Dr Ayushi Gupta
Food is essential for our bodies to develop, function properly, repair cells and tissues, and produce energy for day to day chores. But over time there has been a shift from healthy to unhealthy food choices and especially with the advent of social media, entertainment industry etc. Things like body Dysmorphia has become very common. Well, what is body Dysmorphia and how it affects people is a whole different discussion but in short, it is a condition in which a person is obsessed with some or the other part of his/her body and thinks that, that particular part (which is absolutely normal and functioning) is flawed and so that person tries to hide that part and constantly compares it to other people, for eg- if someone thinks that his/her nose is flawed or have a flabby arm and that constantly haunts the person and affects his /her mental peace, that come under body Dysmorphia. Today’s topic of discussion however is a group of conditions that come under Eating Disorders. Literally it means disorders related to eating but in reality it’s more than just about food, it’s a range of behavioral conditions that cause a person to develop severe and persistent unhealthy eating related habits and associated distressing thoughts and emotions like obsession with food and weight, over exercising, not eating proper food or eating inedible things, binge eating and vomiting it out and this is because either the person doesn’t want to gain weight as this person has body Dysmorphia and obsessed with losing weight and looking slim and in a certain shape or that person is extremely picky and instead of eating normal food eats things that are not of any nutritional value. This person can develop serious physical, psychological and social consequences like severe nutritional deficiencies, not being able to focus on work, problem in conceiving etc. And all this can affect literally each and every aspect of that person’s life. Now the question is why our elders didn’t have it and why mainly one gender and a particular age group is affected more.
Well some of our elders might have had it but back then it wasn’t talked about much and in fact having more weight and fuller bodies was considered a sign of good wealth. Studies have shown that genetics do Play a role i.e., people having a sibling or parent with eating disorder are more likely to develop it at some point in their life. Also people who are perfectionist, impulsive are also more likely to have it and how can we forget our society and its pressures to look a certain way, no matter what the person is feeling from within. Eating disorders can occur in association with other psychiatric disorders like OCD, anxiety disorders etc. Although people of any gender and age can be affected but most commonly affected are the females between age-group of 12-35 years.
These females may show dramatic weight loss, excuses to avoid meal time, always occupied with food and measuring calories of each and everything that eat, denying the feeling of being hungry, patterns of binge eating and purging, excessively exercising etc. which in turn affects them in different ways like developing constipation, feeling lethargic, dizzy and tired all the time, developing sleep and menstrual irregularities, dry skin, thin brittle hair and nails, poor immunity, difficulty in concentration etc. Eating disorders include a group of conditions:Anorexia Nervosa – one of the most common type of eating disorder. Mainly seen in young adolescent females who don’t want to gain weight even if they are underweight, so they limit their food intake and may over exercise or use laxatives or vomit out the food taken i.e., they either lose weight by calories restriction (restricting type of anorexia) or by binge eating and then purging it out (binge eating and purging type of anorexia).
Bulimia Nervosa – these people tend to binge eat until they are painfully full and then, to compensate for the calories consumed and because of the fear of gaining weight, they purge it out by forced vomiting or using laxatives or enemas etc.
It is somewhat similar to binge eating and purging type of anorexia but in bulimia usually the weight is maintained. During these episodes of binge eating, these people can’t control how much they are eating. And these recurrent purging episodes may lead to inflamed throat, gut irritation, acid reflux, electrolyte imbalance etc.Binge Eating Disorder – like bulimia and binge eating and purging type of anorexia, these people also tend to eat a lot of food usually in a short period of time and until they are uncomfortably full. After that, they start feeling ashamed or disgusted of this binge eating behavior but they do nothing to lose weight or restrict calories. They just binge eat, feel ashamed and then again binge eat with these episodes occurring as frequently as 1week to 10 days.
Rumination Disorder – in this, the person tends to regurgitate the food eaten (usually within 30 minutes of eating) and re-chew the food followed by either re- swallowing or spitting it out.
This type might even start infancy or childhood, though like all the other types this is also most commonly seen in young adults and adolescents. However, one thing to note here is that this regurgitation is not due to any medical or gastrointestinal cause but is psychological in nature.PICA – it’s a condition in which a person eats things that are not of any nutritional value and are nor culturally or socially acceptable to eat. Things ingested may vary with person’s age and can be paper, chalk, clay, soap, pebbles etc. to name a few. Eating these non-food substances show some degree of underlying stress or psychological problem that these people are going through.
Pica may lead to various health problems like toxicity of metals, gastrointestinal obstruction, nutritional deficiencies etc. Children less than 2 years have a tendency to put everything they see in their mouth, so they are not included in this category as their brain is not developed properly to understand the difference between edible and inedible things. People having Pica generally have no problem in eating normal food, so eating normal healthy food must be encouraged in these people.
Avoidant Restrictive Food Intake Disorder (ARFID) – these people are extremely picky when it comes to eating food and this leads to nutritional deficiencies as the less amount of food they eat don’t meet their body requirements. This could be due to less appetite or lack of interest in eating or because they avoid food based on its color, odor, texture etc. (But not because of the fear of gaining weight).This leads to weight loss, nutritional deficiencies and/or poor development of body. However the key word here is extreme, as these people are not just picky (which usually a lot of people are) but are extremely picky.
Other specified feeding & eating Disorders include disturbances in eating behavior that impairs a person’s family, social functions and work functions etc, but doesn’t fit in the above mentioned categories, e.g., Orthorexia, atypical anorexia nervosa etc. Now that we know the types of eating disorders and how do they affect us, what’s important is to know how it can be treated. Things as basic as psychotherapy, nutritional counseling to as advanced as medications like antidepressants, mood stabilizers etc can be used to help these people. A very important approach that can be adopted by family and friends of such people is to talk to them, listen to them, hang out with them, and try to build their self esteem and they will eventually let go off the underlying stressful thing that’s triggering their eating disorder.
