Critically evaluate the relative importance of BIOLOGICAL PSYCHOLOGICAL AND SOCIAL FACTORS IN THE PREVENTION OF EATING DISORDERS Abstract Definition The American Psychiatric Association APA describes eating disorders as characterized by a chronic disturbance of eating that damages health and or psychosocial functioning APA 2013 The fifth and last version of the Diagnostic and Statistical Manual of Mental Disorders DSM 5 from the American Psychiatric Association distinguishes between five types of eating disorders Anorexia Nervosa AN Bulimia Nervosa BN Binge Eating Disorder BEN and Avoidant Restrictive Food Intake Disorder ARFID which is more common in children Treasure 2016 Furthermore the DSM 5 includes two new categories of eating disorders that are Other Specific Feeding or Eating Disorder OSFED and Unspecified Feeding or Eating Disorder UFED these two categories aim to acknowledge the conditions that do not fit more precisely in any of the eating disorders mentioned previously Eatingdisorders 2016 The disorder or Anorexia Nervosa is diagnosed when someone s weight is 15 below the expected weight for them according to their height age and sex together with a strong aversion to gain weight and an excessive preoccupation with their weight and food intake 

Treasure 2016 There are two subtypes of AN depending on the presence or absence of binge eating or purging the restrictive type patients employ restrictive behaviours such as under eating and over exercising and the purging type patients use vomiting and laxative abuse Beumont 2002 The Bulimia Nervosa shares some common features with AN Garfinkel 2002 such as an intense preoccupation with body weight and shape It occurs when someone experiences regular episodes of uncontrolled overeating and then takes extreme measures of counteracting weight gain such as vomiting and laxative abuse in BN patient s weight fluctuates within the normal range Hay Claudino 2010 Binge Eating Disorder is the most common disorder amongst adults its main features are frequent and constant overeating episodes that are connected with feelings of loss of control over eating these behaviours are not accompanied by inappropriate compensatory behaviours as in BN Turan Poyraz Özdemir 2015 Patients with Avoidant Restrictive Food Intake Disorder may present similarities to patients with AN as both disorders lead to deficient food intake Strandjord et al 2015 However ARFID patients goal is not to control weight they want to avoid the potential consequences of eating such as vomiting or chocking or they might lack of the interest on food intake Nicely et al 2015 Diagnosis and prevalence Eating disorders and similar behaviours are a usual problem in pre adolescents and adolescents Nicholls 2011 A study on a considerable sample of American young people aged between 9 and 14 years old found that 34 of boys and 43 5 of girls had an eating disorder trait Treasure 2016 These results show how relevant the issue of eating disorders is within teenagers population The lifetime female prevalence rates are around 0 9 for AN 1 5 for BN 3 5 for BED and 10 for subclinical disorders 

Treasure 2016 However less than a 20 of cases of eating disorder agree to receive a treatment Hoek 2016 In a study that aimed to estimate the annual incidence of diagnosed eating disorders in primary care over a 10 year period between 2000 and 2009 in the UK it was found that the incidence of BED increased to 25 per 100000 with its peak onset at 18 years old the incidence of BN stabilized following its rapid increase in the 90s at 22 per 100000 and the incidence of AN has been stable at 15 per 100000 over the last forty years most commonly beginning at the age of 16 Micali et al 2013 In 2016 Treasure identified some gender differences across diagnosis and setting For instance the female male ratio was 10 1 for AN and BN however in the community and child and adolescent settings she found that the ratio was 3 1 This finding suggests that there are limitations in reference to recognize and to accept an illness that is usually attributed to the female gender Community based studies showed that binge eating disorder is more common in obese populations Grilo 2002 Unlike BN and AN the gender ratio in BED is more equalized being around 1 5 1 female to male ratio Smink Van Hoeken Hoek 2012 BED is also the most common eating disorder in adult populations

Turan Poyraz Özdemir 2015 These data shows how eating disorders influence an important part of the population and suggests the need for interventions to prevent these illnesses and to stop these numbers from increasing Preventing the condition Family biological social and cultural factors play an important role in the development and or maintenance of eating disorders Treasures 2016 Most of the early prevention programs approached a single social factor generated for the media of cultural pressure for thinness These prevention programs aimed to emphasize healthy nutrition and weight management as well as cease the unrealistic pressure for leanness Stice 2002 Susceptible populations Epidemiological studies have shown that eating disorders are not randomly distributed among the population Hoek 2002 Young women seem to be the most vulnerable group This might be associated to the subordinate position of women s in society the gender role socialization and the current female ideal of excessive thinness Striegel Moore Smolak 2002 This idea has led research to study the relationship between eating disorders and social and cultural factors

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