Ethics in aesthetics: considering eating disorders in the context of procedures

02 November 2019
Volume 8 · Issue 9

Abstract

Eating disorders are serious mental health conditions associated with many adverse health and quality of life outcomes. Yet, eating disorders are frequently underdiagnosed and undertreated and numerous barriers to their diagnosis and treatment have identified. Surprisingly, although negative body image is a well-established risk factor for eating disorder onset and is common across eating disorder profiles, limited research has explored eating disorders in aesthetic procedure settings. While more research is required, it is possible that people with undiagnosed and/or untreated eating disorders may present for aesthetic procedures. In light of this, as well as the severity of eating disorders, it is advised that aesthetic practitioners possess a comprehensive understanding of eating disorders. Furthermore, gaining a deeper understanding of eating disorders can improve ethical practice; it is recommended that aesthetic practitioners explore and establish screening guidelines and referral processes for patients with suspected eating disorders.

Eating disorders are serious and often chronic mental health conditions characterised by disturbances in eating behaviours and psychological distress related to eating and body image (Fairburn et al, 2003; Klump et al, 2009). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association [APA], 2013) specifies three distinct eating disorders:

  • Anorexia nervosa: identified by significantly low weight, fear of gaining weight and restricted eating patterns
  • Bulimia nervosa: identified by binge eating episodes during which large quantities of food are consumed in short periods of time (≤2 hours) and accompanied by compensatory behaviours (e.g. vomiting, excessive exercise, laxative abuse)
  • Binge eating disorder: identified by recurrent, psychologically distressing binge eating episodes in the absence of compensatory behaviours.
  • Additionally, the DSM-5 includes two further categories of eating disorder, namely, other specified feeding and eating disorder (OFSED) and unspecified feeding and eating disorders (UFED) (APA, 2013). OSFED includes atypical anorexia nervosa (anorexia at a higher body weight), subthreshold bulimia nervosa and binge eating disorder (due to low frequency or limited duration), purging disorder and night eating syndrome. UFED encompasses disordered eating patterns that do not meet any of the criteria above. Notably, eating disorders that fall under the OFSED or UFED categories are no less serious than the aforementioned distinct eating disorders (Fairweather-Schmidt and Wade, 2014).

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