Bulimia Affects More Women than Men

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorder, or DSM, is a classification of mental disorders with associated criteria designed to facilitate more reliable diagnoses of these disorders (American Psychiatric Association, 2013). DSM started in America but is now widely used by students and psychologists to accurately diagnose mental disorders.

There are many psychological conditions that affect more women than men such as depression and anxiety. One that is less known is eating disorders like bulimia and anorexia. Eating disorders are defined as an abnormal change in eating habits that can greatly affect a person’s mental health. Hsu (1989) found that bulimia nervosa is more common among woman as they are more self-conscious about their bodies so will turn to dieting to help control their weight. The media could be a heavy influence on them as celebrities are known to keep in shape for award ceremonies and photo shoots. WebMD has stated that, according to the National Institute of Diabetes and Digestive and Kidney Diseases, patients diagnosed with bulimia have a history of depression. This shows there is a link between depression and eating disorders. This essay with look at the impact of bulimia nervosa and how it affects more women than men.

Bulimia nervosa is very common amongst adolescent girls and young women. Their behaviours can range from episodes of binge eating to over-consumption. By preventing weight gain, women can pick up on other inappropriate behaviour such as self-induced vomiting, misuse of certain medications, fasting or over-exercising. Women are so adamant about their weight and body shape that it can lead to suicide. Crow, Peterson, Swanson, Raymond, Specker, Eckert and Mitchell (2009) conducted a longitudinal study to see if eating disorders are associated with increased mortality and suicide levels. They assessed 1885 patients, using the National Death Index, who had attended a specialised eating disorder clinic within the last 8 to 25 years. They found that mortality and suicide rates were elevated in people suffering from bulimia nervosa. The limitations of this study include no real age range and only including participants from a specific clinic. It lacks population validity and can’t be generalised. Nevertheless, a longitudinal study has many benefits as people are observed over a long period of time, resulting in more accurate and natural results, as stated by Caruana, Roman, Hernandez-Sanchez and Solli (2015).

Unlike anorexia nervosa, people with bulimia nervosa tend to maintain a normal and healthy BMI. This is due to them either overeating or undereating. They are known to experience episodes of binge eating, where they can consume between 1,000 and 2,000 calories, followed by self-induced vomiting to cancel out what they have eaten (Barlow, 2014). To be diagnosed with bulimia nervosa, the patient must show symptoms of repeated episodes of binge eating ranging from once or twice a week to several times a day for a minimum of 3 months. Women can also suffer from other internal problems such as menstrual irregularity or gastrointestinal symptoms. A serious problem is cardiac arrhythmias, although this is rare (American Psychiatric Association, 2013). Due to some patients abusing alcohol and drugs, this can lead to them possibly being diagnosed with borderline personality disorder.

There are some risk factors associated with bulimia such as temper, physiology and genetic problems. Upbringing can cause vulnerability of certain disorders, especially in those who experienced sexual or physical abuse (American Psychiatric Association, 2013). Culture is another issue. Studies found that bulimia nervosa is common in developing countries such as India (Sharan, & Sundar, 2015). A study by Chugh and Puri (2001) found that majority of the obese students from a Delhi background were unhappy with their current weight and their rate of dieting was very high. Gupta, Chaturvedi, Chandarana, & Johnson (2001) compared students from India and Canada and found that women scored equally on the tests. These studies demonstrate that eating disorders do occur in Western countries and the levels may increase, calling for further research.

To close the gap on how eating disorders affect women more, a study was carried out by Striegel-Moore, Rosselli, Perrin, DeBar, Wilson, May and Kraemer (2009). They collected a sample of men and women aged 18 to 35, who were given a questionnaire to fill out by mail or online. Results showed that men were more likely to report overeating while women were more likely to show loss of control. It was found that women were also more likely to report acts of body checking, binge eating and vomiting than men, although there was a small difference between the genders. This study showed that only a minority of men report eating disorders and even then, very few studies include men. Like the last study, this can’t be generalised as only participants from the organization were used. Other limitations include the low response rate, especially among men. This resulted in sampling bias. It also lacks population validity as most of the participants were white, non-Hispanic. Striegel-Moore et al. believed that their study needed to be replicated for future research, showing reliability.

A meta-analysis performed by the UK National Institute for Health and Clinical Excellence found that cognitive behavioural therapy is the most effective treatment for those suffering with bulimia. They also found that this type of therapy is not always the best solution as their sample only showed a small amount making a full recovery from the disorder. Shortly afterwards a new enhanced version was introduced and proved more effective (Fairburn, Cooper, & Shafran, 2003). This version is specifically aimed at young people and inpatients (Cooper & Stewart, 2008; Fairburn, 2008). There are many ways to manage eating disorders. Patients are advised to maintain a stable body weight, stop abnormal behaviour and view themselves positively. Further treatment, other than cognitive behavioural therapy, involves tests to better understand the severity of the illness. From this, doctors can then decide whether the patient needs to be admitted to hospital to help with their disorder or given a course of antidepressants and sent home. Antidepressants such as serotonin are said to be useful in treating bulimia (Sheran, & Sundar, 2015).

Over the years people have been made more aware of eating disorders and there is even an Eating Disorders Awareness Week. Before this launched the Mental Health Foundation found that 1 in 3 people had experienced stigma or discrimination in the workplace. This is due to employers having no education on eating disorders, making them unknowledgeable of the matter. Employees may feel unsupported at work and 38% of respondents said they had to resort to using their holiday to go to appointments. Discrimination can be a threat and affect people’s wellbeing especially when they are experiencing a mental health problem. This may put them off seeking additional help and will affect their physical health. People’s opinions and attitudes towards eating disorders may even convince people to have a breakdown and commit suicide. People even shrug off the disorder and call victims attention seekers or that it’s a lifestyle choice. The launch of Eating Disorder Awareness Week is a great way to give people, especially employers, better understanding of the illness and break the stigma that it isn’t a real disorder. In a world of technology patients often share their own experiences in their blogs about what they went through from suffering from bulimia. Many admit that their upbringing and experiences as a child greatly participated their illness. This could include rejection from relatives or, as mentioned before, physical or sexual abuse. Victims may also try to hide their illness which can lead to depressing and suicidal thoughts.

Overall, many studies don’t include enough men to formally accept that women suffer from eating disorders more than men. What we do know is that women are more likely to admit to the illness than men. More community awareness needs to be built to alleviate the negativity surrounding eating disorders so patients don’t feel like they should hide their illness. This could also help hospitals and clinics to build a safe environment for patients, giving them much needed help and support. Long term treatment is important especially to drop suicide and mortality rates and lessen chances of relapses. If men admitted to suffering from this illness there would be a better chance of them being more involved in research and studies and this would help break the stigma that it is only a female disease.