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Eating disorders in the modern world

Eating disorders are, more often than not, a psychological one. Psychotherapy such as counselling and re-conditioning is often required to set the patient back on a healthy track. Education on what is a healthy diet, managing the self-image and self-esteem are key goals to achieve. Follow up counselling from six months to years after may be needed to ensure that the patient does not relapse.

Eating disorders are abnormal eating habits that involves insufficient or excessive food intake to the point it adversely affects a person's physical and mental health. Although eating disorders are on the rise globally, women in modern cultures are at the highest risk of developing them. Depression, stress, and genetic factors weigh in heavily, but a skewed self-image is perhaps one of the greatest cause of these eating disorders.

There is peer pressure, especially among the younger generation, to look more attractive. Food intake is the most immediate and visible way to achieve what is considered an attractive figure. Some follow crash diets. Some give up eating altogether. Some eat, and force regurgitation of the food. Some go by calorie count rather than nutritional value, assuming that eating the right amount of calories is sufficient, even if it is junk food. These are dangerous mindsets that lead to eating disorders.

Types of eating disorders

There are three primary and two secondary types of eating disorders:

Anorexia Nervosa is a dangerous condition in which people can literally starve themselves to death. Sufferers tend to be already underweight, but refuse to eat much, if at all. They have an intense and overpowering aversion to weight gain, and will do just about anything to be as thin as possible.  This affects 0.5~1% of girls, usually starting between the age of 14 and 18.

Physiological symptoms Psychological symptoms

Excessive weight loss
Scanty or infrequent menstruation
Thinning hair
Dry skin
Cold/swollen hands and feet
Bloated or upset stomach
Low blood pressure
Fatigue
Osteoporosis

Distorted perception of self
(such as insisting they are overweight when they are not)
Preoccupation with food
Refusal to eat
Inability to remember things
Refusing to acknowledge severity of condition
Obsessive-compulsive behaviour
Depression

Bulimia Nervosa sufferers tend to follow a routine of secretive, uncontrolled, or binge eating, thereafter expelling the food deliberately. This includes self-induced vomiting and misuse of laxatives, diet pills, diuretics, excessive exercise, or fasting. This disorder affects 1~3% of the adolescent population.

Physiological symptoms Psychological symptoms

Digestive problems such as indigestion, constipation, and diarrhoea
Irregular menstrual cycles (for girls)
Weakness, tiredness and fatigue
Fluctuations in weight
Fertility problems
Stomach ulcers
Epileptic fits

In severe cases, stomach may rupture, or victim may suffer a sudden, fatal heart attack

Depression
Anxiety
Mood swings and irritability
Low self-esteem
Feeling loss of self-control
Overly conscious about physical appearance and body weight
Obsession with food, dieting and exercise
Feelings of withdrawal
Perfectionism

Binge eating disorder (BED) is at the other end of the spectrum, marked by repeated episodes of uncontrolled eating. This overeating does not stop until the person is uncomfortably full. Unlike anorexia and bulimia, however, is not associated with other inappropriate actions such as inducing vomit and or excessive exercise seen in bulimic persons. This eating disorder tends to begin in late adolescence or early 20s, often after significant weight loss from dieting.

Physiological symptoms Psychological symptoms

Clinically obese (BMI >25)
Fluctuations in weight
Digestive problems
Headaches
Breathlessness

Malnutrition due to binging on food with little or no nutritional value

Depression, low self-esteem
Difficulty with emotions like anger and stress
Feelings of guilt, disgust and shame after binge-eating episode
Embarrassment about binge eating
Finding comfort in food
Feeling a loss of control
Suicidal thoughts
Cycles of bingeing and dieting; Yo-yo dieting
Hiding food and empty containers of food
Difficulty sleeping
Alcohol abuse

Secondary type of eating disorders are as follows:

Eating Disorder Not Otherwise Specified (EDNOS) covers eating disorders which do not meet the clinical diagnosis requirements for specific, formally identified eating disorders. For example, a person may meet most of the criteria of anorexia nervosa despite being at 'normal' weight.

Disordered eating refers to troublesome eating behaviour such as restrictive dieting, bingeing, purging, in lesser frequency or severity than the clinical definition. It can indicate change in eating patterns that occur in relation to a stressful event, such as an illness, trauma, preoccupation with personal appearance, or in preparation for athletic event.

How do we help them, and what are the treatments available?

Sometimes, people without food disorders may display some symptoms, such as inducing vomit before major events, group dieting or excessive exercising. You should attempt to find out their motivation before approaching them.

In other cases, the victim may be obviously affected (such as being extremely underweight). Persons with actual eating disorders often deny that they have a serious problem. Given their state of denial, trying to convince them on your own may be futile or backfire if not handled correctly. In many cases, particularly with anorexia, family or friends must step in and persuade the individual to seek professional treatment.

In extreme cases (which tends to be, with anorexia), hospitalisation to ensure adequate, controlled food intake may be necessary. Patients may be given caloric goals to work towards, and gradually food independence can be allowed if they can meet the intake goals. Greater supervision, however, is necessary whenever the patient relapses.

Eating disorders are, more often than not, a psychological one. Psychotherapy such as counselling and re-conditioning is often required to set the patient back on a healthy track. Education on what is a healthy diet, managing the self-image and self-esteem are key goals to achieve. Follow up counselling from six months to years after may be needed to ensure that the patient does not relapse.

Group therapy has proven to be very effective, and family support is crucial for recovery. Little daily tasks, such as shopping for groceries together help as well. The patient may need to go through a varied of specialists for help, including but not limited to psychologists, psychiatrists, and dieticians.



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