Self-concept is a major part in forming eating disorder. Anorexia nervosa and bulimia nervosa leading health concern in adolescences now a day. The prevalence in Pakistan is 21.7% was reported for anorexia nervosa in nursing students. The aim to write this scholarly paper is to clarify the role of self-concept in eating disorder by self-schema model of eating disorder. In self-schema model self-concept is define in three dimensions. Deficit in identity formation ,in this model we talk about how identity play role in self-concept and if there is a problem in development of identity so how it can effect in later life. Another model talk about distortion in body image that how person perceive negative self and dissatisfy with owns body. Furthermore describe in this model about body dissatisfaction and low self-esteem that how interruption in self-esteem later cause negative thought about body. There are many theories such as psychoanalytic theory and feminist theory which works on self-concept, self-identity, body image and self- esteem. There are many techniques by which we major self-concept, self-esteem in eating disorder. There are many treatments available to cope up with eating disorder such as self-help, psychotherapy, cognitive behavioral therapy and interpersonal therapy and learn new coping strategies for better recovery and it can also help in making self-identity.
“Shape and weight overvaluation occurs when the individual evaluates self-worth largely or almost entirely on body shape and weight, to the exclusion of other domains (e.g., work, hobbies, study, friendships) and is related to but distinct from perfectionism” (Wade & Bulik, 2007;Watson et al., 2011). Eating disorders like anorexia nervosa and bulimia nervosa are leading health concern in youth. The aim to write this paper is to talk about self concept in persons having eating disorder. As in modern era everyone try to look smart and perfect how self-concept was effected on these people.
“In contrast to boys girls were more prone to get this disorder. In Karachi,180 female nursing and medical student prevalence rate of 21.7% was reported for anorexia nervosa. Another study using SCOFF questionnaire 307 out of 446(68.8%) female university student scored two or higher indicating a potential eating disorder and need for clinical assessment”.(journal of college of physician 2011).The anorexia nervosa is the disorder in which person feel serious fear to becoming fat and do strenuous exercise to reduce weight.They perceive themselves as fat and donot satisfy with their body image. In bulimia nervosa the person overuse laxative, induce vomiting by fingering. In these type of disorder it is important to see k effect of self-concept because they have intense negative feeling about self or they dissatisfy with their appearance. The self-concept is said to be the individual’s overall collection of thinking about own self that are linked in memory receive the self-schemas and detailed image about self. The problem in self and interruption in self-concept and thinking burden can lead to developing an eating disorder. In Pakistan the most susceptible group is adolescence because raise in social pressure to retain skinniness body as a result self-esteem of a person. In Pakistani culture eating disorder are hardly studied. In young female dieting and low self-esteem is determined at major risk for eating disorder. There are many theories review that psychoanalytic and feminist orientation has great influence in self-concept of and individual. The psychoanalytic theories talk about decrease self in eating disorder mostly in self-psychological aspects. In feminist theory entire concern on body image, the approach of psychodynamic and feminist theory is that eating disorder have balanced, accurate relevant character. Yet, few data of positive effects and programmes on self esteem. It has one of the reasons that self-esteem approach is comprehensive and undifferentiated. So, it is not possible to taking every aspects of individual’s self image probably necessary when developing eating disorder. In self-concept, self-schema model, there are three category includes 1.Deficit in identity formation 2. Distortion in body image and 3. Body dissatisfaction and low self esteem. (Karen F.Stein p.97 self schema model of eating disorder).Deficit in identity formation, this model target on building up identity in child and adolescence. It is also focus on parent-child affair. According to this theory parents through their expectation on child and the child miss to build up self-governing. Child feels low and in adolescence he/she experiences social difficulties related their identity. According to Bruch’s theory that interruption in self-identity formation is cause of disorder. The influence of parents governing and provide less opportunities to child can developed self-doubt, problem in formation of identity and child face problem in biological and social aspect and feeling of feebleness. Schupak-Neuberg and Nemeroff (1993) “found that women with BN have greater self-concept impairments including higher levels of identity confusion, a greater sense of enmeshment with others, and less stable self-definitions over time than binge eating women who do not engage in compensatory behaviors and controls” Another is body image distortion, in this theory they miss interpretation their body image. It is due to initially lack of parent child relationship. It is suppose to failure in feeling physical indicators like hunger, emotion and alteration in perceive body image. “Due to increasing pressure during adolescence for desire body shape that conforms to the ideal.”(Imran N and Ashraf A). Body image formed somewhat by influence of cultural norms .In western society leanness and attractiveness directly related to women. These concept strengthened through assessment and observation to others such as significant others, colleagues, and media images. According to DSM-IV-TR (APA 2000) that existence of interruption in body image is essential manifestation of eating disorder. In third theory which is body dissatisfaction and low self-esteem. According to Rosenberg (1965) define self-esteem as favorable or unfavorable attitude toward self” (p.15). In eating disorder this disruption in belief against self. In eating disorder assess their body in pessimistic way. “low self-esteem belief may be only part of a larger constellation of self concept deviation associated with the disorders”(Karen F.stein p.100 self schema model of eating disorder). Some studies have found that people having eating disorder with low self-esteem has less effect on treatment. The person with eating disorder has other low self-esteem features like negative self-image, over concern about size, weight and body shape. According to Stice and Whitenton (2002), “almost 25% of adolescent girls have clinical levels of body dissatisfaction, mainly caused by social pressure emanating from family, friends, and media”. My opinion, it is major disorder in adolescence and day by day it getting worst and it is effect on the self-concept of a person. The media can play major role in develop eating disorder by concept of female beauty through advertisement and magazines. There are many side effect of this disorder in terms of building personality, cognitive aspect and behavior of an individual. There is some treatment for such people affecting from eating disorder. Self help is the best intervention. “Studies on ED treatment outcome indicate that psychotherapy focusing on personality dynamics combined with nutritional rehabilitation can improve overall emotional and social functioning and predict better global outcome compared to treatment focusing only on the amelioration of ED symptoms”.(Thompson-Brenner & Westen, 2005).Other treatment is cognitive behavioral therapy and interpersonal therapy also used. About 50% of eating disorder shows great improvement after treatment. Personality patterns treatment result in people with eating disorder is depend upon their coping mechanism decrease restraint and being socialize. Adoption of new coping skills like listening music, reading, playing etc.
In conclusion, eating disorder is a major concern in female more than males and it is very common problem in child and adolescence. There are three main self concept theory of eating disorder which talks about identity formation that how eating disorder creates identity of own self. It also talks about parent child bonding and relation which effects on child’s identity and later it can lead to eating disorder .In body image disturbance how and individual perceive her body in negative way and its effect on behavior. There are many self-positive and more negative aspects. One mainstream methodology to exactly reporting self-perception aggravations in dietary problems is to inspect the precision of figure size estimations and the last is dissatisfaction of body and low self esteem in which disrupting attitude against own self. There are many treatment options by mean of psychotherapy, cognitive behavioral therapy and interpersonal therapy which can help patient in recovery and strengthen their coping mechanism. By learning new strategies person has better option to recover from these disorder. The recommendation is that further research is needed in Pakistan to identify severity of this disorder. Teaching in school, colleges and universities about self awareness is very important aspect to decrease such types of disorders.