Eating disorders on the rise: Poor body image and anxiety are contributors, say experts
An eating disorder diagnosis is a health crisis that disrupts personal and family functioning.
The present pandemic has made people anxious; this has made them binge eat: Dr Vineeta Tandon.
Encouraging children to have healthy eating habit since childhood will prevent eating disorders: Shalini Garwin Bliss.
In early January 2020, the Academy
for Eating Disorders, a US-based professional association in its publication
titled Nine truths about Eating Disorders by Dr Cynthia Bulik brought to
attention the need to spread awareness about the subject. The document aims to
eradicate the stereotypes and educate both medical professionals and the public
about these deadly disorders. In India, unfortunately, there has been sporadic
research on eating disorders, with no published attempt to collate and
summarise the literature landscape. The earliest description of an eating
disorder (ED)-like syndrome came to light in 1694 where two adolescents had
loss of appetite, extreme fasting and weight loss. In India, the occurrence of
ED was not reported until 1966.
A study involving the examination of 210 medical students of Chennai using eating attitudes test (EAT) and BITE self-report questionnaires reported 14.8 per cent of the studied population to have syndrome of eating distress. Another study conducted on a North Indian population revealed the prevalence of bulimia nervosa (BN) to be 0.4 per cent.
What is eating disorder?
According to Shalini Garwin Bliss,
head dietician at the Manipal Hospitals in Gurugram, eating disorders are
characterised by abnormal eating habits. "If we talk to a group of
teenagers in an informal setting about their physical appearance, we will find
that a majority of them are dissatisfied with their weight, as well as, their
physical appearance. Most of the girls are not satisfied with their body image,
they want to have zero figure. This obsession will lead to eating disorder. The
present pandemic has only worsened the condition. Our daily life and routine
has been disturbed. Teenagers for the last two years were home-bound. This
stay-at-home routine restricted activities and social life which in turn has
caused a lot of anxiety among the young. Binge eating or not eating at all has
become common," Bliss said.
'I am fat' syndrome
Dr
Shambhavi Jaiman, psychiatrist, Department of Mental Health and Behavioural
Sciences, Fortis Healthcare tells you that eating disorders have to be seen in
a different light. "Yes, the condition involves overeating along with
purging. Here, the binge eating is associated with the body image – 'we are
fat'. During the pandemic, what was observed is that binge eating is associated
with anxiety. While eating disorders have not gone up per se, anxiety has
definitely gone up. Also, if a person was prone to eating disorders, COVID has
added to the burden," Jaiman said.
Lack of data
Pulkit
Sharma, a Puducherry-based clinical psychologist shared an interesting insight
about lack of data. "In our country, there is a lot of emphasis on
slimness in the society. Being stick thin is normal healthy behaviour. Slimness
is so glorified and idealised that a lot of family and friends don't even
realise that someone around them has an eating disorder. Or for that matter
even think there is an issue. If someone is not eating, is considered good, it
will help her get a good husband," Sharma said.
Symptoms to watch out for
It is important for family and friends to watch eating pattern of people whom they suspect may have this eating disorder. "Such people usually have different eating patterns. They tend to eat a lot and if they have body image issues, they will purge. Others will not eat at all because they think they are fat,"Jaiman said. She sees around 20-30 per cent teenagers who have issues with body image and hence tend to be more prone to eating disorders.
Not just teenagers
Dr Vineeta Tandon, senior consultant, Internal Medicine, PSRI Hospital, New Delhi opines that eating disorders are not limited to teenagers alone. "It affects people all ages. People today are eating a lot of processed foods, package food that is high in sugar and salt. The young prefer to eat less fresh foods. We are moving away from proteins, an important nutrient and are consuming wrong fats – saturated fats than paying attention to the unsaturated ones which we get from fish and nuts. We have incidents of eating disorders on the rise because emotional eating has contributed to it. A lot of people found gratification in eating while they were home-bound," Tandon said.
Disorder linked with mental health
Sharma says that once a person has a certain image about their body, it will change eating habits and relationship with food. "Such people will have lot of anxiety while eating or thinking about food. People today have weighing machines in their homes and they track their eating on health apps and see how many calories they have consumed. Once you get anxious about how you look, everything changes. Poor mental health can precipitate eating disorder," Sharma added.
Types of eating disorders
There are sub-types of anorexia as well. According to Bliss, broadly speaking the six common eating disorders are:
Anorexia: It refers to loss of appetite, especially as a result of disease.
Anorexia nervosa: A disease characterised by refusal to maintain a minimal body weight, intense fear of gaining weight, body image distortion.
Binge: An episode of eating marked by three particular features: Amount of food eaten is larger than most persons would eat, and the excessive eating occurs in a discreet period, usually less than two hours.
Binge Eating Disorder: A disorder characterised by the occurrence of binge eating episodes at least twice a week for a six-month period.
Bulimia nervosa: A disorder characterised by repeated episodes of binge eating followed by inappropriate compensatory methods such as purging, including self-induced vomiting or misuse of laxatives, diuretics or non-purging including fasting or engaging in excessive exercise.
Purging: It is a method intending to reverse
the effect of binge eating. This may involve self-induced vomiting, which is
the most common purging method. Additional methods may include laxatives, enema
and diuretic abuse.
How to manage these disorders
"One of the first steps to prevent eating disorders it to encourage
healthy eating habits since childhood. Make a schedule of eating.
Ensure that you stick to it and include an exercise; it can be walking
or yoga or aerobics or even dancing classes," Bliss said in
conclusion.