Perceptions of anorexia by professionals working with anorexic clients

Abstract

Anorexia is one of the dangerous eating disorders with a high mortality rate (Arcelus, Mitchell, Wales and Nielsen, 2011). It is mainly a disorder occurring in adolescent girls (Sim, et. al, 2012) but male anorexia is on the increase (Saban, 2006). It is caused by body-image distortion (Keizer et.al, 2011) and extreme dieting. There are many factors that account for but media is implicated as the most influential by imprinting a sense of thinness as the ideal body (Thomsen, McCoy and Williams, 2001 ). This is leaving negative consequences for the sufferer. The main objective of this study was to identify the different health professionals and their own understanding, perceptions and management of anorexia nervosa. In doing so, a more holistic picture could be captured. A qualitative approach was used. Five health professionals working with anorexic people were interviewed. The study was conducted at Dar Kenn Għal-Saħħtek where specialized care and attention is given. Eating disorders are surrounded with psychological explanations in relation to the aetiology of the condition. Anorexia is an amalgamation of social, physical, ethnic, biological, family, physiological, developmental and psychological factors (Wozniak, Rekleiti and Roupa, 2012). The disorder can be left hidden for months and even years because of stigmatization (Dorset Mental Health Forum, n.d) so it is important that such disorders should be taken seriously. Anorexia could be classified both as a mental (DSM-IV) and a psychological disorder (Nordqvist, 2015). Similar to the mental disorders, anorexia carries with it stigma. As a result anorexic people could be socially isolated, so support from family and other entities is an essential component towards recovery. From a psychological point of view, people suffering from anorexia gain a sense of pride as they managed to obtain weight loss (Griffiths, 2014) however, regardless this weight loss, anorexics continue to loose weight as they still see themselves fat. Moreover, the upbringing could also be one of the reasons why a person might suffer from anorexia later on in life. Childhood traumas and abuse were also associated with anorexia (Wonderlich, et al 2001). A cause for concern amongst anorexic people was found to be perfectionism. Perfectionism has both positive and negative components. Perfectionism could be maladaptive as it hinders healthy development by isolating unattainable goals and perpetuating a fear of failure (Gilman & Ashby, 2003). It leaves individuals feeling unsatisfied or never good enough (Rice & Preusser, 2002). Other factors that could be contributory factors of anorexia are shame and guilt. They could be regarded as psychologically responsible as they both comprise cognitive, emotional and behavioural factors (Oluyori, 2014). Conflicting ideas exist between professionals. Some regard shame and guilt as a cause of anorexia while others belief that these two components are consequences of anorexia (Burney and Irwin, 2000). Shame and guilt are interwoven as psychological factors responsible in anorexia. Due to the secretive nature of anorexia, health professionals are presented with a tough challenge in diagnosing, treating and supporting the individual sufferer. There were divergences between the health professionals regarding knowledge and attitudes. In fact through this study it emerged that lack of knowledge and training were among the barriers acknowledged by such professionals. Education, both for parents and adolescents, more awareness and training for professionals were among the recommendations of this study.