Reasons behind Self Induced Harm in Cases of Bulimia Nervosa

Bulimia nervosa is considered as an eating disorder which is usually mentioned together with anorexia nervosa and binge eating disorders; this so due to the fact that all three pertain to abnormalities in the eating patterns or tendencies of an individual which cause considerable risk (American Psychiatric Association [APA], 2005). An eating disorder may not sound alarming, but in fact, severe disregard on over overall health may lead to dire consequences, especially in the case of bulimia.In addition, not only can malnutrition be caused by such a disorder, but cardiovascular and deadly complications may also arise (APA, 2005). Not only is bulimia referred to as a type of eating disorder, but it is also considered to be a severe mental health issue characterized by frequent events of binge eating and subsequent purging (Cooper, Todd, & Wells, 2009). This means that a massive amount of food is consumed by the individual with bulimia, and afterwards the food taken is expelled through v arious means of purging.Self-induced vomiting, misuse of laxatives, and misuse of diuretics are considered to be the three main categories of how an individual achieves purging (Mehler, 2003). Due to such actions, the condition of the body would be in a state of severe imbalance, hence causing various symptoms or different levels of severity. The symptoms of bulimia are the occurrence of a continuous case of sore throat, inflamed salivary glands, puffy cheeks, deterioration of the teeth, gastroesophageal reflux disorder, intestinal disorder, kidney disorder, and severe body dehydration (APA, 2005).Bulimia can be differentiated from anorexia and binge eating on the basis of how eating is perceived and reacted upon by the individual, thus having different sets of symptoms. Unlike individuals with anorexia who avoid eating at all costs, bulimics eat a lot of food which is taken out afterwards; its difference to basic binge eating disorder is that instead of purging, individuals with bi nge eating disorder simply reach a state of regret afterwards (Grange & Lock, 2007).It is evident that a person that suffers from bulimia does significant physical harm to their bodies. Also, one must also take into account that individuals with bulimia are also commonly diagnosed with other psychiatric conditions including cases of current and long standing psychiatric disorders; these disorders may include depression, dissociative identity disorder, substance abuse disorder, obsessive compulsive disorder, post traumatic stress disorder, social phobia, and borderline personality disorder (Cooper et al. , 2009).The reason as to why they commit such acts of binge eating and purging, which does not only wear down and considerably weaken the body but also initiates fatal risks and complications, must therefore be identified. Based on statistics, out of 100,000 individuals, 26. 5 females and 0. 8 males are bulimics (Treasure, Schmidt, & Furth, 2003). The presence of such effects and sym ptoms upon an individual with bulimia makes it crucial for people to understand the core reasons so as to be able to identify peers who are currently suffering or at risk from the disorder and to provide proper aid in recovery and treatment as well.The fact that the actions done by bulimics are fueled by social, psychological, and emotional factors, especially their personal appraisal and their concept of ideal physical form, is rather becoming the common perception (Treasure et al. , 2003). However, current trends in studies also suggest genetically based explanations to eating disorders (Grice et al. , 2002). Developments in genetics and biological studies have allowed the possibility of bulimia as being directed by more than the social and behavioral factors, contrary to what was previously thought of.Given the extent of problems and risks as presented, awareness towards the details regarding bulimia nervosa is definitely beneficial. In relation to this, information regarding the causative agents as to why individuals with bulimia commit such harm towards themselves must be established. Therefore, the purpose of this research is to identify the reasons as to why individuals with bulimia nervosa cause harm towards their own bodies. Methods In order to gather sufficient information regarding bulimia nervosa, a preliminary search for basic information from the internet was done. By browsing credible medical websites such as womenshealth.gov, medicinenet. com, mentalhealth. com, and nlm. nih. gov also known as Medline plus, basic familiarization with the disease or disorder was established. It must be understood, however, that this step was merely done in order to learn the basic terms and facts regarding bulimia. It was decided that a brochure on eating disorders from the American Psychiatric Association (APA) is to be utilized as a source since the association is credible and the information is well-presented. Afterwards, a search for online journals related to bulimia nervosa was conducted in several medical, genetic, and psychiatric sites.Related journals were acquired from the databases of American Journal of Genetics (AJG), Archives of General Psychiatry (AGP), and the New England Journal of Medicine (NEJM). Books on bulimia nervosa and eating disorders were provided by several peers. Examples of such books, which are generally recent releases and therefore provide updated information, are Treating Bulimia Nervosa and Binge Eating: An Integrative Metacognitive and Cognitive Therapy Manual by Cooper, Todd and Wells (2009), and Treating Bulimia in Adolescents: A Family Based Approach by Grange and Lock (2007). DiscussionBulimia nervosa is considered to be caused by interconnected aspects, including those of psychosocial and biological origins (Treasure et al. , 2003). Thus, it is possible to assess the probable reasons as to why individuals with bulimia nervosa resort into committing harm towards their own bodies. In this sense, insig hts into the reasons can be efficiently acquired through the review of factors based on psychosocial and biological sources in a separate manner. Problems during early periods of the life of an individual may cause an individual to develop bulimia later on in life.Concerns regarding weight and appearance may develop early during childhood (Keel, 2006). An example of how early cases of problems in self-appraisal arise may be observed in the association between parents and children since these are the first sources of social interactions that an individual is commonly exposed to. When a child is taken good care of by his or her parents, he or she would come to perceive that he or she is rather important or precious; in the opposite sense, a child that is neglected tends to think that he or she is unwanted for several reasons (Treasure et al. , 2003).In this sense, the child might be led to think that something about his or her physical characteristics is undesirable. Furthermore, teas ing and possible mistreatment from the peers of a child regarding his or her appearance, especially their weight, may become imprinted in their thoughts as they age and develop. Thus, early on, a child may possibly develop a desire to lose weight and improve appearance (Treasure et al. , 2003). The point of displeasure towards the current state of appearance is commonly further established during adolescence as this is the phase wherein attraction between genders become apparent.It is also during adolescence that the actions are more controlled by the individual rather than by parents or authoritative figures; adolescents become aware of their capacity to question and to refuse to follow such figures. However, due to the fact that they are still not that knowledgeable, they are considerably prone to mistakes. If an adolescent develops a problem such as bulimia nervosa, it has been connected with increased risks of developing physical as well as mental disorders upon entering early a dulthood (Johnson et al., 2002). In addition, findings of a study done in 2003 reveal that the incidence of bulimia nervosa on adolescents increases as years pass; the main reason as to why teenagers choose to commit actions of risk-related behavior is their heavy focus and attention on physical appearance including weight (Forman, 2005). As a side note, adult incidences of the disorder are very much similar to the adolescent incidences in terms of risk factors, symptoms, and development (Cooper et al. , 2009).All of this information point towards the validation of interplay between psychosocial factors as a potential cause of bulimia nervosa. As a result, it becomes evident that a major reason as to why people with bulimia nervosa harm themselves is to maintain a good physical image, possibly in order to prevent potential negative judgment from other people and to portray a positive public appraisal based on appearance. For those with bulimia nervosa, keeping the ideal physical ima ge is vital and certainly of utmost importance, even more than their own welfare in the long run.In relation to this, the concept of keeping an ideal image may be directed by culture, personal cognitive tendencies, and/or derived from stressful events (Treasure et al. , 2003). Having defined the main reason behind the harm caused by individuals towards themselves based upon psychosocial factors, it is now important to assess the biologically based reasons behind it. As with numerous diseases and disorders, there is a current trend of discovering or determining the genetic triggers which initiate the onset of such problems.As mentioned, current research has revealed that there is a genetic or biological basis in the occurrence of bulimia nervosa (APA, 2005). In areas of medicine and genetics, a complex disease is one that is considered to involve the interaction of gene-based and environmental factors. Thus, such diseases cannot be passed on simply from parent to offspring; however, the tendency to develop susceptibility can be passed on and can be induced by mutations (Treasure et al. , 2003). In this sense, a person that is susceptible to develop bulimia nervosa is depicted to have genes or alleles that allow such susceptibility.Alone, a susceptibility gene cannot cause the development of the disease, but upon the addition of additional susceptibility genes, the interaction between the collection of genes leads to disease development (Treasure et al. , 2003). In fact, a study was conducted in order to assess the specific sets of chromosomes that confer bulimia. In the said study, it was mentioned that a portion of bulimia nervosa cases does indeed have a familial bearing, suggesting that its incidence in families with members that has bulimia is observed to be rather connected in terms of successive or prior cases of bulimia in the family (Cynthia et al., 2003). Given this, the researchers opted to analyze a significantly large sample wherein genetic data was collected and analyzed in order to determine where the susceptibility gene of bulimia is located. Exactly 308 families were used as sample, wherein a linkage analysis of the families regarding heritable genetic characteristics of bulimia, such as vomiting, was conducted. The results of the study from linkage analysis have shown that a dominant linkage results was observed between D10S1430 and D10S1423, implying that the effects of chromosome 10p in families with bulimia are the common denominator (Cynthia et al., 2003). With such proof of genetic basis in developing bulimia, especially since it was proven to be heritable, it becomes evident that there is indeed a biological basis in the presence of the disorder. In this sense, an individual may cause harm to themselves due to genetic interaction between susceptibility genes which confer bulimia and its symptoms, for example when genes that code for self-induced vomiting are activated, the individual will tend to induce vomiting upo n him or herself.Since bulimia can be considered as rather hereditary, environmental implications of affected families may also cause other members with sufficient susceptibility genes to develop bulimia. In this sense, there are mainly two identified reasons behind the harm those individuals with bulimia cause upon themselves. The first reason is in order to maintain a desired physical appearance of weight as dictated by personal, cognitive, stress, or cultural factors.The second reason is that the activation of certain genes, especially those in chromosome 10p, may cause the development of symptoms related to bulimia, which in turn may cause the development of the overall disorder. These results are not surprising due to the fact that it has long been a common thought that bulimia has psychosocial roots. Also, regarding the development of a genetically based causative agent to bulimia, it is a trend today, with the vast development in genetics, that certain diseases may be trigger ed by genetic factors.However, as mentioned, pointing out these reasons directly is rather beneficial so that individuals will become aware of the possible causes of developing bulimia and continuous suffering due to the disorder. In effect, individuals can practically assess cases where bulimia can already be detected and also provide preventive support to individuals which may have a higher risk of developing the disorder. In terms of future implications and significance of such results, these data can provide further insight and proof that bulimia nervosa, resulting in self-induced harm, is not only triggered by psychosocial factors but genetic factors as well.Hence, further research may make use of the data presented in order to provide further information regarding the specific areas under psychosocial factors and/or genetic factors. Conclusion The research yielded information regarding the causative agents of self induced harm in individuals with bulimia nervosa. It has been d etermined that the causes of self-induced harm can be divided into categories: psychosocial and genetic. In terms of psychosocial, it has been assessed that the roots of the problem may start young, possibly during infancy or childhood.The development into adolescence also further increases the risk of individuals to develop bulimia as the focus towards appearance is increased. Due to various factors such as negative peer judgment and inappropriate self-concept based on behavior, cognitive, cultural, and stress-related aspects, a person may choose to maintain optimum appearance and weight as he or she may see fit through self-induced vomiting which is a form of self-induced harm.In terms of the genetic factors, it has been assessed that the symptoms of bulimia nervosa is rather heritable; hence, the occurrence of the disorder has a familial basis. Specific effects of numerous susceptibility genes, which are generally connected to chromosome 10p, provide the genetic basis of the deve lopment of the problems associated with bulimia. In addition, it was also mentioned that self-induced harm such as purging is activated by specific genetic elements.Therefore, the aim of the research to list the reasons behind self-induced harm in cases of bulimia has been completely fulfilled due to the fact that the two main reasons for self-induced harm was enumerated, one being a desire for maintaining or developing an ideal appearance and weight-based on varying criteria and the other being the interaction of genetic elements which, when triggered, can lead to the symptoms such as induced vomiting which is considered to be self-induced harm. ReferencesAmerican Psychiatric Association. (2006, November). Let’s Talk Facts About Eating Disorders. [Borchure]. Arlington, Virginia: American Psychiatric Association. Retrieved April 23, 2009 from http://www. healthyminds. org/factsheets/LTF-EatingDisorders. pdf. Cooper, M. , Todd, G. , & Wells, A. (2009). Treating Bulimia Nervosa and Binge Eating: An Integrative Metacognitive and Cognitive Therapy Manual. New York: Routledge. Cynthia, M. B. , Delvin, B. , Bacanu, S. , Thornton, L. , Klump, K. L. , Fichter, M.M. et al. (2003). Significant linkage in chromosome 10p in families with bulimia nervosa. American Journal of Human Genetics, 72 (1), 200–207. Forman, S. F. (2005). [Review of the book Clinical Handbook of Eating Disorders – An Integrated Approach]. The New England Journal of Medicine, 352 (6), 636. Retrieved April 23, 2009 from http://content. nejm. org/cgi/reprint/352/6/636. pdf. Grange, D. L. & Lock, J. (2007). Treating Bulimia in Adolescents: A Family Based Approach. New York: The Guilford Press.Grice, D. E. , Halmi, K. A. , Fichter, M. M. , Strober, M. Woodside, D. B. , Treasure, J. T. et al. (2002). Evidence for a susceptibility gene for anorexia nervosa on chromosome 1. American Journal of Human Genetics, 70, 787–792. Retrieved April 22, 2009 from http://www. pubmedcentral. n ih. gov/picrender. fcgi? artid=384957&blobtype=pdf. Johnson, J. G. , Cohen, P. , Kasen, S. , Brook, J. S. (2002). Eating disorders during adolescence and the risk for physical and mental disorders during early adulthood.Archives of General Psychiatry, 59, 545 – 552. Retrieved April 23, 2009 from http://archpsyc. ama-assn. org/cgi/reprint/59/6/545. pdf. Keel, P. K. (2006). Eating Disorders. New York: Infobase Publishing. Mehler, P. S. (2003). Clinical practice: Bulimia nervosa. The New England Journal of Medicine, 349 (9), 875–882. Retrieved April 22, 2009 from http://content. nejm. org/cgi/reprint/349/9/875. pdf. Treasure, J. , Schmidt, U. , & Furth, E. V. (2003). Handbook of Eating Disorders 2nd Edition. England: John Wiley & Sons Ltd.