There is disorder in order. Any teenager on Instagram or TikTok knows that following orders of social media’s look-good gurus affirms weight fears and creates eating disorders. Their inspiration is to be one of the girls with nearly zero percent body fat on #thinspiration and #bonespiration. Some starve for ‘likes’. Those who cannot make it to Size Zero, go binge-eating—both disorderly conduct on Zomato. Chennai-based eating disorder specialist Dr Udipi Gauthamadas is on record saying, “Disturbed eating attitudes and behaviours affect about 25 to 40 percent of adolescent girls and around 20 percent of adolescent boys.”
Anorexia nervosa patients forcefully throw up and resist food. Those with bulimia nervosa adopt repeated cycles of binge-eating and starving. Both are dangerous, not only for the body, but also for emotional well-being. “Most of the patients, especially young girls with eating disorders, are unaware of the actual cause of their problems. At times, they cannot even tolerate the smell of food. Often they visit GPs, who may be unfamiliar with the issue. This often leads to wrong diagnosis or delay in treatment,” says Dr Anjali Chhabria, psychiatrist and director of Mind Temple Centre, Mumbai. In India, awareness of the disorder is low. So is the number of studies.
A recent study by Wales-based Swansea University indicated that people suffering from eating disorders have probably faced mental or physical trauma in adolescence. In the West, eating disorders are a well-known malaise and treatment is easily available. In India, most of patients suffer in silence. “There is a continuous spike in cases among young girls and women aged between 15 and 35 years. And in young boys too. The guilt and fear of being fat forces them to purge calories by self-induced vomiting,” says Dr Jitendra Nagpal, head of the psychiatry department, Moolchand Hospital, Delhi.
Eating disorder is not just about ‘not eating well’. It is also a mental condition. According to government data, 10.6 percent Indians have mental health issues—roughly around 150 million citizens. Only 10 percent get treatment for food-induced problems. “It’s difficult for a general practitioner to judge the difference between an eating disorder and simple dieting because they are not trained and updated to handle such cases,” says Dr GS Grawal, senior consultant and chairman of Wellness Health and You. “Doctors should be given due training to tackle these cases,” he adds.
Unhealthy eating habits have genetic origins in some cases. Mostly it is social. Body-shaming is a widespread trend on social media, since all it takes is a cell phone camera to upload a weight-challenged person eating a double cheese burger at McDonald’s. International studies show that cyberbullying, such as fat-shaming chain mails are often responsible for low self-esteem and eating disorders.
Body activists are hitting back with body-positive articles on Women’s Web, online petitions and tactics like taking a screenshot for posting on help sites. Psychologists believe patients can benefit from Dialectical Behavioural Therapy (DBT) that transforms negative thinking patterns and destructive behaviours into positive outcomes as treatment. So does Cognitive Behavioral Therapy that combines talk and behavioural therapy. Are Instaphrases like “thin is beautiful” and “thigh gaps are sexy” really worth throwing up? Food for thought.
In a recent report, researchers from Karolinska Institute in Sweden suggest that eating disorders may be targeted by use of a smartphone app-based therapy. “Anorexic patients can normalise their eating rate by adjusting food intake to feedback from a smartphone app,” says Per Sodersten, lead author of the research in the journal Frontiers in Neuroscience. “Subjects eat food from a plate that sits on a scale connected to their smartphone. The scale records the weight loss of the plate during the meal, and via an app creates a curve of food intake, meal duration and rate of eating,” says Sodersten.
A reference curve for eating rate and a reference curve for the feeling of fullness are also displayed on the screen of the smartphone. The subject can thus adapt their own curves in real time to the reference curves, which are based on eating behaviour recorded in healthy controls. Through this feedback, patients learn to visualise what normal portions of food look like and how to eat at a normal rate.
Raise the flag
- Failure to thrive
- Any dieting, excessive preoccupation on the calorie content of food/quality of food ingested
- Eating only healthy food
- Cutting out food groups
- Excessive exercise
- Spending an undue amount of time in front of the mirror scrutinising the body
- Criticising one’s body, voicing wishes to lose weight
- Disappearing after every meal to the toilet
- Bruised knuckles
- Quantities of food disappearing from the house
- Use a holistic approach
- Timely psychological assessment and counselling
- Special session with the family about dos and don’ts
- Encourage yoga, meditation, dance and music therapies