KOCHI: In the 2017 film ‘To the Bone’, the protagonist, Ellen, played by English-American actress Lilly Collins, is an undernourished, shrivelled shadow. The movie deals with anorexia nervosa, an eating disorder. Interestingly, according to the actress, it wasn't hard to play the lead as she had fallen prey to the clutches of eating disorders for over a decade. With celebrities and public figures such the late Princess of Wales, Diana, who was adversely affected by bulimia to pop singer Demi Lovato, who lives with an eating disorder and a million adolescents opening about their battles, the stigma over such disorders has decreased and awareness increased.
Types
Anorexia nervosa: Victims are desperate to adapt their bodies into an ‘ideal’ image and restrict their food intake perpetually.
Bulimia nervosa: Individuals are rather aware of their tendency to overeat albeit purge or vomit by force upon feeling guilty.
Binge-eating: The person assumes food can provide a solution to anxiety and depression and consumes large amounts.
Orthorexia: Victims are obsessed with healthy eating, counting calories and choosing to eat food from specific groups.
“Anorexia and bulimia are mostly seen in adolescents, primarily girls. They're influenced by their peers and pop culture. The last stage of growth and development is the adolescent stage when the individual requires the right amount of nutrients. And when the person refuses to consume the appropriate amount of food, he or she is robbed of sufficient calories and their growth is largely affected,” said Mumtaz Khalid, consulting clinal nutritionist, Rainbow Polyclinic. Elaborating on common eating disorders, she said: “Anorexics are constantly worried about weight gain – they eat little to none. As for those affected by bulimia, frequent purging can cause irritability in the throat, thereby cracking the oesophagus.”
It's all in the mind
However, despite revolving around food, the disorder takes root in the mind. “Many are carried away by society's expectations of what an ideal body image is. They live in fear of having a body figure that is incompatible with what they assume is an ‘ideal’ image. They might be as thin as someone who is starving for days. Unfortunately, they’re unable to see past it and refuse to come to terms that the reality is pathological,” said Dr C J John, psychiatrist and senior consultant at the Medical Trust Hospital, Ernakulam. Those affected by eating disorders are mostly victims of depression.
Treatment
Lack of awareness is a pivotal issue. “Professional intervention arrives late as society tends to ignore problems revolved around eating eventually leading to the victim's death. A multidisciplinary approach is the solution wherein a dietician, endocrinologist and psychologist or psychiatrist are involved. The self-esteem of the individual has to be boosted. Their emotional disturbances and difficulty in handling frustrations must be addressed by psychotherapy. Some would need medicines which can alleviate their anxiety and depression,” said Dr C J John. The pathological mindset must be addressed primarily, after which the dietician intervenes.