Bulimia as a Debilitating Mental Disorder, Research Paper Example

A major conundrum that both scholars and mental health experts continue to face pertains to why some people suffer from mental illness where their minds fail to thrive in modern contexts. Despite the pervasive notion that humans are naturally selected to reproduce and fully thrive in various contexts, the answer to this dilemma is nebulous due to the fact that not all persons can regulate and get their emotions under control. Some persons afflicted by mental health issues are prone to perceiving apparitions or hearing sounds and seeing people who have never existed. Other persons afflicted by mental health issues are unable to focus their attention enough or maintain healthy and functional social relations with others. Indeed, disorders of the mind have profoundly affected the human condition and social functioning in a trenchant manner, often varying along the spectrum and continuum of the health problem or disorder suffered from. Doctors and medical researchers alike have hitherto researched, examined, assessed and evaluated whether or not mental disorders exist on a continuum with normal functioning or if they are inherently and qualitatively separate dimensional categories. Most mental disorders that medical experts are cognizant exist along a continuum that has a number of intermediate conditions and steps in between a person struggling with trenchant and severe, deep-seated issues and an individual who falls in the normal range, even those suffering from maladies that are perceived as being qualitatively distinct mental health conditions such as autism, bipolar disorder, and schizophrenia (Hinshaw, 2014). However, eating disorders such as bulimia nervosa are often not usually discursively framed as a mental health disorder amongst laypersons. This paper will explore the etiology of bulimia nervosa in both males and females, provide a literature review of the studies and findings on combating bulimia nervosa, and provide new avenues for possible research in effort to abate escalating rates of bulimia nervosa due to cultural and social expectations of beauty. Innovative interventions are thus of paramount importance in order to combat such disordered cognition and behaviors.

Adolescent females and males alike discern cultural values according to and communicated by various externalities such as the media, religion, educational institutions, family evident in modern western civilization and culture (Keel et al., 1997, p. 59.). These macro influences have undergirded the push for individuals to figure out ways to control their own bodies in order to live up to the seemingly impossible expectations and standards imposes on both men and women regardless of age via disordered eating behaviors. Within the past two decades, however, psychologists and other medical researchers have spawned a proliferation of studies conducted in order to combat why both male and female young adults engage in bulimic behaviors (Gordon, 1990). A pioneer in the nascent epistemological assessment of eating disorder, Dr. Hilde Bruch castigates individuals who are categorized as bulimic due to the fact that she believes that those individuals victimize themselves and place blame on learned behaviors from external influences instead of owning up to their own fallibility which is why they turn to the masochistic behaviors undergirding bulimia. Extant studies and research explicitly demonstrates that clients strive to adhere to social expectations that are conveyed within the mass media, which is why bulimic behaviors have become pervasive in diverse contexts and clinical settings. More poignantly, the corpus of scholarly research pinpoints how particular family relationships immensely impact and contribute to the germination of certain psychological characteristics that correlate with bulimic behaviors.

As such, bulimia represents a person’s efforts to achieve homeostasis in a world that is high-paced, stressful, frenetic, and overtly demanding. Indeed, epochal contingencies have gradually evolved and revolved, which explains why many young females and males alike suffer from triggered conflicting perceptions of how their corporeality functions as a representation of male and female identity. The current literature on bulimia contains explicit and extensive information regarding the condition, pointing to the stark and unfortunately reality that there is a complex matrix of influences on how individuals develop bulimic behaviors that puts both women and men alike at risk for incurring such eating and lifestyle behaviors. The struggle for healthcare officials and advocates is that bulimia has only recently been defined or pinpointed as a psychological malady that only impacts and plagues females in western culture and society.

Because bulimia has only recently been identified as a psychological disease according to several sociologists and psychologists in addition to other medical experts that adversely impacts males, there remains a dearth of studies and research on incidences of bulimia within the male populace. As such, far more research, data and information is necessary. Nonetheless, extant literature regarding the etiology of bulimia in both female and males is quite similar despite the pejorative viewpoints of disordered eating habits in a gendered fashion. Thwarting the prevailing population perception that bulimia is just a female mental disorder, scholars point to the extant literature that proffers counter-narratives to discursive prejudice embedded in western society and culture. Evaluating the idiosyncratic psychopathologies of bulimic patients regardless of gender, nurse and doctors assert cogent evidence that bulimia does not discriminate to any gender-specific category yet purportedly undermines the equality of all Americans to the same degree. As a result it is of paramount importance that the American populace is made cognizant of how all people regardless of their demographics are susceptible or vulnerable to bulimia retains the capacity towards improving interventions via the discovery of how to prevent the debilitating mental health issue prior to its untimely inception. By disseminating meaningful information as an educative tool regarding the vulnerability of all persons to the vagaries of bulimia represents meaningful progress to address bulimia, cure it, and discovering why a person adopted and embraced such behaviors. Thus, the etiology of bulimia can never be pinpointed to just one source or perpetrated act, thereby discursively framing the malady as minimally genetic and thus biological by nature.

Clinicians have conducted a handful of studies and surveys aimed at analyzing and assessing the development of bulimic perception and behaviors within the male population since the studies on bulimia are predominately about female identity issues since it became labeled as a female malady by many. As such, prominent clinicians have hitherto incorrectly eschewed how bulimia directly threatens the health and well-being of the male populace. Throughout history, medical experts and researchers have procured evidence about how bulimia has profoundly impacted both men and women alike. Elite and renowned men who lived during the time of Roman hegemony demonstrated the practice known as the binge-purge syndrome is a signifier of an individuals social status and/or wealth (Keel, 1997, p. 24). However, bulimia has only recently been formally acknowledged by physicians and other medical personnel as a distinct illness that is mutually exclusive from binge eating disorder which is why the studies conducted during the 1970s or prior must be read, analyzed, and assessed through a grain of salt because of their blaring lack of reliability.

Despites nebulous findings regarding the etiology of bulimia nervosa and why it evolves in such a celeritous manner, there has nonetheless been extensive research that mainly focuses on how bulimia burgeons within women regardless of their age. Bulimia more commonly develops in females due to the fact that discourses place immense pressure on women to remain thin because within modern contingencies there is a general disregard for human life. Ultimately, women often incur disordered eating behaviors almost subconsciously due to the fact that males or friends always tell the afflicted that they are fine to drive when it is not true. Indeed, comprehensive research has placed it focus on how bulimia develops in females due to the stringent cultural practices in place therein.

Nevertheless, medical experts and researchers believe that before the 1800s, there were various cases from a revisionist standpoint of individuals suffering from bulimia nervosa that were predominately men and not women (Keel, 1997, p. 26). Despite such findings, western civilization and culture such as in the United States and in western European nations continue to discursive frame bulimia nervosa as a solely learned female malady. To add nuance to the ongoing dialogue between critics and proponent, psychiatrist Dr. Blake Woodside published one of his medical studies in which he investigated evaluated men who suffered from self-reported eating disorders of some sort. Woodside (2001), who works as a practicing psychiatrist at a public hospital, conducted a study in which male participants who reported suffering from discernibly abnormal eating behaviors were compared with their female counterparts who also were diagnosed as having an eating disorder (Woodside, 2001, p. 259). After an extensive study, Woodside (2001) observed that “men are generally very similar to women in terms of comparing psychopathology…the illnesses are much more equivalent in prevalence than was previously thought” (Woodside, 2001, p. 259). This view articulated by Woodside is shared by many other seminal psychologists who continue to try and seek answers with regards to eating disorders that can be fatal if taken to such a far extreme.

In a slightly different vein, renowned psychiatrist J. Polivy conducted study pertaining to the perception of calories in addition to the timely regulation of intake in both restrained and unrestrained subjects. Results demonstrate that the sole difference found between male and female subjects in its epistemology remains in the sheer reality that females often always score higher on the restraint scale, which itself retains a litany of intimations that will be discussed later. This discovery supports the conclusion that bulimia affects males just as much as it does females, and the higher incidence of dieting undergirds elevated rates of bulimia among women who are tested and prove that it is not due to intrinsic differences between the sexes (Agras & Kirkley, p. 372). However, the lack of research and clinical studies about bulimia in males renders such conclusions tenuous, reductive, and shifty. Nonetheless, the research clearly demonstrates that similar psychological triggers for developing eating disorders have been found to be comparable between the sexes pertaining the etiology of this abnormal behavior: low self-esteem, depression, anxiety, and difficulty in dealing with emotional and personal problems (Keel, 1997, p. 41). Because the majority of Americans, who often tend to appeal to reductive and vitriolic cognitions regarding the eating behaviors of an adolescent girl’s disordered eating habits, a vast array of male bulimics feel too humiliated and ashamed to admit that they suffer from such a disease that preoccupies them every minute of every day of their lives in addition to their close family and friends. Such findings indicate that clinical studies on male bulimic behaviors absolutely need to by explored in order to advocating for patients and enacting tangible and effective changes.

This particular study was chosen because of the implications regarding clinical studies conducted on bulimic male subjects and because the least severe case were not incorporated. Moreover, this study underscores the gendered component of the disease which further underscores the necessity of DNPs to both educate largely illiterate and/or uneducated women regarding safe practices and their rights enshrined be laws of the country in which they live. Indeed, as mentioned previously the gendered nature of bulimia hinders boys and adult males to avoid seeking healthcare services from professionals (Schneider, 1991, p. 196). The dearth of reliable quantitative, and concrete information and date ultimately germinates because of the firmly entrenched gender biases through which normal Americans view homosexuality in a pejorative manner. Richard Gordon, a renowned and often controversial scholar within the field of psychology and academia at large, wrote in his Anorexia and Bulimia: The Anatomy of a Social Epidemic details from a theoretical perspective. Gordon (1991) contends that eating disorders such as bulimia (which manifests in various forms pertaining to food consumption or working out too much), solely impacts men who try to play the woman’s role vis-à-vis their physical appearance and stature, which eschews male emotionality as they relate to their body issues if they struggle with them (Gordon, 2013, p. 65). It is a general misconception that only women are affected by bulimia and other associated mental illnesses because of a hegemonic male order that is slowly being dismantled as doctors and researchers continue to find new evidence that disordered eating is a universal phenomenon that must be addressed in order to prevent any further premature deaths from manifesting.

There has hitherto been extensive and comprehensive studies and research regarding how the brains of women who self reported suicidal tendencies due to the fact that there were external cultural pressures on females who go at all costs to remain skinny (Gordon,1998, p. 51). A handful of well-known psychiatrists such as Dr. Hilde Bruch assert that the susceptibility of women to the development and germination of an eating due to their unapologetic desire to achieve a seemingly unattainable degree of thinness (Root, 1987, p. 4). Paul Garfinkel and Davir Garner conducted of the most famous studies that underscored how rigid and impossible it is for women to achieve their desired level of thinness, as biological reality was incommensurate with the attainment of this ideal. They looked closely at two of the most pronounced standards of female beauty: the winners of the Miss America pageant as a litmus test in addition to the playmate of the month for the voyeuristic magazine entitled Playboy over a two decade span that commenced in 1960 (p. 26). For each of these respective barometers of beauty and sensuality, the authors noted that the winners gradually appeared to have less curves and were unequivocally much thinner as time passed. The authors concurrently procured data gleaned from medical discourse regarding the size of the average woman in western society, which revealed that while the cultural ideal of the female figure became thinner, the weight of the average woman increased during this same period of time. As such, Garner and Garfinkel effectively quantified the sociological trend of disordered eating habits germinating and persisting in order to chase after the cultural ideal despite the fact that biological reality was incommensurate (Boskind-White & White, 1986, p. 368). Agras & Kirkley (1986) further correlate bulimia with the rising pressure to be thin as evinced in published magazines over the span of eight decades. They conducted a systematic examination of images of women and their body measurements to underscore that during the 1960s there was a pronounced orientation towards women pursuing an androgynous figure which called for less pronounced hips and smaller bust size. At the same time, articles published in medical journals during the 1960s also more commonly featured discussions on bulimia as a burgeoning psychiatric problem. Although causal conclusions cannot definitively be drawn from this data set, the observations nonetheless align with the contention that females began feeling more and more pressure to maintain a level of thinness beginning in the 1960s in a way that was qualitatively different from cultural pressures that had succumbed to in previous decades. Disordered eating patterns emerged as the avenue through which women could achieve the ideal body image, which validates why bulimia quickly emerged as a serious concern amongst mental health professionals.

Through this cultural preoccupation with thinness, young women feel a degree of internal conflict and confusion over their identity in such a fast-paced and constantly evolving world. Adolescents thus are quite susceptible to external influences such as images of fashion models and media framing of ideal beauty that young girl feel they must emulate and live up to (Kilbourne, 1991, p. 61). Kilbourne (1991) situates the impact of the media on female corporeality through a feminist lens, positing that images circulating in the mass media and inundating female viewers on a quotidian basis reinforce the feeling of female inferiority via a portrayal of the ideal female beauty as something that is unnatural and could never be fully attained (Kilbourne, 1994, p. 365). Through deliberate advertising, American society cultivates an immense trepidation in becoming fat as a means of constraining feminine power an autonomy. Males are cognizant that female empowerment continues to be enhanced, which is why men have undertaken several efforts to “keep women small and not allow them to take up too much space both literally and figuratively” (Kilbourne, 1994, p. 403). As such, the media presents an image of the female as fragile in evince that women can be successful and gain a sense of power if they pursue the cultural ideal of thinness and remain “feminine” according to hegemonic standards (p. 403). While magazine covers and advertisement deliberately cultivate fear and anxiety about weight to make profits off of viewers, they also convey an undergirding cultural concern and anxiety regarding the perceive threat of female empowerment to the hegemonic cultural ideology. By placing such intense emphasis on the need for women to control their appetites and weight in order to achieve the desired level of thinness, society at-large has perpetuated a pathology in females that equates thinness and the physical manifestation of self-restraint vis-à-vis their body shape with being a good person (Root, 1983 p. 28). This notion intimates that there remains a need for healthcare officials to develop new interventions that specifically target social and cultural factors that contribute to the onset of disordered eating behaviors such as bulimia in which an individual consumes vast quantities of food only to the self-induce vomit so as not to gain any calories. Pathologies continue to perpetuate this debilitating and disturbing condition due to the internalization of a cultural ideal that is

Although the majority of the literature on bulimia and its etiology focuses on female subjects, there have been some studies conducted on male subjects in order to ascertain whether or not men in the western world also face pressures to achieve a certain body type. The dearth of studies has resulted in limited research that prevents scholars from making firm causal connections, yet they nonetheless underscore that men turn to bulimia as well in response to cultural pressures they face. Manhood in the western world translates into the need for muscularity as a signifier of strong manhood, If men cannot achieve such a super-male standard, they then turn their shame and humiliation inward (Pope et al., 2000, p. 19). Males and females both decry the fat body, which is why men and women alike are vulnerable to disordered eating behaviors and pathologies to prevent becoming fat (Keel, p. 39). As such, men too face similar psychological quandaries that their female bodies do with regards to sculpting the perfect body through constant exercise and disordered eating patterns as a validation of their own self worth. Pope et al. (2000) argue that means enhanced dissatisfaction with their own bodies has spawned abnormal eating pathologies. Recent studies attest to this assertion because within the past three decades, dissatisfaction has sharply risen from 15% to almost 50% of all people surveyed, a rate that is commensurate with female dissatisfaction (Pope et al., 2000, p. 130). Men also succumb to cultural ideals and have fallen a victim to what psychiatrists have dubbed the Adonis Complex—a non-medical term that encapsulates male body concerns with regards to their body image (p. 2)—in the male pursuit of a lean yet muscular body type. Named after the Greek God Adonis whose corporeal shape emerged as the prototypical male figure, this disorder is manifested by men who lift weights too much, exercise more than they should, engage in steroid abuse that can be fatal if done incorrectly, and disordered eating characterized by binging and purging quickly thereafter (PPope et al., 2000, p. 133). Males thus aim to transcend any feelings of infallibility and inadequacy and gain self-worth through the binging and purging process. It must be noted that bulimia as a mental health disorder does not always necessarily involve food in the binge and purge process. Over exercising after eating what one considers to the be too much food is also considered purging and thus part and parcel of the bulimic syndrome.

In conclusion, both psychological and sociological research provides various inroads and insight into ascertaining the etiology of bulimia and other debilitating mental health conditions. Such a lack of clarity, combined with the label of a feminine disease has limited the sales boosted therein. Extant studies underscore how bulimia does not care about socially constructed identities, as mother and husband, sister and both, etc always gets complicated when issues about the estate are invoked. The literature reveals how both familial and cultural factors play into the persistence of patriarchy in both the western and eastern religious worlds alike. Many members of the medical community render disordered eating a female problem that reinforces women’s subservient position via patriarchal devaluation within a culture that can only be described as image obsessed. Cultural forces at the macro level unequivocally trigger bulimic behaviors and pathologies in girls as well as men through the media, and the complex psychological dimensions of the mental health disorder has rendered it quite difficult for experts to devise an effective solution to combat and/or cure it. No fully effective intervention has been ascertained to this day, although psychiatrists continue to work with those with disordered eating pathologies. The recidivism rate remains quite high, which reveals the need for future research on the subject. Armed with such meticulous insight and understanding of bulimia as a mental health disorder afflicting both men and women will help experts today work towards deconstructing the gender bias of disordered so that they can comprehend the full scope of the illness. The dissemination of information that is medically correct will also raise awareness of it and help raise financials to conduct more in-depth studies on the nature of the development of bulimic pathologies.

References

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Boskind-White, M. & White, C. (1986). Bulimarexia: An historical-socio-cultural perspective, in Handbook of eating disorders: Physiology, psychology, and treatment of obesity, anorexia, and bulimia. Ed. Kelly D. Brown and John P. Foreyt. New York: Basic Books, Inc. pp. 353-366.

Brownell, K.D., & Foreyt, J.P. (eds). Handbook of eating disorders: Physiology, psychology, and treatment of obesity, anorexia, and blimia. New York: Basic Books, Inc. pp. 353-513.

Elfhag, K. & Yvonne Linne, Y. (2005). Gender differences in associations of eating pathology between mothers and their adolescent offspring. Obesity Research, 13(6), 1070-1076.

Gordon, R.A. (1990). Anorexia and bulimia: Anatomy of a social epidemic. Cambridge: Blackwell Publishers.

Keel, P.K. et al. (1997). Mothers, fathers, and daughters: Dieting and disordered eating. Eating Disorders: The Journal of Treatment and Prevention, 5(3), 216-228.

Kilbourne, J. (1994). Still killing us softly: Advertising and the obsession with thinness, in Feminist perspectives on eating disorders. Ed. Patricia Fallon, M. Katzman & S. C. Wooley. New York: The Guilford P. pp. 394-118.

Pope, H.G., Phillips, K.A., & Olivardia, R. (2000). The Adonis Complex: The Secret Crisis of Male Body Obsession. New York: Free Press.

Root, M.P., Fallon, P., & Friedrich,W.N. (1983). Bulimia: A systems approach to Treatment. New York: W. W. Norton & Company, Inc.

Schneider, J.A. (1991). Gender identity Issues in male bulimia, in Psychodynamic treatment of anorexia nervosa and bulimia. New York: The Guilford Press. Pp. 194-217.

Woodside, B. (1995). Gender differences in eating disorders, in Gender and psychopathology. New York: American Psychiatric Publishers. Pp. 253-68.