Adult Obesity in America, Research Paper Example

Abstract

This paper presents a discussion about obesity in adults across America. In general, an overview of the obesity issue in nature of psychological assessment on treatment of binge-eating disorder.  There is no strong empirical evidence of diagnostic features and associated disorders features depending on specific culture, age, and gender for obesity disorder according to DSM-IV-TR.  The availability of information accord to the DSM-IV, characterizes this disorder as Eating Disorder Not Otherwise Specified that does not meet the criteria for any specific Eating Disorder. The origins of diagnostic methods identify the effects of over eating, meal planning mismanagement, and medication dosage measurements.

In the research study, Dissonance-Intervention respondents showed greater reductions in body dissatisfactions and binge- eating disorder symptoms were assessed on two demographic groups, white women and black women. One distinctive case study provides an insight of pre-existing biological and environment functionings affect an individual, psychiatric patients, and healthy patients without psychotic disorders on binge-eating disorder. Another individualized case study elaborated the comorbidity of medical condition with psychological issues in which provides an understanding on how to resolve the issue through psychotherapy and pharmacology therapy in combined. The cognitive behavioral therapy (CBT) and behavioral weight loss (BWL) program proved to be the best treatment plan for Adults with obesity disorder.

Binge-Eating Disorder

The provisional criteria for Binge Eating Disorder in DSM-IV characterize this disorder as Eating Disorder Not Otherwise Specified that does not meet the criteria for any specific Eating Disorder. It is also called ‘Obesity’, which defines as the condition of being obese; increased body weight caused by excessive accumulation of fat.

One of the criteria set examples in the DSM-IV includes a disorder as Binge-eating disorder: recurrent episodes of binge eating in the absence of the regular use of inappropriate compensatory behaviors characteristic of Bulimia Nervosa (American Psychiatric Association, 2000).  The excessive eating pattern behaviors impaired control indicated that those behaviors are beyond control like eating very rapidly, eating until feeling uncomfortably full, eating large amounts of food when not hungry, eating alone and feeling disgust, guilt, or depression after overeating.

Those binge episodes marked distress of unpleasant feelings about body weight and shape. Usually, it average at least 2 days a week for a period of at least 6 months with an age onset in the late adolescence to early adulthood for the disorder to occur.  A recurrent episode of binge eating is characterized by eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances.

Secondly, a sense of lack of control overeating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating) and repeated occurrence of temptation to eat due to tension, anxiety or depression impact the individual. In addition, the associated feathers may be comorbid to dysphoric moods, such as depression and anxiety.

Individuals with such moods intend to shred their tendencies in creating their own meal plans as they see fit and manageable to overcome their emotions. Binge eating is not associated to the course of Anorexia Nervosa or Bulimia Nervosa Disorders because of the clinical symptoms does not match within each other (American Psychiatric Association, 2000).

Case Studies

A certified diabetic educator and nurse practitioner, Cypress (1999) consults a 52-year old woman about weight management including controlling her Type 2 diabetes. This 52-year old woman weighted at 256 lbs at the time of the visit. She also had this obesity problem for five years and could not do what doctor repetitively advised her to lose weight and exercise and follow special diet to improve her health status.

Her weight continued to increase over time because of her fear of hypoglycemia, shakiness, and diaphoresis. She has Type 2 diabetes for 9 years with presents of complaints on fatigue, difficulty losing weight, and no motivation.  She was diagnosed with depression and prescribed an antidepressant medication. She explained her tendency to eat a lot at night to prevent the thinking of hypoglycemia in the middle of the night.

This nurse practitioner, Marjorie Cypress (1999) changed her insulin dosage to 25 units of NPH and 5 Units of regular insulin twice daily and metformin to 500 mg three times daily. This 52-year old woman came back to the office for a 60-day follow up and her weight decreased to 246 lbs, and she was feeling much more energetic, no longer felt depressed and she joined a walking program.

The combined therapy approach was designed to illustrated this individual health issues focusing on insulin dosage, in which contributes the weight gain, fear of hypoglycemia, and the similarity of symptoms of depression and hypoglycemia (American Diabetes Association, 1999).

Another case-controlled study on a group discussion treatment on obesity, healthy comparison (HC) group of women and psychiatric comparison (PC) group of women, both groups were assessed on the factors of BED symptoms with no history of eating disorder symptoms. The purpose of the study is to identify the risk factors of binge-eating disorder in white women and black women to compare the psychological testing results.

The Risk Factor Interview, Parental Bonding Instrument, Family Discord Scale, and High Parental Demand Scale are the tests used in the study.  It concludes that there are no significant effects for psychiatric comparison group on ethnicity issue. Psychiatric comparison (PC) group has reported that their negative effects of psychosocial and environmental functioning measures that the problems with substance disorders, parental moods, perfectionism, separation from parents, and maternal problems with parenting (Striegel-Moore, 2005) .

Whereas, the healthy comparison (HC) group reported higher exposure to childhood obesity, family overeating or binge eating, family discord, and high parental demands than PC women.  Researchers tests for both groups on interaction and whether if white either women or black women discusses about binge-eating disorder. It was found that black women do not discuss this type of issue with white women in a controlled environment. The study also did not suggest if there are any difference in color of similar Axis 1 disorder and symptoms presented in the obesity problem (Fairburn, et al., 2005)

Treatments

Across studies of clinical therapeutical approaches for patients with obesity problem recommends that a manual-based Cognitive Behavior Therapy (CBT) in a group format is the most appropriate treatment to eliminate binge eating and is reliable source in reducing amount of food intake and a change of eating habituals. This encourages adult patients with obesity to gain motivation to lose weight to the appropriate body mass index (BMI) matching the weight and height in combined. An empirical evidence of remission rates in binge eating is 55% to 70% at post-treatment at a one-year follow up.  Furthermore, it proved that CBT therapy is more effective than pharmacological treatments for the treatment of BED.

For example, according to the Masheb and Wilson (2005) found that either fluoxetine or pill placebo treatment rate of 22% compared to CBT with remission rates of 61%.  In addition, a therapeutic index measures the relativity of desired drug for attaining a medication that is usually produce no toxic symptoms for largest doses to smallest doses routinely seen in the ratio expression. Similarly, a research study on a treatment design for BED showed that behavioral weight loss (BWL) is more effective than fluoxetine to BWL.

However, CBT therapy showed a significance of partial remission rate than BWL at 60% to 31% to one-year follow up full remission rates were 51% and 36% respectively.   The outcomes of combined CBT and BWL treatments indicated that individuals showed a huge significance of reduction in depression and increased in self-efficacy, self-esteem, and life style fulfillment (Devlin, et .al, 2005; Grilo, et .al, 2007).

Conclusion

Psychological disorders that mimic Obesity problem in Adults has affect emotions, feelings, and conscious as a whole self-psychotherapy on eating patterns. Due to the psychological dysfunctioning in an individual impact by this disorder is basically started with biological and environmental influences, and mentally developed into many cognitive impairment ways in which of the negative adversities change negative behaviors. An empirical evidence of  treatment for patients with obesity disorder will be placed in the DSM-V by 2013 with a better precipitation of DSM-V mental disorder classifications and a paradigm of Obesity dimension including treatment plans of CBT (First, M., 2010).  This encourage clinicians, physicians, psychologists, and other mental health professionals to further  research on this growing eating-disorder problem.

References

American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4^th ed., American Psychiatric Association: Washington, DC: Author.

Cypress, M. (1999) Case Study: A 52 Year-Old Woman with Obesity, Poorly Controlled Type 2 Diabetes, and Symptoms of Depression. Journal of Clinical Diabetes, Vol. 17 (3). Retrieved July 24, 2011 from: http://journal.diabetes.org/clinicaldiabetes/V17N31999/Pg142.htm ; American Diabetes Association, 1999.

Delvin, M. J., Goldfein,J. A., Petkova, E., Jiang, H., Raizman, P.S., Wolk, S., et al. (2005) Cognitive behavior therapy and fluoxetine as adjuncts to group behavioral therapy for binge eating disorder. Obesity Research, 13, (1077-1088); Fairburn, 2005; Masheb & Wilson, 2005; Grilo, 2007.

First, M. B. (2010) Clinical Utility in the Revision of the Diagnostic and Statistical Manual of Mental Disorder (DSM). Professional Psychology: Research and Practice, 41 (6), Pp. 465-473. American Psychological Association: Washington, DC.

Striegel-Moore, R.H., Fairburn, C., Wilfley, D., Pike, K. M., & Dohm, F. (2005) Toward an understanding of risk factors for binge-eating disorder in black and white women: a community-based case-control study. Psychological Medicine, 35(6). Retrieved July 24, 2011 from: ProQuest Psychology Journals.