Food is mandatory for everyone to gain nourishment and live a healthy life. It fulfils physical, mental and emotional requirements. In the present age, eating is not just a necessity but a tool to gain popularity and acceptance through faultless body image. Social media and exploding technology availability are making people obsessed with eating baseless viral fad hunger diets to look picture-perfect thin and best 24/7.
While the physical symptoms of starvation are very obvious, when the brain is malnourished, it negatively affects mood, behaviour, appetite regulation, and relationships, and distorts the perception of body weight and shape (body dysmorphia). It starts with a mere interest, slowly becomes an addiction and finally an imbalanced mental state. These are serious and often fatal illnesses. Obsessing over food, and body weight leads to Eating disorders (ED), which are a lifelong battle.
What is ED?
With modernization, ED is becoming more prevalent. ED is a treatable medical illness in which maladaptive eating behaviours cause several health complications. ED frequently co-occur with other psychiatric disorders such as depression, substance abuse, and anxiety.
Warning signs of ED
- Reduced interest in food intake and avoiding specific food like sweets, cereals and high-carbohydrate recipes
- Showing obsessiveness towards eating healthy, calories, activeness and restlessness all the time
- Inability to identify hunger and satiety
- Preferring very small portions of food and not eating a balanced diet
- Spending too much time thinking about food, body weight, recipes, food channels and food shopping
- Displaying angry, tense, or hostile mood at the time of meals
- Using the excess amount of condiments and hot sauce
- Dividing food into very small pieces before eating
- Choosing inappropriate food utensils and food combinations
- Favour eating food in a certain order
- Trying to hide food in napkins, and handbags, give it to dogs and throws food away
- Exhibiting marked weight changes or absence of expected weight gain, weakness, fatigue, or lethargy
- Sudden development of poor concentration, memory loss, insomnia, depression, anxiety complications
- Forced purging after eating
Types of ED
Anorexia nervosa (AN)
- It is a highly distinctive serious mental disorder and affects individuals of all ages, races, and ethnic origins
- Adolescent girls and young adult women are particularly at risk
- Involves the fear of gaining weight, having a distorted body image, a refusal to maintain a normal weight, and using extreme measures to keep the weight off
- Mostly diagnosed after a person is 25-30 per cent below the normal weight for three months or more
- Displays disturbed emotional state
- Targets losing weight purely by dieting and exercising without binge eating or purging
- Sometimes aspires to restrict food intake and exercises intensely to lose weight, and periodically engages in binge eating
- Associated with denial of illness and resistance to treatment
- Consequently, it is difficult to engage individuals with AN in treatment, including nutritional restoration, and weight normalization
Physical signs and effects of AN
Dizziness, anxiety, depression, dry skin and lips, thin hair, intolerance to cold, very low BP, cardiac failure, anaemia, diarrhoea, bloating, abdominal pain, kidney damage, osteoporosis, irregular menstruation, muscle loss and weakness.
Bulemia Nervosa (BN)
- It is a serious and life-threatening ED
- Characterized by a cycle of bingeing and compensatory behaviours of self-induced vomiting to undo or compensate for the effects of binge eating
- Mostly diagnosed if the binge-vomiting cycle occurs at least two times a week
- The act of vomiting causes severe damage to the oesophagus and teeth and it can also cause the gag reflex to be less sensitive
- Sometimes occurs with excessive exercising or fasting
Physical signs and effects of BN
Anxiety, depression, bad breath, tooth decay, sore throat, low BP, fainting, diarrhoea, cramps, constipation, ulcers, pain, irregular menstruation, kidney malfunction, lethargy and tiredness.
Binge eating disorder (BED)
- Consuming food when not feeling physically hungry, experiencing a loss of control over eating behaviour and having food much more rapidly than normal
- Indulging in food until uncomfortably full, eating food alone to avoid embarrassment, or feeling disgusted, depressed, or guilty after the eating
- Accompanied by regular compensatory behaviour not including binge eating occur solely during an episode of bulimia nervosa or anorexia nervosa
Physical signs and effects of BN
Feeling guilty, embarrassed, sleep apnea, high BP and cholesterol, weight gain, gall bladder disease, diabetes, kidney failure and low bone density.
ED not otherwise specified
⦁ This disorder does not meet the criteria for any other specific eating disorder
- Consuming large majority of food at a vague hours
- Involves recurrent episodes of the night eating and excessive food consumption in the evening or after dinnertime
- Eating in between awakening from sleep
- Feel depressed in the evening, and believe that can not get back to sleep without eating
Why eating healthy is necessary to get rid of ED?
ED-associated malnutrition is a serious medical condition. Early recognition and nutritional rehabilitation are key to successful treatment. This should go along with weight stabilization and normalization of eating behaviour. Simultaneously nutrition education involving health risks of following unhealthy eating patterns should be given to the patients. Treatment plans for eating disorders should include psychotherapy, medical care and monitoring, nutritional counselling and medications
Objectives should include
- Restoring adequate nutrition
- Bringing weight to a healthy level
- Reducing excessive exercise
- Stopping binge-purge and binge-eating behaviours
It is not easy to treat co-occurring conditions as part of the ED treatment plan. There is no special kind of diet to cure this illness. Advice should be given to eat a balanced diet including all food groups and a wide variety of nutrients.
Healthy eating tips for ED
Effective treatment should always include regular and appropriate nutrition.
- Eat an adequate amount of food, and essential nutrients, attain ideal weight and follow a healthy lifestyle
- Add the small and steady changes in eating routine and avoid sudden big impractical change
- Eat food regularly at right time and never skip meals
- Be physically active and maintain a steady calm positive mental state
- Stay away from overindulgence in digital options
- Take required rest and sleep well
More awareness needs to be created for ED among all age groups. Proactiveness should be offered towards ED warning signs and possessiveness at right time. Promoting healthy eating habits and regular intake of main meals should be stressed tirelessly for current health and future well-being. Perseverative comprehensive healthcare efforts are required to build confidence, self-acceptance, a positive mindset and steady healthy quality of life.
Eating should be a reason for satisfaction, fulfilment and replenishment and not a cause for scarcity and anxiety. Conscious care and effort should be made to make meal time a happy pleasurable moment alone or with loved ones.
- Progress in Nutrition 2018; Vol. 20, Supplement 2: 29-35
- Rocz Panstw Zakl Hig 2019;70(1):41-48