Gender Factor of Anorexia & Bulimia
Ninety percent of the affected are young females. White upper class and middle-class women usually suffer from this illness. Only 5 % are males. It is believed that males undergo fitness regimes, masking the disorder they would otherwise have expressed. Males would be increasing their body looks and personality to match the earlier development of the females. Swiss females showed an incidence between the ages of 12 and 25. An Australian study showed an incidence among females between 13 and 30 of 5-8% (twice the prevailing rate).
The disorder starts in the adolescent period. This is the age when females develop. These women may be slightly overweight, and they would decide to diet to retain their figure and look pleasing to the opposite sex. With the beginning of the diet, they become more obsessed with the idea. Physical exertion and exercise will be strengthened. Strict adherence to the new regime makes their condition worse, resulting in a skinny look. They lose weight drastically. Any slight weight gain is considered a weakness or failure by themselves. The precipitating factors may be the menarche and the feeling that they have grown up. It may be threatening in that it signifies maturation. Psychologically they may revert to their childhood where their responsibilities and freedom were much less frightening. They cannot be bothered about physical concerns. Autonomy and the fight for independence could manifest in anorexia or bulimia. The symptoms that are seen in bulimia are related to starvation.
The brain is affected: changes in brain size, neurotransmitter balance, and hormone secretion signals. Sex organs become affected. Loss of body weight will cause the loss of fat from the body, inhibiting the estrogens, which are necessary for menstruation. Periods become irregular or do not occur at all. Electrolyte imbalance occurs, and abnormalities affect the blood cells, red and white. The heart is affected, and congestive heart failure could occur. Bradycardia or arrhythmias may also be seen. Delayed gastric emptying causes a feeling of bloating and constipation. Bone growth is affected, and the girls may go in for osteoporosis. Lethargy and fatigue may accompany the other symptoms.
Male bulimics have an issue of gender identity. For them, too, the main object they identify with is the mother. During the oedipal period, they go beyond the mother fixation to the identification of the father. To acquire the feeling of healthy maleness, their normal psychological development has to allow them to identify with the father. Conflict arises when the boy decides to make the transition. He cannot totally ignore the mother whom he loves, nor can he separate and gain autonomy from her. Though he cherishes the closeness to the mother, it threatens his independence and differentiation of gender. The father must be present to allow the son to achieve that male gender identity. The son first identifies his father through the mother: the presence and the mother’s identification of his maleness. Previous researches indicated that the father did not have an early role in the son’s life where the mother-son dyad dominated and he was the intruder. However, recently, the father has had a “positive and strategic role.”
Many ego functions like the delay of gratification, perception, and intelligence allow the boy to identify his father as important by 18 months of age. Early triangulation allows the child to understand that there is a nonmother, and this provides stable mental representations. If this symbolization is not found in the child’s life, it can have eating disorders or go in for psychoses or schizoid illnesses. An eating disorder may not be a psychotic disorder, but it represents a dysfunctional relationship. The boys could repair the psychic gap by finding an external object and turn to some addiction like alcoholism, substance abuse, and bulimia. A son may not outgrow his fondness for his mother if the father is absent or dead or abusive. The eating disorders in both boys and girls are related to the mother-infant relationship.