Emma Salisbury Cedarville University
1
Anorexia Nervosa, according to the MerriamWebster dictionary, is “a serious eating disorder primarily of young women in their teens and early twenties that is characterized especially by a pathological fear of weight gain leading to faulty eating patterns, malnutrition, and usually excessive weight loss.” According to Sullivan (1995), Anorexia Nervosa is the most deadly mental illness, killing between five percent and twenty percent of those who develop it. Those who struggle with Anorexia are plagued by a perception of themselves as overweight and even obese, while they …show more content…
are in fact very underweight. This perception leads people with Anorexia to starve themselves while exercising vigorously in order to keep shedding pounds. Anorexia Nervosa is correlated strongly with an incorrect body image and faulty self concept, and is classified as a mental illness. While
Anorexia Nervosa’s classification is psychological, its is often manifested in physiological effects to the bones, brain and heart as well as such psychological effects as poor emotional processing, depression and lasting body dysmorphism.
Anorexia Nervosa has many serious physiological effects. The main physiological areas this paper will be focusing on are the effects on the bones, heart, and brain. Halvorsen, Platou, and
Høiseth found that those who had suffered from an eating disorder in adolescence had a significantly reduced bonemass density in the spine eight years afterwards, even if they had recovered from their eating disorder (2012). Those who have suffered from Anorexia are at a much higher risk for osteoporosis and permanent loss of bone density overall. Halvorsen, Platou, and Høiseth found that even if the person who struggles with Anorexia recovers from it at an early age, as the person grows older she is much more likely to suffer from severe fractures and bone loss than those who have never suffered from Anorexia (2012).
2
One of the most dangerous physical effects of Anorexia is the damage done to the heart.
According to a study by Oflaz et al. (2013), a strong association was found between myocardial fibrosis and Anorexia Nervosa. Because those who have Anorexia do not receive proper nutrition, their heart does not obtain the proper energy and food to keep functioning properly (Feature, n.d.).
However, those with Anorexia still often exercise for extreme amounts of time in order to continue to lose ever more weight. Therefore, their hearts must work very hard without being given enough food and nutrients, resulting in severe damage to the heart, which causes scarring. The scar tissue causes the heart to be less effective at pumping blood, because the scar tissue restricts the expansion of the heart muscles (Holmes, Nunez & Covell, 1997). In turn, the heart must work even harder because it cannot pump a normal amount of blood, bringing about even more damage and more scarring. Eventually, this cycle will lead to heart failure, as the heart is scarred and damaged beyond repair and can no longer put up with the strenuous workload. While this cycle can be stopped at any time in order to prevent further damage, the myocardial scar tissue never goes away and the damage to the heart cannot be undone.
Another body system that Anorexia affects in a potentially irreversible manner is the brain.
According to a study by Mühlau et al., those who had recovered from Anorexia Nervosa had a globally reduced volume of grey matter in their brains than those who had never had Anorexia.
According to this study, “regionspecific gray matter loss in the anterior cingulate cortex is directly related to the severity of Anorexia nervosa, indicating an important role of this area in the pathophysiology of the disorder.” (Mühlau et al., 2007, p.
1850) The anterior cingulate cortex, according to Devinsky, Morrell, and Vogt (1995, p. 279), “appears to play a crucial role in initiation, motivation, and goaldirected behaviours.” In other words, the physical system in the brain
3
that seems to affect motivations and behaviors is distinctly different in those with Anorexia. While the full effect of the damage has not yet been fully determined, this grey matter has not been proven to fully return even after patients returned to a normal weight.
Anorexia Nervosa also has severe longterm emotional and psychological effects. First of all, there has been shown to be a strong correlation between poor emotional processing and
Anorexia (Oldershaw et al, 2012). Many people with Anorexia cite a need for control as being a major factor in their struggle with this illness. At times, Anorexia is a coping mechanism to help a person deal with feelings of helplessness. One controls the food put into the body, and by putting less food into the body one can manipulate the size of the body to be considered more desirable. …show more content…
A teenaged girl of an average weight might turn to Anorexia because of external stress and helplessness. Anorexia will give her a sense of control as she begins to lose extreme amounts of weight. She may have been considered physically unremarkable before, but Anorexia may cause her to be considered more desirable physically. Therefore, her behavior is rewarded by internal relief and external validation by others, and the Anorexia will likely continue to grow worse. In order to continually make herself feel better, she must continue losing ever more weight (Oldershaw et al,
2012). By the time that she and the others around her realize the extent of her problem, the thought patterns of Anorexia will have hijacked her mind and, potentially, her will to live.
A significant correlation has been drawn between Anorexia and major depression (Pollice,
Kaye, Greeno, & Weltzin, 1997). There are shared genetic and environmental factors that seem to help cause a comorbidity of these two disorders. Both are related to poor or incorrect coping mechanisms, though in an interesting contrast major depression is primarily caused by learned helplessness while Anorexia often seems to be a struggle for control (Oldershaw et al, 2012).
4
However, both illnesses are caused by incorrect mental images of the self and are ultimately physically and emotionally selfdestructive. The correlation between these two alreadydangerous mental illnesses is especially important, as both are potentially deadly in their own right and together may lead to increased risk of death or suicide (Pollice, Kaye, Greeno, & Weltzin, 1997). Once the
Anorexic’s disorder begins to hijack her life, she may feel a devastating loss of the control she thought she had. The Anorexia will begin to control her, instead of giving her control. This loss of perceived control may lead to an extreme sense of helplessness as the person realizes that her coping mechanism has failed (Oldershaw et al, 2012). Consequently, she may become severely depressed and suicidal. Accordingly, since major depression and Anorexia seem to be correlated, therapists who are treating patients for one of these disorders can begin to watch for signs of the other in order to give patients all of the help and treatment they need (Surgenor & Maguire, 2013). In an equally devastating effect, those who have suffered from Anorexia Nervosa often have longlasting bodyimage dysmorphism (Cash & Deagle, 1997). The dysmorphism may come in the form of a perceptual bodyimage distortion causing the person to actually visualize herself as fat or obese overall, despite the fact that many of her bones may be showing. In such a case, a severely underweight person may genuinely believe she must still lose an extreme amount of weight in order to appear normal or of an average weight. Or, the body dimorphism may also come in the form of a cognitiveevaluative distortion causing the person to simply be dissatisfied with her body, despite the fact that she knows she may be of average or belowaverage weight. Therefore, a person may see a part or parts of her body as looking fat, causing her to keep attempting to make it better and become her ideal of perfection through weight loss (Cash & Deagle, 1997).
Those with
Anorexia form a mental ideal body or ideal weight, always very skewed towards extreme thinness,
5
and then starve themselves in order to reach it (Cash & Deagle, 1997). Based on personal reports of those who struggle with Anorexia and the shocking evidence of proAna websites and
“thinspiration,” the Anorexic ideal is truly skeletal. Because a person must starve herself to reach this ideal, food is often seen as an enemy or temptation. Surrendering to this enemy is weakness and giving into this temptation is tantamount to sin, and so the person may fast or eat extremely little for very extended periods of time. Because sufferers train themselves see food as an enemy, Anorexia leads to a continuing difficult relationship with food.
In conclusion, the emotional and physical effects of Anorexia Nervosa are severe and longlasting. Damage to the heart and bones, as well as shrinkage of the grey matter of the brain may last throughout the entirety of a person’s life even if she recovers from her eating
disorder.
Additionally, the mental and emotional health of those who struggle with Anorexia may also be affected severely during duration of the disease and even after the eating disorder has been physically overcome.
6
References: Anorexia Nervosa. (n.d.). MerriamWebster. Retrieved March 25, 2014, from http://www.merriamwebster.com/dictionary/anorexia%20nervosa Cash, T. F., & Deagle, E. A. (1997). The nature and extent of bodyimage disturbances in anorexia nervosa and bulimia nervosa: a metaanalysis. International Journal of Eating Disorders,22(2), 107126. Devinsky, O., Morrell, M., & Vogt, B. (1995). Contributions of anterior cingulate cortex to behaviour. Brain, 118(1), 279306. ESV: study Bible : English standard version. (ESV text ed.). (2007). Wheaton, Ill.:
Crossway Bibles. Feature, G. (n.d.). Anorexia: the body neglected. WebMD. Retrieved March 24, 2014, http://www.webmd.com/mentalhealth/anorexianervosa/features/anorexiabodynegl ected
7
Halvorsen, I., Platou, D., & Høiseth, A. (2012). Bone mass eight years after treatment for adolescentonset anorexia nervosa. European Eating Disorders Review, 20(5),
386392.
Holmes, J. W., Nunez, J. A., & Covell, J. W. (1997). Functional implications of myocardial scar structure. American Journal of Physiology, 272, H2123H2130. Mühlau, M., Zimmer, C., Cebulla, M. H., Leibl, C., Conrad, B., Ilg, R., et al. (2007).
Gray matter decrease of the anterior cingulate cortex in anorexia nervosa.
American Journal of Psychiatry,164(12), 18501857. Oflaz, S., Dursun, M., Oflaz, H., Cizgici, A. Y., Gurdal, A., Polat, N., et al. (2013).
Assessment of myocardial damage by cardiac MRI in patients with Anorexia
Nervosa. International Journal of Eating Disorders, 46(8), 862866. Oldershaw, A., Dejong, H., Hambrook, D., Broadbent, H., Tchanturia, K., Treasure, J., et al. (2012). Emotional processing following recovery from anorexia nervosa.
European Eating Disorders Review, 20(6), 502509. Pollice, C., Kaye, W. H., Greeno, C. G., & Weltzin, T. E. (1997). Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa.
International Journal of Eating Disorders,21(4), 367376. Sullivan, P. F. (1995). Mortality in Anorexia Nervosa. The American Journal of
Psychology, 153.7, 10734. Retrieved April 7, 2014, from the EBSCO database. Surgenor, L. J., & Maguire, S. (2013). Assessment of anorexia nervosa: an overview of universal issues and contextual challenges. journal of eating disorders, 1(1), 29.
8
Biblical Integration
As this paper has indicated, Anorexia Nervosa is based on an incorrect perception of one’s body, as well as poor coping mechanisms in reaction to a loss of control or feeling of inadequacy. This brings about severe physical effects that may last a lifetime. As a Christian, one may be concerned to help others gain a correct view of the body as God sees it in order to help others recover from or avoid this disorder. The Biblical view of the body includes that humans were made in the image of God and
He has made each person for a relationship with Himself, as well as the fact that Christians are commanded to offer their bodies to God and care for their bodies accordingly.
From the beginning of the the Bible, the importance of the body is emphasized. According to
Genesis 1:2627, all humans are made in the image of God and are reflections of His likeness. Also,
Psalm 139:1314 indicates that God is intimately involved in the creation of a child in the womb,
9
creating a masterpiece. Therefore, the body is valuable and should be accepted since it is God’s handiwork in a reflection of Himself. Christians especially are called in Romans 12:12 to offer their bodies to God to bring glory to Him. In order to glorify God most in one’s body, one ought to seek health instead of one’s own unhealthy perception of beauty. As 1 Corinthians 6:1920 states, the
Christian’s body is the temple of the Holy Spirit, and one should care for it accordingly.
In response to the emotional causes and effects of Anorexia, one should remember that God is the one who is to be in control. One may desire security in a feeling of control and a perception of beauty, but the only true security and peace can be found in surrendering totally to the loving care of one’s Creator and ultimate Lover.
10