Anorexia and Bulimia: A Vicious Cycle of Western Cultural Influence and Self-Control

The exaggerated acceptance of Western culture

Greek civilization is the cradle of European and American culture. The ideal of an eight-headed figure was once the ideal in sculpture. Currently, Greeks are shorter and stockier than Chinese people, and the beauty of the past is no longer the same. The most powerful aspect of European and American culture is film. Film culture has flourished in the United States, and the leading ladies are often blonde, blue-eyed, tall, and thin, captivating audiences worldwide. Some people may have exaggerated this. Based on my research on 13,000 young women aged 12-25 in China, I found that more than half of them complained about having large thighs, waists, hips, and calves. Their ideal weight was 11% less than the Department of Health's standard weight. Ironically, 1,800 people considered 45 kilograms to be the thinnest weight, and not a single person weighed less than 45 kilograms. It is evident that our society's obsession with thinness is becoming increasingly apparent.

The pursuit of self-control -- a vicious cycle

Analyzing anorexia and bulimia may require a multi-faceted model of pathogenic factors. The decision to diet or fast may be a reaction to a psychological disorder, most typically involving low self-esteem, helplessness, or feelings of ineffectiveness due to illness. Dieting can temporarily relieve the stress of unresolved problems by restoring a sense of control and self-control.

However, the problem persists, and the issues arising from hunger lead to further dieting, creating a vicious cycle that gradually develops until the patient experiences hunger symptoms or enters a vicious cycle of continuous dieting, binge eating, and laxatives. Common hunger symptoms, and the physical and behavioral manifestations of most anorexia patients, are side effects of hunger and can be recovered through nutritional rehabilitation. However, the excessive pursuit of thinness due to distorted body image in anorexia is not something that can be reversed.

Many patients with bulimia were originally overweight, so their weight not being within the normal range doesn't rule out the possibility of starvation. In these patients, binge eating is simply a reaction to insufficient calories, and laxatives are merely an attempt to eliminate unnecessary calories, which only exacerbates the hunger, creating a vicious cycle. Sometimes, different environmental and emotional cues can trigger binge eating.

treat

Eating disorders involve more than just the onset of symptoms; treatment is multi-faceted. The first step is to restore normal eating habits. For bulimia nervosa, this means stopping dieting, binge eating, and laxative behaviors. For anorexia nervosa, it involves gradually reducing the patient's fear of maintaining a normal weight while slowly regaining their original weight.

Treatment strategies include encouragement and support, the use of psychoeducation and educational materials, and medications to reduce anxiety. Some nutritional enhancement therapies, such as nasogastric tube feeding or intravenous nutrition, can improve very low body weight. However, these feedings and injections alone cannot reverse abnormal eating behaviors. Even secretly allowing patients to avoid certain foods and eat nothing at all will not be effective.

Psychological treatment must be combined with treatment to restore physical health. An individual's psychological disorders can be diagnosed by examining the distorted cognitions underlying these pathological behaviors; helping patients recognize their basic emotional state and then develop additional stress-coping skills; reducing the need to monitor self-esteem through external cues.

Mobilizing family members for therapy is particularly helpful for younger patients. Initially, this type of therapy, involving family members, should focus on increasing their knowledge of the illness and reducing feelings of helplessness, rather than requiring family therapy for all members. A gradual approach is often effective in treating bulimia. A small percentage of bulimia patients also show improvement with simple treatments such as team psychoeducation, providing basic information about the illness, consulting a nutritionist, and weight loss support.

Patients who do not respond to the treatment may seek group therapy or outpatient multi-faceted psychotherapy. If a patient still does not improve, they may be referred for further intensive treatment, such as daytime hospital or inpatient treatment. Some patients may even need to be transferred to a specialized treatment center.

Do you have any unusual eating habits?

Generally speaking, there are many ways to control weight, from common methods like choosing special foods and exercising to abnormal methods such as taking laxatives and inducing vomiting. Studies in Europe and America have shown that more and more teenagers are using abnormal methods to control their weight.

In the Taipei area, when asked, "Do I specifically choose foods that won't make me fat?", 39.9% of respondents answered no, 29.1% answered rarely, 24.0% answered sometimes, of which 5.2% answered usually and 1.7% answered always. Regarding the question, "Do I diet or fast to prevent weight gain?", 45.3% answered no, 25.2% answered rarely, 21.8% answered sometimes, 5.3% answered frequently, and 2.3% answered always.

"To lose weight, I do strenuous exercise," 40.4% answered no, 35.9% answered rarely, 18.8% answered sometimes, 3.3% answered usually, and 1.4% answered always. "I use laxatives, diuretics, or diet pills to excrete the food I eat," 93.2% answered no, 4.3% answered rarely, 1.8% answered sometimes, 0.4% answered usually, and 0.3% answered always.

"I try to vomit or poop out what I eat," 79.9% answered no, 13.3% answered rarely, 4.8% answered sometimes, 1.3% answered usually, and 0.8% answered always. Although those who take extreme weight loss methods are a minority, the number is gradually increasing.

Regarding methods of weight control, the rates of deviant behaviors such as taking laxatives and inducing vomiting were slightly lower in the survey results than in studies from Europe and the United States. Taking bulimia as an example, one of the indicators is self-inducing vomiting after binge eating. Johnson's 1983 survey of 1,268 teenage girls found that the rate of self-inducing vomiting to lose weight was as high as 16%, while Killen's 1986 survey of 10th-grade girls in California found a rate of 10.6%, and Mosesy's 1989 survey found a rate of 2%.

Different studies use looser definitions for certain eating behaviors, leading to varying results. While our results are relatively low, the significant harm that improper weight loss methods can cause to the body cannot be ignored. Furthermore, excessive focus on one's weight coupled with an inability to control oneself and resorting to self-harming weight loss methods often indicates underlying psychological issues requiring psychological treatment.