Eating disorders are often not spoken about but it is a serious condition that affects an individual’s physical, psychological and social function. Bulimia and Anorexia Nervosa are just a few known eating disorders but apart from them, binge eating disorder and avoidant restrictive food intake disorder, Pica are also other types. This disorder often co-occurs with anxiety, mood disorders or OCD. And more often women, especially between the ages of 12-35, are affected by eating disorders.
TC46 connected with Dr Jyoti Kapoor, a senior consultant Psychiatrist at Paras Hospital, Gurgaon and founder of mental welling space, Manasthali. Here, she shares her views on the disorder and 8 pointers to remember.
1. Eating disorders cause major physical and psychosocial disturbance
Eating disorders are a persistent disturbance of eating or eating-related behaviour that results in altered consumption or absorption of food which results in significant physical and/or psychosocial disturbance. Various types of eating-related problems are identified in children and adults. DSM V categorizes them under a separate category of feeding and eating disorders. Most common disorders include Pica which is associated with eating non-nutritive, nonfood substances like mud and chalk, Anorexia Nervosa and Bulimia Nervosa which are associated with restrictive food intake and rumination disorders associated with regurgitation and rechewing of food.
2. Women between the ages of 10-30 are more likely to be diagnosed with an eating disorder
The prevalence in age and gender varies based on the type of disorder. Like Pica can be a transient condition in young children and pregnancy but more pathological problems are seen in mentally disabled individuals or associated with other mental conditions. On the other hand, restrictive eating patterns like anorexia nervosa are more commonly seen in women with onset between 10 years to 30 years. In general, the prevalence rate is identified as 5% of the population with onset in adolescence and young adulthood.
The causes range from genetic to psychosocial. Preoccupation with weight and trying to emulate a certain ideal body type is often associated with anorexia nervosa whereas binge eating and bulimia are associated with a preoccupation with food and stress eating.
3. Behavioural patterns or unhealthy eating patterns can be indicators for eating disorders
Eating patterns and beliefs surrounding food indicate whether the pattern is healthy, culturally aligned or unhealthy and not matching with the socio-cultural environment. The following behavioural patterns indicate that the individual may need to be diagnosed with an eating disorder-
- Adopting an overly restrictive diet
- Excessive focus on healthy eating despite ill effects on overall health
- Skipping meals or making excuses for not eating
- Making own meals rather than eating what the family eats
- Persistent worry or complaining about being fat and talk of losing weight
- Repeatedly eating large amounts of sweets or high-fat foods
- Use of dietary supplements, laxatives or herbal products for weight loss
- Excessive exercise with emphasis on burning calories gained from food
- Eating much more food in a meal or snack than is considered normal
- Expressing depression, disgust, shame or guilt about eating habits
These patterns are often associated with mood disturbance, irritability, hiding an eating-related issue, eating in secret, induced vomiting affecting tooth enamel or knuckles of fingers being scratched.
4. Eating disorders emerge from family history, stress or mood disorders
The risk factors include a family history of eating disorders, excessive emphasis by family members on maintaining weight or ‘looking good’, high levels of stress, anxiety and mood disorders like depressive disorders and peer pressure.
5. Eating disorders can affect an individual’s personal and professional life
Eating disorders directly impact physical, mental and social health. Complications include excessive weight loss, nutritional deficiencies, amenorrhea, and digestive tract abnormalities. Psychologically, mood disturbance, anger, irritability, lack of concentration, poor performance, social withdrawal, suicidal ideation and substance abuse disorders are all associated with eating disorders.
6. Learn to have a healthy body image and accept yourself
Acceptance of oneself as who he or she is and avoiding emphasis on a certain preferred body type is important. Instead of talking about weight, talk in terms of health, instead of focusing on body shape, talk in terms of stamina and strength. Inculcate good habits and not restrictive eating patterns. Avoid dieting in front of children or indulge in body shaming of spouse or other family members.
If the child appears to be harbouring strong obsessive ideas around food and eating, it’s better to seek professional help starting with enlisting the support of the child’s paediatrician.
7.Counselling or CBT can help treat eating disorders
Depending on the stage and severity of the clinical condition, counselling, cognitive behaviour therapy and psychotropic medicines are prescribed. Some severe cases of anorexia nervosa need admission to the hospital for managing physical health issues.
8. Every type of treatment is formulated and aimed at addressing and correcting the issue
Once a problem is diagnosed, an individualized treatment plan is formulated to address specific issues. From counselling to a diet plan, everything is aimed at correcting the inaccurate and unhealthy thought patterns that result in such behaviours. Early and regular treatment is associated with good recovery and reduces the chances of relapse.