org/10.1177/2056305117704407
5. Su, X., et al., (2016). Prenatal and early life stress and risk of eating disorders in adolescent girls and young women. European Child & Adolescent Psychiatry 25: 1245. https://doi.org/10.1007/s00787-016-0848-z