Eating disorders are 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 given its effect on mental and physical well-being. Dr. Suchismitha Rajamanya, Internal Medicine Consultant, Manipal Hospital Whitefield, is here with us today to provide insight into the many types of eating disorders and how they can negatively influence our mental health.
The number of cases in India appears to be underreported, either due to lack of awareness of the condition or the stigma associated with mental disorders. Various studies, carried out in small populations, report the incidence, ranging between 4 and 42%. Disorders include conditions such as anorexia nervosa, binge eating disorder, avoidant/restrictive food intake rumination disorder, bulimia nervosa, and pica.
Patients who are at increased risk for eating disorders include:
1. Patients with a history of:
• Childhood adversity
2. Young adults
4. Transgender people
6. Anxiety Disorders
7. Depressive Disorders
There is an increase in the number of eating disorders, especially among young women, thanks to the unhealthy tendency to “be thin” or to reach “size zero”, unrealistic expectations, pressure to maintain social media appearances. These disorders are almost always associated with an underlying psychological problem or mood disorder. Many personalities, like Lady Gaga, Jessica Alba, Princess Diana, Elton John have all suffered from eating disorders and have opened up about it.
Physicians and families can suspect the presence of eating disorders by asking if patients have concerns about their weight, body shape, body image, or eating behaviors. Additionally, short, easy-to-interpret screening questionnaires are available, which can help identify patients who need further evaluation. Eating disorders should be suspected in anyone with intentional drastic weight loss or inappropriate weight gain, fear of eating or eating very little, choking or vomiting of food, binge eating, or binge eating. ingestion of “abnormal” substances. They could have physical health consequences like weak bones, poor immunity, abnormal menstruation, excessive hair loss, anemia, low blood pressure and heart rate.
Here are some of the commonly seen eating disorders:-
1. Anorexia nervosa is a condition in which individuals 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, disgusted, depressed, or guilty after eating too much.
4. Bulimia nervosa is a condition in which patients overeat and later attempt to compensate for their behavior through self-induced vomiting, misuse of medications such as laxatives, diuretics, insulin, or thyroid hormones ; fasting or excessive exercise.
5.PICA is characterized by the condition of eating “abnormal” substances that are not nutritional like 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 and swallowed or spat out.
These disorders can be life-threatening due to general medical complications associated with malnutrition and the possibility of suicide. In addition, patients often refuse treatment.
The mainstays of treatment being psychotherapy, pharmacotherapy and nutritional rehabilitation, a multidisciplinary approach, including a psychiatrist, a psychologist, a doctor and a dietician, is necessary for the comprehensive care of these patients. Eating disorder stigma is to some extent related to dysfunctional thoughts that can potentially interfere with the treatment process. Education of patients and their families that includes biological explanations goes a long way in reducing this stigma. Fostering a healthy social environment and discouraging unhealthy beauty tendencies will ensure that impressionable young minds do not succumb to eating disorders and other mental illnesses.
Also Read: Practical Guide to Combat Emotional Eating