Internal Code: 1IAIJ
Topic: Estimate and Investigate the Prevalence and Determinants of Eating Disorder among ASIAN Students in UK
Literature review
For this literature review, studies regarding eating disorders published between 2007 and 2017 were evaluated using the keywords, specifically focusing on factors causing eating disorders.
Morris et al., (2015) undertook a study to determine the social behavior and outcomes of individuals affected with anorexia. Evaluating the study, it is deemed that emotional empathy is lower in patients with anorexia whereas lower levels of anti-social behavior highlighted their contrasting desire to minimize the presentation of antisocial outcomes during an active state. Tchanturia et al., (2012) explored the social responsibility of individuals affected by anorexia, through the social anhedonia scale. Anorexia led to higher self-reported social anhedonia compared to healthy individuals and clinical severity of this disease was also a determinant of these scores which indicate that anorexia highly affects the social outcomes and social responses of the affected individuals.
Examining the risk factors and symptoms to predict the onset of eating disorders, Stice et al., (2017) found that body dissatisfaction is prevalent in young women although eating disorder is present in male adolescents and male adults. Steinhausen et al., (2015) found that anorexia is substantially higher in individuals belonging to families having a history of the disease which determine the genetic influence on eating disorder. The study also identified risk factors such as anxiety, obsessive-compulsive disorders, personality disorders or substance use which ultimately results in unscheduled eating habits, including dieting and binge eating. The incidence was reported to be in the ascending order of birth which also marks that familial as well as genetic factors could be a significant determinant of eating disorder.
Nilsson et al., (2007) analysed why patients developed anorexia. Former anorexia patients from Sweden who had undergone treatment in child and adolescent psychiatric clinics were interviewed where they were asked questions regarding the cause of the disease. Analysing the facts critically, it was revealed that the reasons for the development of anorexia included family and sociocultural stressor while another factor was self-conscience such as constant strive for perfection and having an exorbitantly high expectation from themselves as well as other individuals. Ma et al., (2008) undertook a study in Shenzhen, China, to find the causative factors of anorexia in patients regarding societal influences and parent-child conflicts where intergenerational conflicts were contextualized in order to explore the rationale and meanings of the sociocultural context of the patient. The first conflict identified was intergenerational control and power struggle, in which the adolescents faced issues with having control over their decisions due to parental pressure and certainly these issues lead to mental illness, fatigue and anorexia. The second conflict was the issue of growing up versus remaining childlike which also creates a sense of dissatisfaction towards life. The third conflict stated the dilemma regarding pursuing individual goals or living up to parental expectations which ultimately allows them to be isolated from social life and disorderly regarding proper food intake pattern. Similar findings have also shown in studies conducted by Cella et al., (2014). The study investigated the relationship between parental bonding and the concept of self, and the effect of this on eating disorders. This was done using a mediation model involving screening of 3158 Italian high school students comprising of 2026 female individuals and 1132 males ages 14-18 years. The study utilized the method of self-report of parental behaviors as perceived by them, influencing their concept of self. The study revealed that low parental care, maternal overprotection and various other attributes of parental bonding behavior were linked with the self-concept of these individuals which install frustration and resentment in them resulting eating disorder. The impact of this modified self-concept influenced one’s own drive for thinness, which affected eating habits as a result of the eating psychopathologies. This was also demonstrated by the body mass index (BMI) and gender of the participants but was irrespective of age which significantly denotes that eating disorder is not age specific.
Smith et al., (2014) examined the relationship between emaciation and beauty on female participants. 30 anorexic women and 29 healthy women were shown various images of thin women, followed by a lexical decision task (LDT) to distinguish words from non-words although sample size should have been high in this regard to obtain precision. The results revealed that participants with anorexia displayed a faster response to words than the controlled group which was symptomatic of their concerns regarding negative or distorted body image. Eating disorder severity was measured with the help of a subscale which helped to project the strength of association of beauty and emaciation. Dodd et al., (2017), asserted that idealization of thinness, over-evaluation of the importance of thinness and the excessive drive for thinness were associated with eating disorders which denoted the obsession of adopting westernization and the perception that slim figure had been the only criteria of true beauty. 80 undergraduate women who had self-reported eating disorders were recruited, images of emaciated, slim, and overweight female bodies were shown and their perceptions were recorded. Utilising Facial Electromyography to measure the activation of facial muscles associated with revulsion, the study concluded that eating disorder was associated with a higher dislike for overweight bodies and reduced aversion for emaciated bodies. Striegel-Moore & Bulik (2007) noted that genetics, early trauma, and cultural factors were significant factors influencing the development of eating disorders which have been demonstrated in recent studies as well.
More comprehensive epidemiological studies are required in order to thoroughly address the clinical presentation of eating disorders in different demographics. Preventive and policy interventions need to be designed to decrease the exposure to thin-ideal messages or to promote negative perceptions of a bulkier body frame. Overall, several papers have been published regarding the reasons for the development of eating disorders where most prominent factors include low self-esteem, familial pressure, socioeconomic factors, culture, and genetics.
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