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英国essay论文精选范文：“Neurogenic bulimia and overeating”，这篇论文讨论了神经性贪食症和暴饮暴食症。神经性厌食症是人们过度减肥而导致的一种饮食失调症。患有神经性厌食症的人往往会拒绝进食或以其他极端的方法减肥。而暴饮暴食症是一种饮食行为障碍的疾病。患者经常会在特殊情况下引发暴食行为，但又怕变胖，最后用非正常地手段来清除已吃的食物。

“The field of eating disorders, although still in its infancy, has involved into a sophisticated, multidisciplinary area of research and treatment.” 1But we do understand more about the eating disorders: anorexia nervosa, bulimia nervosa, and binge eating disorder.

Anorexia nervosa is an eating disorder with the remarkable character of pursuing weight loss that far beyond the normal range.1 This syndrome usually performed as a fear of fatness or pursuit of thinness.3 People with anorexia nervosa have distorted body image and often refuse to eat or lose weight by other extreme methods. 2Bulimia nervosa is an emotionally based disorder that foods are used to satisfy the inner need psychologically rather than physically. Bulimic people feel a powerful urge to eat to meet the abnormal satisfied full feeling. In their “good days”, they usually have no compulsion to binge eat. Binge eating disorder is the most recently described one. 2Patients of binge eating disorder binge eating without the use of compensatory behaviors. They intake excessive foods that far more than the amount normal people need to maintain good nutrition. And people with binge eating disorder do not have anorexia nervosa; neither do they have bulimia nervosa because they don’t use methods like starvation, self-induced vomiting, and laxative to control weight. 4

Between anorexia nervosa and bulimia nervosa, many similarities and differences exist. Both patients over evaluate their shape and weight. Usually normal people assess themselves on the basis of their performance in various domains such as relationships and work.5 However, people with anorexia nervosa and bulimia nervosa judge their self worth exclusively, in terms of body shape and weight and even their ability to control them. In anorexia, there is a sustained and determined pursuit of weight loss. Self induced vomiting and other extreme forms of weight loss behaviors such as misuse of laxatives or diuretics. These patients tend to view their low body weight as a success or accomplishment rather than a torture. But in bulimia nervosa, similar attempts to control body shape and weight undermined by repeat uncontrolled overeating. In a word, both anorexia nervosa and bulimia nervosa patients take extreme methods to lose weight but anorexia nervosa patients don’t have binging eating while bulimia nervosa patients have. The symptom of both disorders also worth to mention. Depression and anxiety disorders are often prominent. Sometime also have liability of mood, impaired concentration, loss of sexual appetite. Other medical complications and health risks include concentration and fatigue loss, skin dryness, abnormal heart function, brittle fingernails and etc. 6

Bulimia nervosa and binge eating disorder share the same symptom of binge eating and limited overlap.5 From the meaning of character, Bulimia means insatiable appetite in Greek that sounds really close to binge eating. Bulimia nervosa can be divided into two types: (1) use of self-induced vomiting, laxatives, or enemas following a binge eating, and (2) use of other inappropriate compensatory behaviors such as excess exercise to avoid weight gain. Binge eating disorder is exactly same as the binge eating part of bulimia nervosa. People with bulimia nervosa usually feel a strong wish to eat and this urge is driven by the belief that the satisfaction could only be achieved by giving into a craving food that is much more intense feelings of hunger. Nowadays many therapists refer to binge eating disorder as compulsive overeating. This disorder usually divides into two common patterns: compulsively snacking over long intervals and consumption of large amount food at one time. Both beyond the requirements to satisfy normal hunger significantly.7However, binge eating disorder occurs against the background of a general tendency to overeat while bulimia nervosa usually go with the dietary restraint.

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Why do eating disorders occur? All three eating disorders anorexia, bulimia nervosa and binge eating have some explanations though none has been proved conclusively. First is the adolescent development explanation. Some adolescents who diet may become so concerned about weight control that their eating behavior escaped from normal and they develop anorexia nervosa. Those who respond to diet by experiencing out of control part may develop bulimia nervosa or binge eating disorder. 8Another is physiological explanation. One hypothesis suggests that an increase in opioid activity occurs in brain that makes people happy when potential anorexia nervosa patients eat inadequate amounts of foods. This “addiction” will lead to more serious anorexia nervosa. It is possible for bulimia nervosa patients that they become sensitized to one or more neuropeptides that drive people to eat. Also, current studies suggest that there exist a defective gene or a combination of genetic factors is the cause of disorders could be true in 50%-80% of anorexia nervosa and bulimia nervosa cases. 8A proportion of eating disorder patients have had childhood experiences that have an impact on later life. Especially women who binge eat or induce vomiting. Eating disorders become ways of abreaction for them. Although eating disorders have many roots, socio cultural pressures cannot be ignored.2People showed the awareness of appearance importance since an early age. The current western culture conception of feminine beauty emphasizes thinness and attractiveness.10More and more women want to achieve an unrealistic ideal by dieting. Phelps and colleges found that concern about body weight increased sharply when girls reached puberty, as did eating disordered behaviors such as self-induced vomiting. 11

Psychological treatments are more effective than drug treatment for all three eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder. There is moderate evidence proved that family based therapy for adolescents has moderate beneficial effect on anorexia nervosa. This involves the family preparing the food and supervising meals and snacks the child must eat. This treatment really works but it could be difficult if both parents are working or the patient become older. By this stage, patients usually are able to return to school or work.  Strong evidence proved that cognitive behavior therapy has moderate beneficial effect on bulimia nervosa since most patients have low self-esteem and moderate evidence proved this therapy has moderate beneficial effect on binge eating disorder. Interpersonal psychotherapy also has moderate beneficial on binge eating disorder proved by modest evidence. Controlling the amount of food intake plus exercise or even the surgery could help binge eating disorder patients control body weight.5

The review of the literature on the incidence and prevalence of eating disorders by two-stage screening approach found that young females have average prevalence rate for anorexia nervosa of 0.3% and the trend from 1935 to 1989 is significant linear increasing and the prevalence rates for bulimia nervosa were 1% and 0.1% for young women and young men. The estimated prevalence of binge eating disorder is more than 1%.Trans- cultural studies showed that anorexia nervosa was rare in non- Western countries in the 1970s and 1980s. 12 However, more recent studies have demonstrated that abnormal eating attitudes and eating disorders, in particular BED and bulimia nervosa, frequently occur in traditional as well as in developing countries and among Whites as well as among Blacks and Asians13. Unfortunately, only small amount of patients with these eating disorders receive mental heath care that means majority people with anorexia nervosa, bulimia nervosa or binge eating disorder lack adequate treatment.

Reference

1.Raymond L.,Leigh C”Eating Disorders a Reference Sourcebook”, Revised Edition. Oryx Press, 1999, P12.

2.Raymond L.,Leigh C”Eating Disorders a Reference Sourcebook”, Revised Edition. Oryx Press, 1999. P14.

3.Suzanne Abraham, “Eating Disorders”, 6th Edition, Oxford press, 2008. P23

4.Suzanne Abraham, “Eating Disorders”, 6th Edition, Oxford press, 2008. P34

5.Fairburn CG, Harrison PJ. (2003).Eating disorders. Lancet. 361(9355):407-16

6.Raymond L.,Leigh C”Eating Disorders a Reference Sourcebook”, Revised Edition. Oryx Press, 1999. P9

7.Raymond L.,Leigh C”Eating Disorders a Reference Sourcebook”, Revised Edition. Oryx Press, 1999. P6

8.Suzanne Abraham, “Eating Disorders”, 6th Edition, Oxford press, 2008. P41

9.Suzanne Abraham, “Eating Disorders”, 6th Edition, Oxford press, 2008. P46

10.Rodin, J. , Silberstein, L. and Striegel-Moore, R. (1985) `Women and Weight: A Normative Discontent', in T.B. Sonderegger (ed.) Nebraska Symposium on Motivation 32: Psychology and Gender, pp. 267-307. Lincoln: University of Nebraska Press.

11.Phelps L., Andrea R., Rizzo F., Johnston L., & Main C., 1993, Prevalence of self-induced vomiting and laxative/medication abuse among female adolescents: A longitudinal study. International Journal of Eating Disorders, 14(3), 375-378

12.Ballot et al., 1981; Buchan & Gregory, 1984; Buhrich, 1981; Famuyiwa, 1988; King & Bhugra, 1989; Lee, Chiu, & Chen, 1989

13.Ghazal, Agoub, Moussaoui, & Battas, 2001; Hoek, van Harten, van Hoeken, & Susser, 1998; Huon, Mingyi, Oliver, & Xiao, 2002; Lee & Lee, 1996; Mumford, Whitehouse, & Choudry, 1992; Nakamura et al., 2000; Nobakht & Dezhkam, 2000

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