Sunday, April 26, 2015

A Rhetorical Analysis of "Are Eating Disorders Culture-Bound Syndromes? Implications for Conceptualizing Their Etiology" by P.K. Keel and "Eating Disorders" by Susan Nolen-Hoeksema

The subject of eating disorders is more than a question of “what,” but also “how” and “why.” Researchers have developed various reasonings in attempts to explain the basis of disorders such as anorexia and bulimia nervosa. An individual may compare him or herself to society's idea of the “perfect body.” I like to refer to this as “death by comparison.” Men and women are so praised for their physicality, that it is no surprise some will go to great extremes in an attempt to reach that same level of “perfection.” From a cultural studies perspective, one may see this as a primary factor in the development of eating disorders. Putting the blame on society, it could be assumed that the perceived perception of what the “perfect body” is can be blamed for many cases of eating disorders faced today. On the contrary, a psychologist may believe that the source of an eating disorder originates internally. Brain structure, genetics, and additional neurological factors contribute to a higher susceptibility for an individual to develop an eating disorder. In regards to establishing a specific etiology to the eating disorder of an individual, psychologists believe that biological and cognitive factors must also be taken into consideration. An article entitled Are Eating Disorders Culture-Bound Syndromes? Implications for Conceptualizing Their Etiology analyzes eating disorders through a cultural perspective. The author of this article incorporates information about cultural standards of weight (also known as the “thin ideal”), first person point of views of individuals suffering from eating disorders, and statistics drawn from empirical data and cross-sectional studies. Additionally, the author assesses cultural factors such as ethnicity, sexual orientation, gender, social status, and cultural norms, and analyzes meaningful artifacts of culture. On the other hand, an article entitled “Eating Disorders” by Susan Nolen-Hoeksema presents a very different perspective on the subject. This particular article analyzes eating disorders through the psychological perspective. The author of this article includes biological and cognitive factors associated with and contributing to the development of eating disorders. The article is written in a non-bias, third person point of view, and emphasizes the use of psychoanalysis to determine the origin of the disorder at hand. Contrasting from Are Eating Disorders Culture-Bound Syndromes?, this article focuses upon concrete, scientific data and internal influences of the individual in question, and how these aspects provoke particular thoughts, feelings, and behaviors. While both concentrations provide valid, plausible explanations, those in the field of cultural studies versus those in the field of psychology bear very contrasting reasoning regarding the development of eating disorders.

A cultural studies researcher would focus upon the ways in which “external forces” play a role in the development of eating disorders. In today`s society, abnormally thin models are plastered all over television, magazines, and billboards. Weight loss supplements and the newest, “most effective” exercise equipment are advertised constantly. It has become nearly impossible to escape implications of weight loss or attaining a “perfect body.” With this being said, a cultural researcher would push individuals to view eating disorders as a cultural issue; caused by societal standards and expectations of looking a particular way. This approach is evident throughout Are Eating Disorders Culture-Bound Syndromes? This particular article emphasizes that although anorexia nervosa and bulimia nervosa are two different eating disorders, both disorders revolve around the same objective: to lose weight. It is no secret that most people who want to lose weight want to do so in order to feel better about themselves. Yet, have we ever considered why being thinner provides a sense of satisfaction and pride? Why is it that we as humans cannot be content with the body that we were given? Cultural studies researchers would put the blame upon society. It is society that is constantly subjecting us to what is “beautiful” or “ideal” in regards to appearance. Some are capable of looking past society`s standards and being comfortable in their own skin. However, there are a plethora of individuals out there that cannot help but be dissatisfied that they do not match up to societal standards. Some will do anything to meet these standards, even if that includes a highly restrictive diet or means of purging. If these actions are persistent, the development of an eating disorder can be expected. According to Are Eating Disorders Culture-Bound Syndromes?, since the mid-twentieth century, the “ideal shape” for women has been portrayed as thinner and thinner (Keel & Klump, 2003). Models on the covers of magazines, beauty pageant contestants, and even Barbie dolls have all become representations of what we believe women should look like. The Psychological Bulletin claims that women who focus upon the media promoted “thin ideal” are more likely to develop an eating disorder. The social pressure to be thin has become even more prevalent on reality television. Cosmetic surgery programs such as Botched present individuals willing to pay hundreds of thousands of dollars in order achieve perfection. From liposuction to inserting artificial abdominal muscles, viewers are being exposed to what the ideal appearance of a human being is assumed to be. If men and women are willing enough to pay all this money to appear thinner, just imagine how much more tempting it may be to partake in eating disorder behaviors free of cost. Furthermore, television shows such as The Biggest Loser promote rapid weight loss through excessive exercise and starvation. Televised beauty pageants such as Miss America or Miss Universe literally reward women for being the “most beautiful,” partially determined through swimsuit competitions; judging the physique of the contestant. A study by the British Journal of Psychiatry concluded that individuals with an increased exposure to television, Internet access, and other forms of media were more likely to be reinforced with the “thin ideal;” dramatically increasing their risk of developing an eating disorder. It is not unusual for us as human beings to follow cultural norms, and to pursue the criterion we believe is necessary in order to endure within our environment. Unfortunately, through the use of media, society has established being thin as the norm we should be attaining. In an extreme effort to achieve this measure, eating disorder behaviors have become a common technique. For this reason, the media and current societal perception of thin as “beauty” can be to blame in the development of eating disorders from the cultural studies perspective; as stressed within Are Eating Disorders Culture-Bound Syndromes?

The impact of societal standards of weight can be further explained by the incremental theory. The incremental theory states that people believe they are “malleable,” and therefore “aspects of their self can be modified” (Arciszewski, 2012, p. 335). As people begin to frequently see a particular body physicality throughout the media, it becomes “implicitly presented as a norm” that they feel they should attain. Although the bodies of most models, celebrities, etc. are unrealistic and unattainable, the incremental theory explains that individuals continue to believe that they can achieve body weights as impractical as these; increasingly the likelihood of developing an eating disorder.

Contrasting from the cultural studies perspective, a psychologist would take cognitive and biological data into consideration when interpreting the development of eating disorders. From the psychological perspective, particular attributes, both cognitive and biological, of the individual make him/her more or less prone to develop an eating disorder. A psychologist would examine how these attributes influence thoughts, feelings, and behaviors associated with eating disorders. This approach is evident throughout the article “Eating Disorders.” The author of the article, Susan Nolen-Hoeksema emphasizes that anorexia nervosa, bulimia nervosa, or any other eating disorder are no different than any other psychological disorder; in that a genetic predisposition to these disorders is possible. In fact, a study of over 30,000 twins discovered a 56% heritability rate for anorexia nervosa (Bulik et al., 2006). Bodily systems and areas of the brain that “regulate appetite, hunger, satiety, initiation of eating, and cessation of eating” play a vital role in the development of eating disorders; primarily the hypothalamus (Nolen-Hoeksema, 2014, p. 350). The principal role of the hypothalamus is to regulate eating. Messages about food consumption and nutrient levels are sent to this part of the brain, signaling the body to stop eating once nutritional needs are satisfied. Carrying these messages to the brain would be impossible without the help of neurotransmitters such as dopamine, norepinephrine, and serotonin. An imbalance in any of these neurochemicals or functional issues of the hypothalamus could lead to difficulties in eating regulation; ultimately evoking an eating disorder. An imbalance of these vital neurochemicals or complications within the hypothalamus could cause the individual to have “trouble detecting hunger accurately or to stop eating when full,” both being common tendencies of people with eating disorders (351). Individuals with anorexia nervosa have been found to have lower levels of hypothalamus activity, and higher levels of serotonin and dopamine. Individuals with bulimia nervosa tend to have a dysregulation of serotonin. This dysregulation could cause the body to crave carbohydrates, leading to the episodes of binge eating experienced with bulimia nervosa. Prior to the binge, bulimics will feel guilt or fear of gaining weight, and then “get rid of” the recently consumed calories by means of purging (Attia & Walsh, 2007; Keet, 2012). Similarly, the frontal lobe has been associated with high levels of impulsivity. An increased level of impulsivity can often be a factor in eating-disorder behaviors such as restricting diets or purging (Polivy & Herman, 2002, p. 190). A psychologist could argue that biological irregularities such as imbalances of neurochemicals or functional issues within the hypothalamus or frontal lobe are leading factors in the development of eating disorders. The abnormalities of either of these features could make assessing fullness, hunger, and cravings troublesome; all being difficulties faced by individuals with eating disorders. Cognitive factors such as low self-esteem and an excessive need to achieve perfectionism have also been linked to the development of eating disorders. Individuals cognitively inclined to either of these conditions tend to engage in drastic measures, including dieting and purging, in order to control their weight (354). Individuals suffering eating disorders tend to possess specific personality traits. Structural and functional abnormalities play a role in the prevalence of these traits. People with eating disorders are commonly “people pleasers,” and highly concerned with the opinions of others; making them more likely to give in to the social pressures of being thin (Fairburn, 2008). With this being said, a psychologist could argue against the cultural studies perspective stating that cognitive abnormalities must be present in order for the individual to develop an eating disorder as a result of exposure to the “thin ideal” within the media. People with eating disorders also tend to speculate everything as good or bad. For instance, if they eat a couple of potato chips, they believe their diet has been corrupted as if they have eaten the entire bag. According to Cognitive Vulnerability to Emotional Disorders, individuals with eating disorders “obsess over their eating routines and plan their days around these routines, down to the smallest detail.” Eating-disorder behaviors can also be coping mechanisms for dealing with distressing emotions. The individual may be too distracted by their emotions to even care to eat, or begin to binge due to stress, feel guilty about the binge, and then purge. Therefore, individuals with depressive-like symptoms are at risk for developing an eating disorder (Bulik, 2005). A study by Health Psychology found that individuals who engaged in “emotional eating” in order to relieve distress were considerably more likely to develop an eating disorder over time. Clearly psychological researchers, such as Susan Nolen-Hoeksema, believe that individual traits such as these are not only commonly present within people with eating disorders, but affect the likelihood and severity of the disorder as well. 

The perspectives regarding the development of eating disorders contrast significantly between psychology and cultural studies; not limited to the contrasting perspectives present within Are Eating Disorders Culture-Bound Syndromes? Implications for Conceptualizing Their Etiology and “Eating Disorders.” The two perspectives are comparable to the question of “nature versus nurture.” Is the development of eating disorders a result of inherited and/or biological factors, or a product of environmental influences, such as the media? A cultural studies researcher would focus upon the ways in which “external forces” (society, cultural norms, etc.) play a role in the development of eating disorders; utilizing empirical data and cross-sectional studies; as done in the article Are Eating Disorders Culture-Bound Syndromes?. A cultural researcher would push individuals to view eating disorders as a cultural issue; caused by societal standards and expectations of looking a particular way. Contrastingly, a psychologist would concentrate on the examination of biological and cognitive factors pertaining to each individual, and discover the psychological reasoning behind the eating disorder of the particular person suffering; utilizing scientific data and concrete facts pertaining to the condition of the brain, and how the condition affects the individual; as done in the article “Eating Disorders”. Basically, psychologists are more concerned with how characteristics of the individual affect their own self, while cultural researchers are concerned with how the individual is affected by factors outside of their own self. Regardless of the differing perceptions, both concentrations can surely agree that development of eating disorders are a significant issue in today`s society.

Works Cited
Abramson, L.Y., Bardone-Cone, A.M., Vohs, K.D., Joiner, T.E., Jr., & Heatherton, T.F. (2006). Cognitive vulnerability to bulimia. Cognitive Vulnerability to Emotional Disorders, 329-364.
Arciszewski, T. (2012). Threat of the thin-ideal body image and body malleability beliefs: Effects on body image self-discrepancies and behavioral intentions. Body Image, 9(3), 334-341.
Attia, E. & Walsh, B.T. (2007). Anorexia nervosa. American Journal of Psychiatry, 164, 1805-1810.
Becker, A.E., Fay, K.E., Agnew-Blais, J., Kahn, A.N., Striegel-Moore, R.H., & Gilman, S.E. (2011) Social network media exposure and adolescent eating pathology in Fiji. British Journal of Psychiatry, 198, 43-50.
Bulik, C.M. (2005). Exploring the gene-environment nexus in eating disorders. Journal of Psychiatry and Neuroscience, 30, 335-339.
Bulik, C.M., Sullivan, P.F., & Kendler, K.S. (2003). Genetic and environmental contributions to obesity and binge eating. International Journal of Eating Disorders, 33, 293-298.
Fairburn, C.G. (2008). Clinical perfectionism, core low self-esteem and interpersonal problems. Cognitive Behavior Therapy and Eating Disorders, 197-220.
Keel, P.K. (2012). Empirical classification of eating disorders. Annual Review of Clinical Psychology, 8, 381-404.
Keel, P.K. & Klump, K.L. (2003). Are eating disorders culture-bound syndromes? Implications for conceptualizing their etiology. Psychological Bulletin, 129, 747-769.
Nolen-Hoeksema, S. "Eating Disorders." Abnormal Psychology. New York, NY: McGraw- Hill Education, 2014. 339-355. Print.
Polivy, J., & Herman, P. C. (2002). Causes of eating disorders. Annual Review of Psychology, 53, 187-213.
Stice, E. (2002) Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128, 825-848.
Stice, E., Presnell, K., & Spangler, D. (2002). Risk factors for binge eating onset in adolescent girls: A 2-year prospective investigation. Health Psychology, 21, 131-138.

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