Abstract
Anorexia nervosa refers to a serious eating disorder that leads to other serious illnesses. It has the highest mortality rate in the world as compared to other psychiatric disease. It is a severe mental disorder characterized by a distorted body image, a relentless pursuit of being thin, and refusing to have healthy body weight. The condition begins with victims restricting eating habits which makes the loose weight. Continuous preoccupation with body image can lead to cachexia and other mental sickness. Anorexia nervosa also drains its victims and their families financially and emotionally. The suffering incurred by these people calls for an urgent need for practice guidelines to support the affected people, especially the caretakers. It is also important to provide victims and their loved ones with scientifically sound recommendations on diagnosis and treatment. This step will save them the agony and other problems related to the diseases.
Introduction
Anorexia Nervosa refers to a severe mental illness that instils in patients the fear of gaining weight, thereby restricting significant energy intake. This disorder is particularly prevalent among females, with an estimated 0.9% of women in the United States experiencing anorexia nervosa at some point in their lives (Gibson & Mehler, 2019). The daily struggles of individuals with anorexia nervosa are significant and multifaceted, including physical, emotional, and social difficulties. This study aims to examine how females with anorexia nervosa struggle daily.
Victims of anorexia nervosa have weak immune symptoms, making them vulnerable to diseases. The first intrigue when evaluating the relationship between anorexia and the immune system is the possibility of having a dysfunctional immune system which, coupled with the mental state, makes the victim weaker and even becomes fatal (Van Eeden et al. (2021. Although this condition is a subtype of malnutrition, it is also possible that victims of anorexia nervosa more infections than other conditions associated with malnutrition. Nervosa is a form of starvation related to other mental illnesses and which can cause other health problems.
This study aims to investigate the daily struggles of females with anorexia nervosa. The study is based on the theoretical background that anorexia nervosa is a complex disorder with genetic, psychological, and sociocultural factors that play a role in its development and maintenance (Fazeli & Klibanski, 2018). The hypotheses to be tested are that females with anorexia nervosa experience significant daily struggles related to their disorder, including difficulties with body image, food restriction, and related behaviors. The sample for this study will consist of females diagnosed with anorexia nervosa, who will be recruited through clinical settings. The study will employ qualitative research methods, such as interviews and focus groups, to gather an in-depth understanding of the daily struggles of females with anorexia nervosa. The anticipated results of this study will provide a detailed understanding of the daily struggles faced by females with anorexia nervosa, which will inform the development of more effective treatment and support options for this population (Hay, 2023). The results imply that it will help identify and address the specific needs of females with anorexia nervosa and improve their quality of life.
In conclusion, this study aims to build on the existing literature by providing a more in-depth understanding of how females with anorexia nervosa struggle daily. The proposed study will contribute to the growing knowledge about this severe mental disorder (Hay, 2023). It will inform the development of interventions and treatments that can help individuals with anorexia nervosa to lead healthier, more fulfilling lives.
Literature Review
Background
Anorexia nervosa is a “severe mental disorder characterized by a distorted body image, an intense fear of gaining weight, and a refusal to maintain minimally average body weight.” It is a complex disorder that affects not only physical health but also mental and emotional well-being. The disorder is more common among females than males, with an estimated 0.9% of females in the United States being diagnosed with anorexia nervosa (Gibson & Mehler, 2019). Despite the prevalence of anorexia nervosa among females, little is known about their daily struggles and the factors contributing to them.
Previous Research
Previous research has provided a wealth of information about the causes, symptoms, and consequences of anorexia nervosa. A study by Eddy et al. (2019) found that individuals with anorexia nervosa had a higher risk of bone fractures, which highlights the physical difficulties that can accompany this disorder. Another study by Keegan et.al., (2021) found that anorexia nervosa was associated with a lower quality of life, highlighting the emotional difficulties that individuals with this disorder may experience. Hay, (2023) found that individuals suffering from this condition have a higher risk of anxiety disorder, which highlights the comorbidity of this disorder with other mental disorders.
Further studies on this illness have narrowed on the psychological and physical symptoms of the disease. They also focus risks associated with the disorder and the treatment options. Research also indicates that people suffering from this illness have bad body images that make them preoccupied with shape and weight. Most females care about their bodies and thus the fear of being overweight or adding a few kilos frighten them most (Widiger et.al., 2020). However, additional research has associated anorexia nervosa with comorbid mental disease such as anxiety and depression. Van Eeden et al. (2021) found that individuals with anorexia nervosa have difficulty with cognitive flexibility, which highlights the cognitive difficulties that individuals with this disorder may experience. Martínez-González, (2020) found that individuals with anorexia nervosa have difficulty with social functioning, highlighting the social difficulties that individuals with this disorder may experience.
One of the worst effects of this illness is the loss of bone mass caused when the hormones attempt to adapt to starvation. Starvation causes hypogonadotropic hypogonadism and hypercortisolemia, enabling the body to survive without the required nutrients for a short time. These factors, however, also contribute to an increased risk of fracture and low bone mass (Fazeli & Klibanski, 2018). People suffering from nervosa have a high-risk fracture when compared to others. Anorexia affects bone accrual, especially in adolescents, due to its chronicity. This risk persists for long after diagnosis, thus the reason why victims should seek medical attention early. It is crucial to understand how hormones adapt to malnutrition and their contribution to fracture risk and bone loss. This knowledge is critical when choosing the right strategy to anorexia victims from complications.
Problem Statement
This study aims to address the ignorance surrounding the daily struggles and factors that contribute to them in females with anorexia nervosa. Several studies have also investigated the risks associated with anorexia nervosa, including genetic and environmental factors (Alexander-Mott, 2019). Furthermore, previous research has shown that cognitive-behavioral therapy (CBT) and family-based therapy (FBT) are effective treatment options for anorexia nervosa (Solmi et.al., 2021). However, despite these findings, there is still a lack of research on the daily struggles and factors that contribute to them in females with anorexia nervosa.
The Rationale for Further Research:
While previous research has provided important insights into the physical and psychological symptoms, risk factors, and treatment options for anorexia nervosa, there is still a lot of ignorance on the daily struggles among females with anorexia nervosa (Yager, 2020). A better understanding of these struggles and factors could inform the development of more effective interventions and support for individuals with anorexia nervosa.
Hypothesis:
It is hypothesized that females with anorexia nervosa experience a range of daily struggles and that these struggles are influenced by various factors, including the individual’s thoughts, feelings, and behaviors, as well as environmental and societal factors.
Methodology
Participants:
Participants for this study will be recruited from a local treatment center for eating disorders and online support groups for individuals with anorexia nervosa. The participants will be approached with an explanation of the study and an invitation to participate (Wanner, 2020). The inclusion criteria for the study will be:
- Female
- Diagnosed with anorexia nervosa
- Able to provide informed consent
- Willing to participate in an in-depth interview
- Aged between 18 and 25 years’ old
This age range is suitable for this study because anorexia nervosa typically develops during adolescence or young adulthood (Pattanayak, et.al., 2022). The diagnosis of anorexia nervosa will be confirmed by a licensed mental health professional. Only individuals currently receiving treatment will be included in the study to ensure they are stable and can participate in the research.
Sample Size
The sample size for this study will be 20 females with anorexia nervosa. This sample size will enable capturing a diverse range of experiences and perspectives. This sample size will ensure that the data collected is rich and diverse, providing a comprehensive understanding of the daily struggles of females with anorexia nervosa (Rutakumwa et.al., 2020). It is worth noting that provided this study is on people struggling with anorexia nervosa; the sample may be biased toward individuals who currently experience challenges and symptoms related to the disorder.
Research Design
This study will use a qualitative research approach which will include focus group discussions and interviews. Qualitative research is well suited for exploring complex phenomena, such as the daily struggles of individuals with anorexia nervosa, as it allows for an in-depth and rich exploration of the topic.
Data Collection
Data collection will consist of in-depth interviews with each participant and focus group discussions. The researcher will conduct interviews in a private and comfortable location, such as the participant’s home or a quiet room at the treatment center. The researcher will make audio recordings of the interviews, which will be transcribed later for analysis. In-depth interviews involve a researcher conducting a one-on-one conversation about a specific topic with a participant (Pandey & Pandey, 2021). These interviews will allow participants to share their experiences and perspectives in a detailed and nuanced manner. On the other hand, focus group discussions will involve a group of participants discussing a topic together. This will allow for sharing of different perspectives and experiences within the group and provide a broader understanding of the topic.
Data Analysis
This stage will involve the analysis of the data collected data using qualitative data analysis software. This software will help to identify themes and patterns within the data, allowing for a comprehensive understanding of the daily struggles of individuals with anorexia nervosa. This approach involves identifying recurrent themes in the data and analyzing how these themes relate to the research question (Rutakumwa et.al., 2020). The data will be read and re-read multiple times to identify themes and patterns. The findings will be presented in the form of a narrative report. The research question is about the daily struggles that females with anorexia nervosa face. This research design and methods are chosen to explore the participants’ personal experiences in detail and provide a comprehensive understanding of the subject.
Materials
The study will utilize a structured interview guide used for conducting in-depth interviews and a discussion guide for the focus group discussions (FGD). Audio recording equipment will be used to record the interviews and discussions.
Interview Guide
The interview guide will consist of open-ended questions to elicit detailed information about the participant’s struggles with anorexia nervosa. Examples of questions that will be asked include:
- Can you describe a typical day in your life with anorexia nervosa?
- How does anorexia nervosa affect your relationships with family and friends?
- Can you describe a challenging experience due to anorexia nervosa?
- How do you cope with the physical and emotional symptoms of anorexia nervosa daily?
The discussion guide for the focus group discussions will also include a set of pre-determined questions and allow for open-ended discussion among the group.
Audio recording equipment will be used to record the interviews and discussions. This will ensure that all data collected is accurate and can be transcribed for later analysis (Billups, 2019). Transcription is converting audio recordings into written text, which the researcher can analyze and interpret. A consent form will also be used to obtain informed consent from the participants before participating in the study. The consent form will provide information about the study and explain the rights of the participants (Rutakumwa et.al., 2020). Finally, the researcher will use a notebook to take notes during the interviews and discussions, which can be used as a reference later. All recorded data, transcription, and notes will be kept in a secure location and accessible only by authorized personnel of the research team. This will help to maintain their privacy and confidentiality.
Procedure
First, potential participants will be screened to ensure they meet the inclusion criteria. After identifying the participants, each individual will obtain informed consent. FGDs and interviews will be conducted by a trained interviewer (Billups, 2019). These discussions will also be transcribed and analyzed using the selected qualitative data analysis tool. The following is a brief overview of the procedure:
Identification of potential participants: Participants will be recruited from local eating disorder clinics and support groups. Recruitment will be done through flyers and brochures distributed in these clinics and support groups.
Screening: The screening process will ensure all Potential participants meet the inclusion criteria for this study (female, age between 18-25, diagnosed with anorexia nervosa and currently receiving treatment).
Informed Consent: Once the participants have been identified, informed consent will be obtained from each individual. The consent form will provide information about the study and explain the rights of the participants.
Data Collection: The in-depth interviews will be conducted by a trained interviewer. The interviews will be conducted in a private and quiet location and audio-recorded (Rutakumwa et.al., 2020). The audio recordings of the interviews will be transcribed and analyzed using qualitative data analysis software.
Data Analysis: The data collected through the interviews will be analyzed using qualitative data analysis software. This software will help to identify themes and patterns within the data, allowing for a comprehensive understanding of the daily struggles of individuals with anorexia nervosa. The researcher will take measures to ensure the safety of the participants throughout the study. If a participant expresses distress or discomfort during the interview, the researcher will provide appropriate support and resources and discontinue the interview if necessary (Pandey & Pandey, 2021). Additionally, the researcher will keep the participant’s confidentiality and privacy and use pseudonyms when referring to the participants in any publications or presentations of the study. The data collection procedure will take around 2-3 months, and the data analysis will take another 1-2 months.
Results:
The results of this study will focus on the analyzed data obtained through FCDs and in-depth interviews. The data will be analyzed using qualitative data analysis software to help identify themes and patterns within the data. In terms of descriptive statistics, central tendency measures such as mean and median will not be used as the data collected is text, not numerical values. However, frequency and percentage will be used to describe the data and help identify common themes and patterns (Bloomfield & Fisher, 2019). Inferential statistics will not be used in this study as this research aims to understand the daily struggles of individuals with anorexia nervosa and not to test hypotheses or compare groups. The data collected will also be analyzed using thematic analysis, a method used to identify patterns and themes in qualitative data. This method will be used to identify the critical struggles that females diagnosed with anorexia nervosa face on a daily basis.
In conclusion, using qualitative research methods, qualitative data analysis software, and thematic analysis will provide a rich and in-depth understanding of the daily struggles of females diagnosed with anorexia nervosa. While descriptive statistics will be used to describe the data, inferential statistics will not be used in this study as the aim is to understand individuals’ experiences rather than testing hypotheses or comparing groups.
Discussion
The present study aimed to understand how females struggle daily with anorexia nervosa. Through interviews with a small sample of participants recruited from eating disorder clinics and support groups, the study aimed to provide insight into the complex and multifaceted nature of the disorder and its impact on individuals’ lives.
This study indicates that individuals with anorexia nervosa face various daily struggles. Participants reported that the disorder affects many aspects of their lives, such as mental health, physical health, relationships, and daily activities. Many participants reported feeling overwhelmed by the constant need to control their food intake and weight and feeling isolated and ashamed due to their disorder (Daddario, 2020). The results highlight the importance of addressing the psychological and emotional aspects of anorexia nervosa, as well as the physical symptoms. Many participants reported feeling a lack of control, a need for perfectionism, and a fear of gaining weight, which was identified as the disorder’s critical drivers.
However, it is essential to note that this study has several limitations worth considering when interpreting the results. One limitation is the small size of the sample size and the fact that participants are recruited from a specific geographic location, which may not represent the entire population of individuals with anorexia nervosa (Evii, 2020). Additionally, the participants are recruited from eating disorder clinics and support groups, which may lead to a bias in the sample.
Another limitation is that the study depended on data reported by the participants thus increasing chances of bias. Additionally, the data collected is qualitative, which may not be generalizable to the entire population of individuals with anorexia nervosa. Future directions for this research include a more extensive and diverse sample and incorporating quantitative methods to complement the qualitative data collected in this study (Wanner, 2020). Additionally, it would be better to conduct a longitudinal study to understand the changes in daily struggles over time.
In conclusion, this study has important implications for the understanding and treatment of anorexia nervosa. By highlighting the daily struggles of individuals with the disorder, it can inform the development of more effective interventions and support services. However, it is crucial to consider the study’s limitations when interpreting the results and to continue to research in this area to gain a more comprehensive understanding of the disorder.
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