Eating disorders are mental disorders. They might be, relatively speaking, either with a minus sign or a plus sign.
With a minus sign – lack of appetite, oppression of the desire to eat, anxiety about weight and body shape – anorexia nervosa.
With a plus sign – a very strong appetite, excessive anxiety about weight and body shape, when a person eats a lot, and then, due to guilt and shame, can compensate for gluttony with strong physical exertion, causing vomiting – this is bulimia. In 2014, the DSM-5 American Mental Illness Guide introduced another plus sign disorder, binge eating, which is not yet in our reference literature.
During such an attack, a lot of high-calorie foods are eaten (4000-6000 calories), but there is no any compensatory behavior (strong physical activity to burn calories, induce vomiting, etc.).
It is also worth noting orthorexia – a manic desire to live a healthy lifestyle, eat “clean and proper” food.
Until recently, anorexia and bulimia were called “American diseases.” How did it happen that in our country they also became quite common?
Alas, this is a sad popularity. In fact, these diseases have always existed. The first case of anorexia, which is described in the literature, is the story of St. Catherine – Catherine of Siena (XIV century). She ate so little that even church priests were wary of such asceticism.
There is a very small amount of statistics on the disease in Ukraine, so we have to rely on the data from the United States, where people seek help more often. According to various sources, anorexia affects from 1 to 4.2 percent of the population, bulimia – from 4 to 10 percent.
The doctor of medicine Galina Pilyagina once said that “in psychiatry there are only two zones that border on death – suicide and anorexia.”
Are things really that bad?
Anorexia in mortality leads among all mental illnesses. The reason is not only death from cachexia (exhaustion), but also a high risk of suicide. Let me just tell you what anorexia does to the body (I’ll tell you through a female example, men are less likely to have this disease).
During all day, a girl can eat half an apple, a few tablespoons of oatmeal – that’s all. An incredible deficiency of trace elements occurs, hypocalcemia begins, hair, teeth, nails, skin suffer, bones become fragile. Metabolism slows down, the person is constantly freezing. The nervous system, the heart begins to suffer, because he needs potassium, magnesium.
In fact, at the age of 15, the girl has all the signs of menopause … And this is terrible … It is important to understand: if a woman suffering from anorexia says that she will stop the hunger strike when she reaches a certain weight, then, alas, having achieved what she wants, she can no longer stop – the brain begins to work differently.
The danger hits adolescent only, or anorexia does not spare adult female as well?
The most vulnerable category is, adolescents, of course, as long as they are the ones experiencing a hormonal surge. The body changes dramatically, and they do not understand what is happening to them.
I remember a 22-year-old girl who weighed 37 kilograms. By the way, at that time my 12-year-old son had more weight … The girl was suffering by anorexia for several years, while she constantly worked, used antidepressants, which she prescribed to herself.
It always amazes how anorexia patients have strength to go to work every day.
There is an interesting evolutionary theory,which claims that anorexia was useful for the survival of mankind. What does a hungry person feel? He does not want anything, feels weakness, headache, cramps in his stomach.
If a person has a genetic predisposition to anorexia, they feel a surge of strength, their mood is increased. Imagine: while the tribe is starving for energy, the anorexic is vigorous and finds food, saves everyone, but dies soon.
Are people with a genetic predisposition at risk for eating disorders?
If there is no genetic predisposition, then you can not get an eating disorder. But how to check whether you have this predisposition or not? Alas, in the Ukrainian laboratories such analyzes are not yet done.
An important role is played by the example of mom. If she constantly sits on strict diets, the child will adopt this model and consider that it is normal to severely limit themselves in food.
The risk group includes those who are brought up in overly controlling, guardianship families, perfectionists who need to do everything as best as possible or not at all. By the way, a father who practices endlessly can also become the “trigger” of the disease.
Bulimia can be triggered by a trauma, including of a sexual nature, some kind of severe stress. Outwardly, bulimics are quite successful people, they look good, make good money. And they rarely seek help because of a sense of shame. We can recall the example of Princess Diana, who suffered from bulimia.
How to find the line between a truly healthy lifestyle and an eating disorder – orthorexia?
In fact, this line is very thin. When a person devotes all his time to drawing up shopping plans, searching for “the very” right products and preparing them correctly — this is a disorder.
All this cannot be done without prejudice to social life. Such a person is secluded, because those around him do not understand what he is doing and why it is so important to him. In fact, arugula or broccoli becomes a friend of orthorex.
I’ll tell you about a funny and simultaneously sad case at the same time. Recently, one girl wrote to me that she wants to lose weight, but it’s hard for her to follow a diet. It turned out that she only ate boiled and slightly salted broccoli (!) and washed it down with water.
To be honest, at first I thought it was some kind of trolling. It turned out that the person really sat on such a “diet”, experiencing a constant feeling of hunger.
Who is most likely to suffer from orthorexia?
Among orthorexics, there are quite a lot of both women and men. In 2015, I conducted a study of the need-motivational sphere of people with orthorexia to understand what motivates these people to act this way.
There was believed that such behavior is inherent in people who are frightened by the outside world, but my research has shown that the leading need of people with orthorexia is self-affirmation.
A person with orthorexia thinks something like this (I’m obviousely exaggerating): “I eat wonderfully, and therefore I live better than you; I am pure, correct, and therefore I can lecture you.”
Is there any way to test yourself for having first signs of an eating disorder?
Such methods will help to check one’s relationship with food: test EAT-26, Dutch questionnaire of eating behavior, Rome questionnaire ORTO-15 – will help to understand whether there is a case of nervous orthorexia.
All these techniques can be easily found and accessed on the Internet. Examples of behavior that should alert: sharp weight loss, constant dissatisfaction with one’s appearance.
During the meal, everything is divided into very small pieces, chewed very slowly and washed down with a large amount of water.
A separate tip for teenage mothers: respect their personal boundaries (knock before entering, close the door to the child’s room), ask why they are depressed, and do not require them to be the best of the best – these are simple but important things.
Because parents often lead an already exhausted child to a psychotherapist. And you understand that the moment of the initial stage is missed. While the treatment of any eating disorder is an expensive and difficult process.
Since there are practically no specialized departments and clinics in our country, such patients are treated either in gastroenterology or in psychiatric departments of hospitals. There are no government programs that would finance such psychotherapy, and there are very few specialists who specialize in the ED treatment and have real training in this field. Therefore, it is so important to be considerate of yourself and your loved ones!