Bulemia Nervosa

Bulimia Nervosa Colleges and universities around the country are reporting an increased prevalence of eating problems among young female students. Difficulties include obsession with food, starvation dieting, severe weight loss, obesity, and compulsive binge eating, often followed by self-induced vomiting (Hesse-Biber, 1989, p.71). Since the beginning of the women's liberation movement in the 1970's, the Western world has seen a severe increase in the rate of eating disorders, especially bulimia nervosa, in young girls, adolescents, and college-aged women. The questions that must be posed are: What are the reasons for eating disorders among college-aged women? Why has there been such a drastic rise in eating disorders in the past few decades? How can this be prevented? It is the purpose of this paper to discuss these questions (after first defining bulimia nervosa and attempting to explain its etiology) and give an overview of several possible answers, determined following an examination of current psychological literature in this area of concern. However, the reasons that many women have issues with food and eating are myriad and complex. They touch on every aspect of being female, and no single answer sufficiently explains the phenomenon of girls who overeat or undereat as a response to stress. Bulimia, a term derived from the Greek words meaning ox and hunger, is a food obsession in which the sufferer repeatedly cycles between bingeing and purging (Chassler, 1998, p.397). In comparing bulimia nervosa to true anorexia nervosa, the basic psychopathology is similar; both display a morbid fear of fatness. The anorectic patient will starve, and the bulimic patient, who can only maintain starving for a limited period, eat and purge (Chassler, 1998, p.397). For a girl who suffers from bulimia nervosa, food becomes equivocal with comfort, relaxation, and escape. The binge begins because a person feels low, often rejected, and she turns to food almost as a narcotic. A typical binge session consists of consuming high-caloric foods and then vomiting, which begins as necessary unpleasantness which evolves into a sensual, addictive muscular convulsion (Chassler, 1998, p.398). According to Freud, bulimia could be explained as a woman's perception of eating as erotic. By blending oral incorporative mechanisms with active oedipal-genital wishes, the woman is reflecting the child's wish to eat and thereby conceive father's baby. He wrote, Do you know, for instance, why X.Y suffers from hysterical vomiting? Because in phantasy she is pregnant, because she is so insatiable that she cannot put up with not having a baby by her last phantasy lover as well. But she must vomit too, because in that case she will be starved and emaciated, and will lose her beauty and no longer be attractive to anyone. Thus the sense of the symptom is a contradictory pair of wish-fulfilments (Chassler, 1998, p.401). While Freud's theory seems outlandish, psychoanalytic psychologists do propose that the syndrome seems to be rooted in psychological, social, and biological concepts of female sexuality. They have concluded, bulimia is interpreted as the simultaneous enactment of conflicting wishes for merger and autonomy (Chassler, 1998, p.402). From a social-psychological standpoint, the disproportionate number of women compared to men afflicted by bulimia nervosa implies that the social construction of gender (the ways in which society defines gender, implying that sex is biological, fixed, and unchanging, while gender, or femininity and masculinity, is done, transient and ever-changing) plays an important part in the etiology of the disorder. It is hypothesized that the risk of developing this disorder depends, in part, on the composition of a woman's gender identity (Klingenspor, 1994, p.407). Being feminine means being attuned to and responsive to the needs of others. Independence, competence, and assertiveness, that is, the psychological tools for getting one's own needs met, define masculinity (Klingenspor, 1994, p.409). Thus, women are considered more compliant and passive compared to men. According to a study by Broverman, because masculine attributes are valued more than feminine ones, sex defines membership in unequal social categories. Corresponding to this finding, many studies indicate that the average adolescent Western girl is more anxious, insecure, depressed, and self-conscious than her male counterpart (Klingenspor, 1994, p.409). In her book, Anatomy of a Food Addiction, author Anne Katherine (1991) calls eating the great escape and pinpoints the vulnerabilities of women to childhood origins (p. 70). She believes that girls are taught that they cannot fight or flee. Unlike boys, who have the outlets of strenuous play and fighting to release anger, girls are taught that they must cope within the difficult situation while remaining in it. In the girl-child's attempts to find solace in a situation from which she cannot escape, she learns that sweet food will release chemicals that soothe her when she is frightened and angry. Thus, she learns rather early in life that food gives her a way to avoid feeling trapped and overwhelmed. This conditioned response to stress then carries over into maturation, and in situations where the young woman feels overwhelmed, frightened, cornered, confused, miserable, or lonely, the body seeks relief, and the whole organism tries to lead her into a way of release. Even if the woman has made a conscious decision to not overeat in response to stress, the whole person has been deeply trained to eat anyway, and she automatically, unthinkingly reaches for something to eat or drink. This drive for release is almost unstoppable (Katherine, 1991, p.71). Katherine describes this strong drive for eating in terms of Maslow's hierarchy of needs--safety and security come far before appearance and artistic taste. Thus, if a girl is fearful or uncertain, it is natural to reach for substances that she has learned give her a feeling of security and safety. Other branches of psychology assume that the causes of bulimia nervosa reflect the interaction of biological predisposition, intrapsychic conflict, family, social factors, disturbed interpersonal relationships, interpersonal sensitivity, and social isolation. Although how biological factors affect the development of bulimia is unclear, some scientists believe that bulimia may be a symptom of a biologically mediated affective disorder. However, this theory is quite controversial. Recently, familial contributions to the etiology and course of bulimia nervosa have been accounted for. Often, women who overeat or undereat have been cited to have had a childhood background of profound deprivation and emotional deficit. Such individuals learned in their families that they were not wanted, worthwhile, or valued. They did not learn to ask for help or to expect their needs to be met. They did not learn healthy ways to handle conflict, difficult emotions, or disappointments. Neither did they learn that the solution to loneliness is to seek friendship. Such individuals may have been severely abused in their homes and have no knowledge of awareness of the abuse (Katherine, 1991, p. 52).