Suggest and explain at least 3 plausible causes, which may have led a client to develop an eating disorder. Suggest some practical steps you could suggest a client put in place to overcome each of them.

Suggest and explain at least 3 plausible causes, which may have led a client to develop an eating disorder. Consider mass media, bullying, lack of education, existing mental health problems, and failed attempt at weight loss.

The causes of eating disorders could be split into the following categories; mental health, interpersonal, social, biological and genetic.

1. Mental health issues

Some individuals have psychological traits or imbalances which have led to low self esteem, often experiencing feelings of inadequacy or having a lack of control in their life. Some experience depression, anxiety, anger, loneliness or stress; by controlling their food intake they gain some control over these feelings. Some people may have had failed attempts at weight loss causing any of the above mental health issues, which leads to taking dieting or control of food to an extreme, leading ultimately to an eating disorder.

2. Interpersonal issues

Bullying or teasing about weight, race, ethnicity or appearance or, in fact, any issue can lead to people to take extreme control over their diet or comfort eating and purging to deal with the problem and/or to fit in. Difficult personal relationships, a history of sexual or physical abuse, and adverse childhood experiences affect the way people see themselves and their role within society. They may see themselves in a negative light and be striving for perfectionism as they see others; one way of achieving this is to appear desirable on the outside by controlling their body image/ size.

3. Social factors

Lack of education can lead to eating disorders. For example, when children or their parents have missed out on schooling or have not received information about good nutrition, self-care and the results of long term effects dieting and extreme food control. They are then not in a position to curb behaviours that encourage mental health issues or feelings of dissatisfaction. These feelings are then displaced and food is used as a tool to gain the things they feel they lack.

Cultural pressures, often influenced from the mass media (billboards, magazines, instagram, you tube), of having the perfect body can lead to individuals developing eating disorders. There is a narrow definition of beauty seeing only thinness or a specific shape as beautiful. It has become a cultural norm to value people based on appearance rather than inner qualities. There are links between this and people feeling as though they don’t fit into society and abnormal eating.

Eating disorders appear to be mostly confined to countries where food is abundant, thinness is marketed as a desired image and dieting is normal behaviour. Although the media expose us to these images they will create dissatisfaction in individuals with the traits above; they use these images as motivation towards their goal. Polivy and Herman, 2001 (as reported in Geissler and Powers Human Nutrition) have said that sociocultural factors channel dissatisfaction felt towards a focus on body shape and size. This is an outlet for individuals pathology resulting in thinness being pursued by those who can see no better way to solve their problems.

4. Biological factors

Still in the research phase, imbalances have been noted in those chemicals which control hunger and digestion. These chemicals would affect a persons motivation towards what they ate, when and how often. This results in a battle with a persons conscious thoughts on what they should be eating and how they desire to look, leading to mental health issues and eating disorders.

5. Genetic factors

Current research shows that there is a genetic factor linked to eating disorders. The most recent studies show that an individual who has a close relative (parent or sibling) with an eating disorder is 11 times more likely to develop one themselves. Twin studies have shown that 40-60% of the risk of developing an eating disorder is genetic, although the specific genes have not been identified yet.

Other studies have shown that genes involved with mood, appetite regulation, reward, food intake, and weight regulation all lead to the development of an eating disorder. More specifically researchers have discovered this is likely related to the involvement of serotonin. Studies have been difficult to draw convulsive results from as there isn’t one gene responsible but a selection all playing a small part to increase the risk.

Genetics is not the sole instigator of developing an eating disorder and combines with environmental factors e.g. certain genes may predispose an individual to behave in a certain way under external pressure.

An individual that develops an eating disorder is likely to have been affected by a combination of all of the above issues and factors.

Consider each of the barriers to change above, suggest some practical steps you could suggest a client put in place to overcome each of them.

I’m not sure that the causes of eating disorders as discussed in task 1 are always the same as the barriers to wanting to or being able to lose weight. However, I will pick a specific point from each of the causes to discuss as though it were a barrier and how a client may be able to overcome it.

1. Mental health issues; stress.

If stress is causing bad eating habits leading to an eating disorder it may be appropriate for the client to look at the causes of stress. Is work particularly difficult at the moment for example. Can the workload be managed differently to relieve the stress, would meditation at break times help to unwind before eating or can eating to deal with stress be replaced by going for a walk or to the gym instead?

2. Interpersonal issues; bullying.

If the client is experiencing bullying, which has resulted in an eating disorder, I would suggest that the client may like to try the following; if they feel safe to do so, speak to a superior to directly address the bullying behaviour. This can work towards removing the cause of the eating disorder. The client may prefer to find/ create a support network of people experiencing similar issues or have similar interests outside of the issues they experience, this can be a distraction from the negative behaviour/ emotions and strengthen positive relationships/ emotions. If the client doesn’t feel that they are able to do these steps at this time 1-1 counselling may be of benefit to address how they react to the bullying to help create coping strategies away from relying on food

3. Social factors; feeling as though they don’t fit the normal/ desired image

If these thoughts were leading towards the client developing an eating disorder I would suggest to look at the reality of the images they are seeing. For example many photos are staged to catch the subject at just the right angle or are edited to create the image they want to portray to the world for example these images by Chessie King: Celebrities are outfitted often for free in the best clothes available and have the funds and flexibility to have personal trainers and caterers – they also put themselves under extreme pressure to look a certain way; but are they happy or comfortable with what they do? The rise in reported mental health issues among the stars suggest not.

Counselling and seeking advice and guidance from a weight management consultant are great first steps. I would encourage clients to consider what they are unhappy with and why. Feeling dissatisfied with the shape of your nose may take you down a path of using tapping or other techniques to free yourself from negative thinking and accepting who you are. Feeling dissatisfied with dress size would lead to discussions about realistic goals why they became that weight and steps such as addressing nutrition imbalances and exercise plans to each a goal.

Find a positive role model that the client can follow for inspiration both mentally and physically. Look around the supermarket these people are the genuine representations of normal or average.

Some clients will have a deeper seated psychological trait that can’t be reasoned with and these clients will need further help from doctors and mental health practitioners.

4. Biological factors; chemical imbalances

While these are little recognised if tests have confirmed that an organ/ gland/ hormone is not functioning properly in the body I would advise my client to find out as much as they can about how this imbalance effects their body. Through knowledge they can gain control over their behaviour towards the effects of the imbalances. Maybe doctors can prescribe medication to address the imbalance or the client may discover certain foods need to be eliminated (under the supervision of a dietician) or certain exercise routines need to be put in place (with a personal trainer).

5. Genetic factors

Again the client would need to have found out from medical professionals what the genetic predisposition means to their overall health. That knowledge can be used to fuel the direction they focus their behaviour towards food. Visualisation can help clients to gain perspective on their goals and focus their intent. They can try to make positive connections between eating/ exercise and emotional happiness and take control of these rather than focussing on the factors that are out of their control. Creating positive mantras to motivate clients may also help as well as setting goals that are achievable, being in control and managing behaviour in small positive steps.

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