Eating disorders constitute a group of conditions in which individuals have abnormal eating habits that impair their health and psychosocial functioning. It is important to identify and diagnose people with this disorder in view of its effect on mental and physical well-being. Dr Suchismitha Rajamanya, Consultant in Internal Medicine, Manipal Hospital Whitefield, is here with us today to give us an insight into the many types of eating disorders and how they can have a detrimental influence on our mental health.
The number of cases in India appears to be underestimated due to a lack of awareness of this condition or the stigma associated with mental disorders. Various studies, carried out in small populations, report the incidence, which ranges between 4-42%. Disorders include conditions such as anorexia nervosa, binge eating, rumination disorder, avoidant/restrictive food intake disorder, bulimia nervosa, and pica.
Patients who are at increased risk for eating disorders include:
1. Patients with a history of:
•Adversity during childhood
•Trauma
2. Young adults
3. females
4. Transgender people
5. Athletes
6. Anxiety disorders
7. Depressive disorders
8. Stiffness
9. Perfectionism.
There is an increase in the number of eating disorders, especially in young women, thanks to the unhealthy tendency to ‘get thin’ or achieve ‘size zero’, unrealistic expectations, pressure to keep up appearances on social media. These disorders are almost always associated with an underlying psychological problem or mood disorder. Numerous personalities, such as Lady Gaga, Jessica Alba, Princess Diana, Elton John, have suffered from eating disorders and have opened up about it.
Physicians and families may suspect eating disorders by asking if patients have any concerns about the patient’s weight, body shape, body image, or eating behaviors. In addition, short, easy-to-interpret screening questionnaires are available, which can help identify patients who need further evaluation. Eating disorders should be suspected in anyone who has drastic voluntary weight loss or inappropriate weight gain, fear of eating food or eating too little, choking or vomiting food, binge eating, or eating “abnormal” substances. They could have physical health consequences such as weak bones, poor immunity, abnormal menstruation, excessive hair loss, anemia, low blood pressure and heart rate.
Below are some of the most common eating disorders:-
1. Anorexia nervosa is a condition in which people are afraid of gaining weight and have an abnormal perception of their weight and body shape.
2. In avoidant/restrictive food intake disorder, patients lack interest in food or develop a conditioned negative response to food intake, such as choking or vomiting.
3. In binge eating disorder, patients tend to eat faster than normal, eat unusually large amounts of food until they feel uncomfortably full, feel disgusted with themselves, depressed, or guilty after overeating.
4. Bulimia Nervosa is a condition in which patients overeat and then attempt to compensate for their behavior with self-induced vomiting, misuse of medications such as laxatives, diuretics, insulin, or thyroid hormone; fasting or excessive exercise.
5.PICA is characterized by the condition of eating ‘abnormal’ substances that are not nutritious such as chalk, sand, clay, raw rice, cement. It is usually associated with iron deficiency anemia and mood disorders.
6. In rumination disorder, patients repeatedly take out food, which may be chewed, swallowed, or spit out.
These disorders can be life-threatening due to the general medical complications associated with malnutrition and the possibility of suicide. Furthermore, patients often refuse treatment.
Since the mainstays of treatment are psychotherapy, pharmacotherapy, and nutritional rehabilitation, a multidisciplinary approach including a psychiatrist, psychologist, physician, and dietician is required for the overall management of these patients. The stigma of eating disorders is to some extent related to dysfunctional thoughts that may interfere with the treatment process. Patient and family education that includes biological explanations goes a long way toward reducing this stigma. Foster a healthy social environment and Discourage unhealthy beauty trends. will ensure that impressionable young minds do not succumb to eating disorders and other mental illnesses.
Also read: No-nonsense guide to combat emotional eating
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