CHENNAI: We live in an age of apps that ‘perfect’ your facial features, cut the fat, lighten skin tone and do what a fairy Godmother once did with the swipe of a wand in fairy tales. At a time when self-worth is measured in the number of likes one gets for pictures and the number of friends and followers one has online, a lot boils down to that ‘perfect’ picture. With this comes an almost unrealistic expectation or aspiration of how one should look, which is fuelling the prevalence of eating disorders which is dismissed by many. While the prevalence of eating disorders in India is lower than that of western countries it appears to be increasing, according to experts.
An eating disorder is defined as a persistent disturbance of eating behaviour or behaviour intended to control weight, which significantly impairs physical health or psychosocial functioning, often turning out to be a chronic psychiatric condition. They tend to be emotional disorders that focus on food, but are actually attempts to deal with perfectionism and a desire to gain control by strictly regulating food and weight, experts said. The common types of eating disorders include anorexia nervosa, bulimia nervosa and binge eating disorder.Treatment for these kinds of disorders has to be a multi-pronged approach, experts said.
“Dietary treatment alone will not help without counselling as it is a psychological problem,” said Raj. “When someone has anorexia nervosa, there are a number of other issues that they face like dental issues, acidity, chronic sore throat and so on. In order to treat such a patient, it is imperative to have a good general physician who can help with sorting out the medical issues, a trained psychologist or counsellor who can help in bringing in a positive outlook on body image and a dietician who can educate the patient on the importance of a balanced diet.”
Psychological counsellor Sneha Hindocha concurred with Raj’s view. She stressed the importance of a holistic approach to the treatment process and said acceptance of the issue is the first step towards treatment.“When it comes to body image issues, the only way a patient can get better is if they accept and believe that they are okay with the way their bodies are,” said Hindocha.
“Counselling is a powerful tool that can help such patients but when it comes to severe cases, medication is a must, especially in severe anorexia cases where the patient has lost a lot of weight as it can be life-threatening. The support of family and friends is essential in these cases as they play a bigger role than the counsellor. Sensitising them to the needs of the patients is crucial.”
Anorexia nervosa is an eating disorder characterised by excessive restriction on food intake and irrational fear of gaining weight, often accompanied by a distorted body self-perception, explained a report published in the Indian Journal of Psychological Medicine in April, 2015. It is clinically diagnosed more frequently in females, with type and severity varying with each case. While the cases of anorexia nervosa are reported greatly in the grey literatures of the western countries, the number of clinical cases in India is on the rise, the report said. The age of onset for most cases ranges between 12 to 20 years and most cases are brought to clinical attention only when there are severe somatic complaints. In developing countries like India, severe anorexia is not commonly reported.
“The body gets its energy from carbohydrates, proteins and fats,” said dietician Dr Preethi Raj. “In the case of anorexia, the patient generally restricts carbohydrates which is very harmful as in the case of adolescents and young adults, carbohydrates should constitute 45-65% of the total calories. Not having a proper intake can lead to adverse issues like malnutrition and muscle loss. Further, it has protein sparing action. Most of them take fruits and vegetables only and it doesn’t give enough protein and fat. Protein is important for immunity fighting against infection while fat makes hormones.”
Experts have emphasised greatly the role that social media played in sparking a negative body image. They said that, in turn, lays the foundation for eating disorders to gain a stronghold in the minds of impressionable youngsters.“Social media is the forum where the perception of the self and worthiness of the self is measured today,” said Mumbai-based cyber psychologist Nirali Bhatia. “Being picture perfect and the need to be accepted, appreciated and acknowledged by others weighs down heavily on a number of people. There’s also a huge information overload that has come in with the internet, which provides young children with access to unverified information too early that has the potential to colour their perception.”
Raj said that parents and friends should look out for a few tell-tale signs. These include malnutrition, sunken eyes, bloated belly, constipation or diarrhoea, erratic menstrual cycle, insomnia or disturbed sleep, waking up in the wee hours of the morning and frequent changes in weight.
“Eating disorders tend to stem from low self-esteem and peer pressure,” said Bhatia. “I have noticed that a number of young children are facing issues of binge eating where it forms a cycle of overeating and starvation. Most of these children are either bullied in person or online and find some comfort in food. They tend to get a rush the moment they eat, which relieves their stress and right after that they feel a sense of guilt and starve themselves.”
Experts believe that awareness is the key to overcoming these disorders. They said that most people take these issues lightly as they themselves do not know how these disorders can wreck havoc on their bodies.
What is an eating disorder?
Persistent disturbance of eating behaviour or behaviour intended to control weight, which significantly impairs physical health or psychosocial functioning, is often turning out to be a chronic psychiatric condition
What are the causes of eating disorders?
No precise causes, but depression, anxiety, low self-esteem, and substance abuse could be factors
Who is most prone to developing eating disorders?
Teenage girls and young women are most prone to developing these disorders. However, they can occur among men as well
What is making eating disorders increase in developing countries?
The advent of technology and internet and their standard of ‘beauty’ is being attributed to the spike in cases of eating disorders in developing countries
What is anorexia nervosa?
Most common form of eating disorder
Exists predominantly in young women and teenage girls who are vulnerable and extremely self-conscious.
Extremely scared of gaining weight and suffer from extremely low self-esteem
Become obsessed with their weight and outer appearance
If left untreated, anorexia can lead to organ failure and undernourishment.
What is bulimia nervosa?
Experience phases of binge eating
Eat copious amounts of food, mostly junk food and then purge
Either vomit or misuse laxatives to throw out every ounce of food that their body consumed
Result of a distorted self-image
Consider themselves fat and are scared of putting on any weight
Can lead to abnormal heart beat, bleeding from esophagus due to excessive reflux of stomach acid, kidney failure, and dental problems
Signs and symptoms to watch out for
Extreme fear of weight gain
Relentless need for exercise (in case of anorexia & bulimia)