Eating Disorder 

Have you ever wondered why some people struggle with their relationship with food? Eating disorders are a bunch of disorders related to mental health that affect millions worldwide. These disorders can adversely affect an individual's physical and emotional well-being, often causing distress and interfering with daily life. Understanding eating disorders is crucial for early detection and effective treatment. 

This blog aims to disclose various types of eating disorders, their symptoms, and potential causes. 

What is Eating Disorder? 

Eating disorders can be classified as serious mental health disorders that severely affect a person's relationship with food, weight, and appearance. These complex disorders impact both emotional and physical well-being, often leading to distressing thoughts and persistent disturbances in eating behaviours.

They can have a profound effect on an individual's physical, psychological, and social functioning. 

Types of Eating Disorder 

Eating disorders involve an extreme focus on food, eating, and often weight. These conditions can significantly impact a person's physical and mental health. The most common types include: 

1. Anorexia Nervosa: Characterised by severe calorie restriction, intense fear of gaining excessive weight, and distorted body image. It has two subtypes: 

• Restricting type: Weight loss through dieting, fasting, or excessive exercise. 
• Binge-eating and purging type: This may involve eating very little or bingeing, followed by purging. 

2. Bulimia Nervosa: Involves bouts of binge eating followed by compensatory behaviours like purging, fasting, or excessive exercise. 

3. Binge Eating Disorder (BED): Characterised by consuming large amounts of food rapidly, often in secret, accompanied by feelings of distress or shame. 

4. Avoidant/Restrictive Food Intake Disorder (ARFID): Characterised by a decreased interest in eating or avoidance of certain foods, leading to nutritional deficiencies. 

5. Pica: The persistent eating of non-food items like ice, dirt, or paper. 

6. Rumination Disorder: Involves regularly regurgitating food, re-chewing it, and either re-swallowing or spitting it out. 

Symptoms of Eating Disorder 

Eating disorders manifest through various symptoms, depending on the specific condition. 

• Anorexia nervosa often involves severely restricted calorie intake and an intense fear of gaining weight. People with anorexia may exhibit dramatic weight loss, wear loose clothing to hide their bodies, and obsessively count calories. They might also avoid eating in front of others and exercise excessively. 
• A person with bulimia nervosa shows phases of binge eating followed by purging behaviours. Signs include multiple trips to the toilets after meals, evidence of vomiting, and the use of laxatives or diuretics. 
• Individuals with bulimia may also show scarred knuckles from inducing vomiting and complain about being "fat" despite normal weight. 
• People with binge eating disorders report consuming large amounts of food rapidly, often in secret. They may hoard food, eat when not hungry, and feel distressed or ashamed about their eating habits. They might skip meals or avoid eating in front of others. 

Causes of Eating Disorder 

One cannot pinpoint the exact reasons for eating disorders, but research suggests that a complex interplay of factors contributes to their development. These conditions arise from a combination of genetic, biological, environmental, and social influences. 

Some individuals may possess genes that make them more prone to developing these 
conditions. 

• Biological factors, such as any change in brain chemicals, may also contribute to the onset of eating disorders. These alterations can affect mood, appetite, and behaviour, potentially leading to disordered eating patterns. 
• Some people may use extreme measures to limit food intake or avoid certain food groups when they feel other aspects of their lives are difficult to manage. 

Diagnosis of Eating Disorder 

Doctors diagnose eating disorders through a combination of physical and psychological 
evaluations. 

• During a physical exam, doctors check vital signs, including blood pressure, breathing rate, and pulse. Lab investigations, such as a complete blood count and liver, kidney, and thyroid function tests, help assess overall health. 
• A psychological evaluation by a mental health expert is crucial. They ask questions about eating habits, attitudes towards food, and body perception. While these questions can be personal, honest answers often help in accurate diagnosis and curation of effective treatment plans. 
• To receive a diagnosis, individuals must meet the criteria for a specific type of eating disorder. 

Treatment for Eating Disorder 

Treating eating disorders involves a comprehensive approach tailored to the individual's specific needs. A team of mental health experts, registered dietitians, and medical specialists work together to address the physical, psychological & nutritional aspects of the condition. 

• Psychotherapy plays a crucial role in eating disorder treatment. Enhanced cognitive behavioural therapy (CBT-e) has proven effective for bulimia nervosa and binge-eating disorder, helping patients recognise and change distorted thoughts related to their eating habits. Family-based eating disorder cure can be beneficial for teens, involving parents in the recovery process. 
• Nutrition education is essential, focusing on establishing healthy eating patterns and correcting nutritional deficiencies. 
• Sometimes, medication may be prescribed, particularly antidepressants, for disorders involving binge-eating behaviours. 
• For severe cases, inpatient treatment or day programmes may be necessary to stabilise medical conditions and provide intensive support. 

Risk Factors for Eating Disorder 

Several factors can increase a person's susceptibility to an eating disorder, such as: 

• Genetics: Individuals with close relatives who have eating disorders are at higher risk. 
• Perfectionism: Self-oriented perfectionism is associated with various types of eating disorders. 
• Environmental factors: Experiences of trauma, bullying, or teasing about weight can trigger disordered eating behaviours. 
• Age: Eating disorders are most common in teens and early twenties. Participation in activities that emphasise appearance, like modelling or certain sports, can also heighten risk. 

Complications of Eating Disorder 

Long-term eating disorders can devastate an individual's life, affecting their physical health, emotional well-being, career, and relationships. 

• Anorexia nervosa can cause thinning of bones, muscle wasting, and damage to the heart's structure and function. It may result in low blood pressure, slowed breathing & a drop in internal body temperature. Individuals with anorexia often experience lethargy and infertility. 
• Bulimia nervosa can lead to a chronically inflamed throat, worn tooth enamel, and gastrointestinal problems. Severe dehydration and electrolyte imbalances from purging behaviours can cause stroke or heart attack. 
• Binge eating disorder often results in obesity-related health issues and an increased risk of co-occurring mental health disorders. 

When to See a Doctor 

Seeking professional help is the most essential aspect when dealing with eating disorders. Individuals should contact a doctor if their relationship with food causes distress or interferes with daily activities. Immediate medical attention is necessary for eating disorder symptoms like chest pain, breathing difficulty, heart palpitations, dizziness, fainting, severe sore throat, acid reflux, slurred speech, or blurred vision. 

Prevention 

While there's no guaranteed way to prevent eating disorders, individuals can take steps to develop healthy eating habits and reduce the risk. 
. 
Opting for a diet abundant in whole grains, fruits, and vegetables while limiting salt, sugar, alcohol, and unhealthy fats is crucial. 

• It's important to avoid extreme dieting and instead consult a dietitian for a personalised weight management plan if needed. 
• Engaging in at least 150 minutes of aerobic activity weekly, such as brisk walking, can promote overall health. 
• Taking expert's help for mental health issues, including depression, anxiety, or self- esteem problems, is equally important. 
• Parents can help their children develop healthy eating behaviours by: 
• Avoiding dieting around children 
• Talking openly about the dangers of unhealthy eating choices 
• Encouraging a positive body image, regardless of shape or size 
• Seeking help from doctors to identify early signs of eating disorders 
• To foster a healthier society, individuals can: 
• Speak out against the "thin ideal" and its negative impact 
• Be positive role models by living a well-rounded lifestyle 
• Recognise that health comes in all shapes and sizes  
• Avoid engaging in "fat talk" and challenge media portrayals of beauty 
• Promote self-esteem based on qualities other than physical appearance 

Conclusion 

Eating disorders are not a single condition but a cluster of mental health disorders that can impact an individual's physical and emotional well-being. They are treatable, and early intervention can make a significant difference in recovery. We can create a more supportive environment by promoting positive body image, challenging societal beauty standards, and fostering self-esteem based on qualities beyond physical appearance. 

FAQ's 

1. How common are eating disorders? 

Eating disorders affect a large section of the population. In India, eating disorders affect up to 2-3% of the population. 

2. Is eating disorders a bad thing? 

Eating disorders can be considered serious health conditions that affect both physical and mental well-being. These conditions can harm the heart, digestive system, bones, teeth, and mouth. They're also linked with depression, anxiety, self-harm, and suicidal thoughts. 

3. Why do eating disorders develop? 

The exact cause of eating disorders is not known. They result from a complex interplay of factors, including: 

• Genetics: Family and twin studies suggest that eating disorders run in families. 
• Biology: Changes in brain chemicals may play a role. 
• Environment: Stressors such as illness, trauma, or loss can trigger the onset. 
• Social Factors: Cultural and social ideals, especially regarding body image, contribute to the development of these disorders. 

4. How do we fix eating disorders? 

Treatment for eating disorders depends on the type and individual needs. A comprehensive approach typically includes: 

• Enhanced cognitive behavioural therapy (CBT-e) 
• Nutrition counselling 
• Antidepressants 
• Involving parents in the recovery process.

Dr. Snehal Makeshwar

MBBS, MD (Medicine), DNB (Gastroenterology), Fellowship in EUS
Ganga CARE Hospital Limited, Nagpur

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