Running head: ANOREXIA NERVOSA IN ADOLESENT GIRLS

Anorexia Nervosa in Adolescent Girls: Impact on Mental Health

Olha Kovalenko

Masaryk University
ANOREXIA NERVOSA IN ADOLESENT GIRLS

Introduction
 

In the last fifteen years, the obsession of being skinny has increased by more than fifty

percent among 12–18-year-old girls. In 2015, the national Gallup poll manifested that in a

group of five teenage girls three of them are exceedingly concerned about their "extra"

kilograms and want to lose weight. Together with dangerous approaches to diets, most young

girls pursue extreme measures, such as fasting, vomiting, exercising till losing consciousness,

or using laxatives and diuretics. Our time is afflicted with anorexia. Whenever there are

conversations about the "ugliness of fullness", criticizing others' appearances, and mocking

surpluses, a sensitive girl is traumatized and the idea of attaining the "standard of appearance"

becomes the basis for forming exaggerated standards. Magazine covers depict women with

ideal parameters and shapes, which are considered the standard of beauty and role models.

These photographs are often additionally computer-enhanced and taken in near-perfect

circumstances. The average woman could not possibly compete with these images. The media

screams about beauty standards, and the message that thinner is better is everywhere,

exposure to this can increase body dissatisfaction in girls. We often see ‘perfect’ bodies and

start comparing ourselves with edited and unrealistic pictures of women. Weight stigma is

discrimination or stereotyping based on a person’s weight and is damaging and pervasive in

our society (National Eating Disorders Association, 2019). But, despite the physiological

impossibility to achieve this ideal, girls still try to change themselves, setting unrealistic

goals, thus harming their health. We can say that young girls become victims of propaganda

and stereotypes about the female body that have been formed in society. 

Anorexia nervosa (further AN) is primarily associated with a fear of gaining weight on

the one hand and a feeling of low self-esteem on the other. Anorexia is adopted by girls as a

radical, powerful means of losing weight. AN is characterized by a refusal to maintain body

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weight, an intense fear of gaining weight, and a disturbance in the way body weight or shape

is experienced (American Psychiatric Association, 1998). It is a serious and potentially lethal

illness, which may result in death in 10 percent of cases. Anorexia nervosa is characterized by

the relentless pursuit of thinness, emaciation, and the obsessive fear of gaining weight. The

eating disorder has a huge and dangerous impact on teenage girls’ nervous system, which at

their age has not yet fully formed. To understand the extreme danger of anorexia nervosa and

why it is still around us, we have to look at the factors that lead girls to this psychological

illness and how it affects their mental health and changes their behavior. 

Reasons of Appearing

The female body has become an object of critical evaluation and objectification since

the advent of the term "fashion". In adolescence, appearance plays an important role.

Increased attention to one's appearance, mockery of peers, careless remarks by authoritative

persons for the girl, especially her father or brothers, and incorrect speeches of envious

girlfriends can play a fatal role in the development of anorexia nervosa. This happens, as a

rule, in socially quite successful families. Before girls` first period they don`t usually think

about dieting and the term ‘diet’ they will probably explain as ‘healthy eating’. After young

women have grown taller, menstruated, and increased their body weight that their perception

of dieting includes the idea that dieting aims to lose weight. 13-year-old students from junior

high and high schools in Toronto, Ottawa and Hamilton, trying to lose body weight, were

asked if dieting was different after their first period and lots of girls had such answers as:

“Dieting becomes more serious and you think about it more”, “I put stacks of weight”, “You

feel you are getting fat”, “I worry what people think – mostly boys”, “I try to lose weight for

my boyfriend” (Jones JM, Bennett S,…). Analyzing the answers, we can notice that most girls

started feeling uncomfortable in their bodies and can`t get used to their body changes.

Anorexia nervosa develops, as a rule, in three stages. The first stage is when the girl ceases to
ANOREXIA NERVOSA IN ADOLESENT GIRLS

like herself in the mirror: her figure, weight, and size, and, therefore, for the first time the girl

has the idea that something needs to be changed in life. At best, it will be the right approach

to the problem: exercise, the right diet without restrictions and harsh measures, that is, the

right desire for a healthy lifestyle. It is very important that with anorexia nervosa, the girl does

not stop at this and, accordingly, the second period begins, when it seems to her that such

measures (sport, diet) are not enough, and therefore she loads herself with even greater

physical exertion, the number of diets increases, the calorie content of products decreases, and

now, there is already a loss of body weight by 10, 20, or even 30 kilograms. She still does not

like her in the mirror and continues torturing herself. As a rule, the so-called "evacuation" of

food is added to physical activity and strict diets. The girl tries to remove only the eaten food

from the body by resorting to artificially induced vomiting, and the use of diuretics and

laxatives, and, accordingly, the result of the third stage is serious health problems. There are

drastic changes in eating behavior: the girl begins to monitor the calorie content of food, the

time and place of eating, drink extremely much water, avoid carbohydrates and fats. There are

lots of factors, that lead to the such dangerous eating disorder, let`s focus on mental reasons

that on most occasions cause eating disorders. 

Bullying

Bullying is one of the most common factors among anorexic girls. It can be existed in

family and come from parents and siblings, for instance, parents tell the girl to lose weight,

forbid eating specific products and food, explaining their actions for the benefit of the child,

but do not even notice that such actions lead to developing of anorexia nervosa and harming

their children mental health, attitude to themselves. Girls suffer from parents and try to lose

weight by looking for extreme measures, start restricting food, do too much sport, and do not

notice how they destroy themselves and their mental health. In addition, if in the family there

is a person with anorexia nervosa, for example, a mother, it will be a big risk for her daughter
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to become anorexic as her parent. That is because children often take after their parents and

unconsciously follow their habits and lifestyle. Usually, girls pay significant attention to other

people, most of their age, and compare themselves with other adolescent girls. The pressure

from friends or classmates, sometimes it could be bullying or girls just trying to follow their

friends in dieting. It can be a trigger, if one of her friends starts dieting, the girl decides that

she also must lose weight. Anorexics take to heart any comment in their direction about the

body, and because of it, the most common triggers for girls are people, who once or more

comment on their appearance. Sometimes even an unfamiliar person can become a starting

point for a girl to fall into a vicious and endless circle of starvation, overeating, and self-

hatred. 60% of those affected by eating disorders said that bullying contributed to the

development of their eating disorder (National Eating Disorders Association, 2019). 

Media influence

The good news about online health information is that the Internet can in deed be a

useful tool for better understanding anorexia, learning about treatment options, and locating

community, support. Proactive eating disorders organizations such as the Academy for Eating

Disorders (AED), the National Association for Anorexia Nervosa and Associated Disorders

(ANAD), and the National Eating Disorders Association (NEDA) maintain helpful Web sites

that provide information and resources for anorexia patients and their loved ones, as well as

for the public. The Internet is also fast becoming a treatment tool. Although research in this

area is limited, preliminary results show that certain forms of Internet-based intervention may

provide a future complement to traditional face-to-face treatments (Shepphird, 2009).

Unfortunately, while there are many Internet sites that offer practical and helpful

information about anorexia, there are also numerous Web sites that host just the opposite,

offering information that is inaccurate, misleading, and even dangerous. The past decade has

witnessed a surge in popularity in a genre of Web sites referred to as "Pro-Ana' (pro-anorexia)

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and "Pro-Mia" (pro-bulimia) in their content (Shepphird, 2009). Users and hosts alike are

predominantly teenage girls who engage in unhealthy dialogue about anorexia nervosa, body

image, and other issues related to disordered eating. Alarmingly one of the main ideas

promoted on these Web sites is that anorexia is a lifestyle choice, not an illness. Eating

disorders are heralded as a means of achieving "perfection”, and attempts are made to aid

others in disordered behaviors by providing information about purging agents, ideas for

severely restricting food intake, and "tips" for "staying strong" in the quest for the "perfect "

body. Slogans, poems, personal stories, and photographs of dangerously underweight women

and are offered to girls. Hosts and visitors alike share thoughts on ways to keep their

behaviors hidden from loved ones, oppose intervention from healthcare professionals and

refuse family involvement in recovery. The proliferation of these Web sites is of great

concern. In addition, Pro-Ana content is popping up on popular social networking sites such

as MySpace and Facebook, technologies used by upwards of 80-96% of all 12- to 17-year-

olds (Shepphird, 2009). A recent study published in the medical journal Pediatrics showed

that teens looking for eating disorders information on the Internet are more likely to be

hospitalized for their condition than teens who do not seek such information online.

Through compliments and admonishments, through images and words, she

discovers the meaning of the words pretty and ugly; she soon knows that to

be pleased is to be pretty as a picture; she tries to resemble an image, she

disguises herself, she looks at herself in the mirror, she compares herself to

princesses and fairies from tales. (Beauvoir, Simone de, 1949 [2010: 304]).

Perfectionism

One of the strongest risk factors for anorexia nervosa is perfectionism, especially self-

oriented perfectionism, which involves setting unrealistic expectations for yourself.  It’s sadly

not uncommon to dislike your appearance, but girls who develop eating disorders are more
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likely to report higher levels of body image dissatisfaction and internalization of the

appearance ideal.  Body dissatisfaction has been classified as one of the main diagnostic

characteristics of eating disorders (Galanter & Kleber, 1994). Individuals with eating

disorders suffer from severe feelings of fatness and unattractiveness and are characterized by

intense body loathing (Cash & Deagle, 1997). 

Anxiety

Social anxiety and low social skills can lead to the development of anorexia nervosa.

Girls are afraid of communicating and being in public, so they want to be invisible to others,

deciding to become as skinny as possible to protect, as they suppose, themselves from people.

Teenage girls avoid groups of their age and are closed and stressed. For them, being skinny is

a way to disappear and be unnoticed by other people. Lifetime anxiety disorders were

reported in approximately 60% of women with anorexia nervosa (Bulik CM, Sullivan PF,

Fear JL, Joyce PR, 1997). Anorexic patients often report that their anxiety generally centers

on a fear of criticism or humiliation from people when in public. Girls are afraid of judging in

both body shape and size, for what and how much they eat. Teenagers do not feel safe and

always think about the criticism of their personalities, they suffer from self-loathing, self-

criticism, and shame. Eating disorder sufferers are extremely vulnerable to negative thoughts,

whether it is their own, others, or even how they perceive others to feel about them. (National

Eating Disorders Association, 2019)

Anorexia nervosa and attitude to food

Eating behavior changes a lot during the period of anorexia nervosa. Girls are

obsessed with counting calories and controlling their eating. Teenagers follow a strict diet and

sometimes practice starvation, to see results on the scales. Every time girl thinks about the

food she ate and recounts calories, can keep a diary. As an attempt of avoiding eating, they

often cook for their family, but never eat, because girls try to use as high-calorie food as
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possible, so anorexic girls are sure that they will not eat that food. Not only calorie

calculations stuck in girls` heads. They avoid ‘dangerous’ food, as they believe, (the food

which can lead to overeating, e.g., chocolates, chips, pasta, bread) divide food into ‘good’ and

‘bad’. She blames herself for every eaten calorie and punish by hard training or taking

laxatives. The girl avoids events and celebrations with food because it threatens to overheat.

An anorexic girl refuses to let anybody watch her eating. She tries not to eat with others and if

she is forcibly seated at the dinner table – the girl will pretend eating or just stare at her empty

plate, thinking about how fat she is. The girl will not eat even if family members try to force

her. One way to achieve control and avoidance of food may be to impose distance between

the self and food by infusing it with disgusting properties. This enables the avoidance of food

and food-related stimuli that would act as a trigger for eating. (Jayne Griffiths & Nicholas A.

Troop, 2006.) As such, food may be transformed by disgust into a forbidden substance that

should not be incorporated into the body (Orbach, 1986). 

Attitude to body

Girls have an unhealthy attitude toward their bodies, problems with adequate physical

condition assessment, and constant obsessive thoughts about their bodies. They concentrate

too much on their body, so it becomes an obsession. Anorexics spend most of their day

looking in the mirror, searching for the slightest changes. She takes pictures and videos

herself almost every day to see the progress. The girl has panic attacks if she notices small

changes in her body or sees small weight gain, even if not thinking about that it could be just

stagnant water in the body. Many of them are extremely bright, but, surprisingly, anorexic

girls cannot remember simple statements made just a minute ago. They seem immobilized by

the eating disorder and remain focused on only one thing: avoid eating.  Psychotherapists

consider anorexia as a way to remain a child: the girl bodily returns, as it were, to pre-

adolescence, becoming a girl again. Often it happens due to the fact that the role of a girl, the
ANOREXIA NERVOSA IN ADOLESENT GIRLS

ability to identify oneself with a woman unconsciously frightens a teenage girl very much,

and dietary restrictions make it possible to influence this process.

Conclusion

Anorexia nervosa is a common mental illness among teenage girls, who face the

problem of getting old and notice changes in their bodies. In the teenage years the identity is

being formed, the girl investigates her peculiarity, asks and tries to find out the answers to her

questions: «Who am I?», «What am I like?» and, what is the most important for the topic of

eating disorders, «How do I want to look like?». The illusion «I will be slim – I will become

beautiful» is formed. Lots of girls from a young age understood from mass media that

attractiveness is the most important for a woman and think that anorexic models from

magazines are the best example to follow. Girls become the first victims of the fashion world

and advertisements thus, they know about the dangerous risks, but it does not stop them,

because of the desire of being pretty and comply with general beauty standards. The

consequences of anorexia nervosa are harmful to mental girls` health. It significantly changes

their life: habits, way of thinking, attitude toward themselves and their surroundings. AN is

still existing in our society because many people still try to follow the lives of others, criticize

their appearance, etc. The modeling business is just beginning to abandon outdated beauty

standards, but there are still people who believe that a beautiful body equals a thin body. With

the advent of social networks, adolescents have access to various publics that can injure and

affect their worldview, including in relation to their appearance. The thin body propaganda

still exists in the media space and people are growing up with inflated standards in

representing the female body. The influence of the patriarchal society is reverberating as

women are sexualized and given unnatural body proportions in the media. The lack of sexual

education can also be considered one of the factors in the existence of anorexia today. People

don't know enough about the built body, and when they see a Playboy girl, they want to look
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exactly like her, without even thinking about having a huge layer of photoshop and the right

angle. Due to the cult of a beautiful body, we forget that each body is unique, and we are not

obliged to follow someone's requirements and advice on how we should look.

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