,This essay will introduce the reader to three eating disorders namely, Anorexia
Nervosa, Bulimia Nervosa and Binge eating. The first section of this essay contains
diagnostic criteria and the clinical features of these disorders according to the
Diagnostic Statistical Manual Volume 5 (DSM-5). The second section will critically
discuss how South African black females are no longer perceived to be “immune”
from eating disorders.
An eating disorder is a psychological (mental) illness. It starts in the mind but it can
have dangerous effect on the body. Some people are obsessed with being thin
therefore they diet and exercise excessively. At opposite extreme are those who eat
extremely and cannot stop (Ambrose & Deisler: 2014).
Over the years there have been several attempts to set clinical or diagnostic criteria
to define Anorexia Nervosa, Bulimia Nervosa, Binge eating and other related eating
disorders. Classifications have been established by the World Health Organization
and the American Psychiatric Association. The diagnostic criteria however, changed
quite drastically with each revision, moving to what we can call an ‘eating disorder’
(Costin, 2016).
The DSM-5 expanded from previous editions by including Binge- eating disorder,
pica, rumination disorder, and avoidant/restrictive food intake disorder, in addition to
the more traditional eating disorders of Anorexia nervosa and Bulimia nervosa
(American Psychiatric Association, 2013).
Most people occasionally experience disordered eating and resolve to be more
restrained. Women make up 90% of sufferers from eating disorders, they struggle
between appetite and food adverts on one hand as well as the dictates of fashion on
the other hand (Morris, 2011). “For women with eating disorders, the rift between the
mind and the body has deepened over the years, and the chasm may be too wide to
mend easily.” (Kirkpatrick, 2018: p20). Detailed discussion of the above mentioned
disorders is done on the ensuing section.
, Section A
1. ANOREXIA NERVOSA DISORDER
According to (Treasure & Alexander, 2013) the word Anorexia means loss of
appetite. Anorexia is more like self starvation where someone becomes so obsessed
with losing weight and dieting that he or she ignores the body’s hunger signals. They
went further to say although a person with anorexia is always hungry, he or she
takes pride in denying hunger, feeling more in control and independent.
The DSM-5 describes Anorexia Nervosa as loss of appetite which is distinguished by
three core criteria, namely: (1) persistent restriction of energy intake, (2) a great fear
of becoming fat and (3) disturbance in self-perception of body shape or size. There
are two subtypes of the disorder which are referred to as restricting type and binge-
eating/purging type.
Restricting type involves weight loss through severe dieting or exercising, 15% below
the ‘Body Mass Index’ (BMI). The binge-eating/purging type involves self-induced
vomiting or use of laxatives or diuretics to control weight, often after binge eating.
There do not appear to be any studies in South Africa that suggest anorexia nervosa
among black females. However, we cannot be too hasty and dismiss anorexia
nervosa among black South Africans (Le Grange, Louw, Breen, & Katzman, 2004)
The student understands Anorexia Nervosa to be a psychological illness that causes
one to starve themselves as a result of extreme fear of being fat. The person has the
perception that they are fat /big despite contrary evidence that they are not. They
maintain their desired body by eating less. Keeping a thin body is a great
achievement.
1.1 DSM-5 diagnostic criteria for Anorexia Nervosa Disorder