Eating disorders explained

People may be addicted to food – a behavioural response to emotions such as stress, sadness, or anger at times.

Bollywood actress Richa Chadha recently opened up about eating disorders and issues with her body with a leading daily and said she would indulge in munching on protein bars and drinking red bulls, for long hours at work.

Versatile actor Aamir Khan says that he is a compulsive eater, wherein he eats almost everything if he’s not dieting.

In her Netflix documentary, Miss Americana, American singer-songwriter, Taylor Swift has also spoken about her relationship with food stating that very often she would be so hungry after performances that she would feel weak, and on the verge of passing out.

As body image and self-esteem play a large role in eating disorders, it comes as no surprise that many celebrities such as Taylor Swift have struggled with the same. Such disorders may however affect anyone, not only celebrities.

Understanding eating disorders

Anorexia nervosa, bulimia nervosa, and binge-eating are some of many common eating disorders, states Dr. J Anish Anand, Consultant Internal Medicine, Apollo Hospitals.

“Most often, EDs involve dangerous eating habits focused too much on one’s weight, body shape, and food.  These behaviours, in turn, may significantly impact a body’s ability to obtain the required nutrition,” says Dr. Anand. “Moreover, people with anorexia nervosa and bulimia nervosa tend to be perfectionists with low self-esteem and are extremely critical of themselves and their bodies.”

Manifestations of the disorder

Dr Anand lists some eating disorders –

Anorexia nervosa: An anorexic individual, limits calories excessively or uses other methods to lose weight, such as extreme exercises; using laxatives or abnormal diet plans; or vomiting after eating.

“Efforts to reduce weight, even when underweight, can cause severe health problems,” warns Dr Anand.

Bulimia nervosa: Bulimic persons also restrict their eating. They however eat large amounts of food in a short time and then try ridding themselves of the extra calories in an unhealthy manner—out of guilt, shame, and an intense fear of weight gain. Bulimics may also indulge in forced vomiting, exercising too much, or using laxatives to get rid of the calories.

Binge-eating: Binge-eaters feel guilty, disgusted, or ashamed by their behaviour and the amount of food eaten. They however do not try to ‘compensate’ with excessive exercise or purging, as bulimics or anorexics do.

Rumination disorder: Those suffering from this disorder regurgitate food after eating, though not due to a medical condition or any of the above eating disorders. Food is brought back up into the mouth, frequently even unintentionally, without nausea or gagging, and it’s re-chewed and swallowed or spat out. “This disorder may cause malnutrition if the food is spat out,” cautions Dr. Anand.

Avoidant or restrictive food intake: In this case, food isn’t avoided for the fear of weight gain. One just avoids food with certain sensory stimuli—color, texture, smell or taste or from concerns of the consequences of eating, such as choking.

RISK FACTORS AND SEEKING HELP

As with other mental illnesses, ED is caused by genetics and biology as well as psychological and emotional health. While some may have genes that increase their risk of developing eating problems, biological factors such as changes in brain chemicals may also cause eating disorders. Additionally, those with low self-esteem, perfectionism, impulsive behaviour and troubled relationships tend to have ED.

Anorexia or bulimia, likelier among teenage girls and young women than teenage boys and young men, often develops in teens and early 20s.

Factors increasing the risk include family history wherein a history of anxiety, depression or obsessive-compulsiveness, and dieting and starvation may affect the brain, influencing mood changes, rigidity in thinking, anxiety and reduced appetite and any kind of stress.

EDs are difficult to manage/overcome by oneself. In fact, many with eating disorders may not even think they need treatment.

PREVENTION AND TREATMENT

Some strategies to help your children develop healthy eating behaviours –

  • Avoid dieting in front of them.
  • Talk to them about the risks of unhealthy eating choices.
  • Cultivate and reinforce a healthy body image for yourself and others; avoid criticizing your own body in front of your children.

Dr. Anand believes the first step in treating anorexia nervosa is to assist your kids in regaining weight to a healthy level. “For patients with bulimia nervosa interrupting the binge-purge cycle is important. For patients with binge eating disorders, it is important to interrupt and stop binges,” he says.

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Behavioural indicators of EDs

  • Excessive focus on healthy eating
  • Skipping meals; making excuses for not eating
  • Adopting restrictive vegetarian diets
  • Making one’s own meals rather than eating with family
  • Withdrawing from social activities
  • Persistent complaints about being fat
  • Frequent checking in the mirror for flaws in body shape
  • Eating large amounts of sweets or high-fat food
  • Use of dietary supplements, laxatives or herbal products for losing weight
  • Intense exercising
  • Calluses on knuckles from inducing vomiting
  • Loss of tooth enamel from repeated vomiting
  • Leaving during meals for using the toilet
  • Eating more snack or food at once than is normal
  • Expressing depression, disgust or guilt about eating habits
  • Eating secretly

Complications from Eds

The more severe, or long the eating disorder, the likelier for one to experience serious complications, such as the following –

  • Menstrual periods diminish or stop
  • Osteopenia or osteoporosis (thinning of the bones) occurs through calcium loss
  • Hair/nails become brittle
  • Skin dries and may take on a yellowish cast
  • Mild or severe anemia; and muscles, including the heart muscle, waste away
  • Severe constipation
  • Drop in blood pressure slowed breathing and pulse rates
  • Internal body temperature falls, causing one to feel cold all the time
  • Depression and suicidal thoughts
  • Problems with growth
  • Relationship problems
  • Substance use disorders
  • Work/school issues
  • Death

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