Anorexia and bulimia are not just eating disorders. They hit deep down affecting mental peace and overall well-being, writes Farhana Madar
Eating disorders do not distinguish. They don’t distinguish between class, religion, society, age or gender. The most prominent example that comes to mind when we talk about eating disorders is the late Lady Diana of the UK. She revealed about her fight with binging and puking almost a decade after her condition started post her marriage in 1981. The revelation was intended to raise awareness about the condition which even now is not taken seriously. And it’s not just her. Celebs like Jane Fonda, Lady Gaga and Elton John too have faced these disorders.
Control over one’s own body in the relentless pursuit of thinness leads to eating disorders. The most common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating. They exist alone and, in some people, in combination.
While anorexia results from starvation for huge periods of time in the absolute fear to gain weight, bulimia results from that very same starvation, followed by the pattern of a sudden food binge that is then compensated by purging, out of extreme guilt, or fear to gain weight. Those caught in this battle not only lose a healthy bodyweight, but simultaneously, lose their sense of rationality as no weight seems to be low enough.
The vicious circle
To give us a deeper insight, counselling psychologist, Munira Soni explains, “People in societal pop-culture, whether consciously or subconsciously, perpetuate the idea of thinness through their conversations, judgements and teasing of their peers and other family members. There is a chronic passive obsession about weight within families too, where wives ask their husbands if they look fat in what they’re wearing, or within circles of friends, perhaps, first time seeing someone in a while, and the first thing they utter is that about the person gaining or losing weight.”
Soni also believes that entertainment media plays a responsible role in this matter, stating, “Visuals and daily soaps spend countless hours telling us to lose weight, be thin and beautiful, to buy what they offer because people will like us. It rarely depicts men and women with ‘average’ body-types or simple clothes, ingraining in the back of all our minds that this is the type of life we want. Overweight characters are typically portrayed as lazy, the one with no friends, or ‘the bad guy’, while thin women and pumped-up men are the successful, popular, sexy and powerful ones.”
Recognition and therapy
Many times, out of fear to lose ‘control’ that has been attained, people with eating disorders often try to shove their problem under the rug.
“For anorexia, the most obvious signs are extreme weight loss, a starved appearance with sunken eyes and cheeks, a dull and yellowish or pale complexion, hair loss, a tendency to exercise excessively, reduced libido, depression, missed periods or stoppage of menstruation in women, fainting spells and constipation. Behaviourally there may be irritability, obsessive talk about food or severe criticism of it, social isolation, mood swings and lowered tolerance,” informs Niloufer Ebrahim, consultant psychologist of Jehangir Hospital, Pune.
“For bulimia, there’s self-loathing linked to a poor body image, guilt about eating, physical outcomes include rotten teeth, ulcers, severely inflamed throat, and erratic menstruation. Psychological impact includes depression, anger and poor social behaviour,” continues Embrahim.
It is important to understand that the role of a psychologist extends far beyond the aspect of clinical therapy. Ebrahim informs, “The process is not magical. It includes addressing coping strategies, body image issues, and many other behavioural traits. As psychologists and psychotherapist, we are dependent on acceptance by the client of his/her eating disorder and a willingness to work on the issues. They must understand how life threatening Anorexia can be. The psychologist/therapist must be well versed in the subject, in physiological issues, suicide prevention and have tons of empathy and patience through therapy sessions, and be prepared for pitfalls and failures.
A healthy diet
Along with drastic weight loss and weakness that results from malnourishment, one of the most common symptoms faced due to anorexia is a lack of cognitive functioning and focus. Without the consumption of enough nutrients and foods, the brain and its neurons would simply fail to operate or co-operate enough, hindering the victim’s ability to remember things of the past or attain focus in the present. Thus, and so, finding an empathetic and certified dietician is crucial, to help restore body weight as well as improve brain functionality.
“Establishing ‘trust’ with individuals plays a pivotal role in helping them create a healthy relationship with food. Self-starvation would have caused a number of serious health issues including, but not exclusive of protein and vitamin deficiencies. Primary focus thus needs to be its restoration than the weight gain. The perception of losing weight as a way to achieve happiness and self-mastery is lethal. It is usually achieved by starvation and/or induced vomiting, losing out Sodium and Chloride from the body causing electrolyte imbalance,” says Vaishali Chavan Bathija, nutritionist at Gold’s Gym while adding, “One needs to work on quality and quantity of food and fluids. Initially small meals should be given, gradually increasing the intake. This will help achieve the weekly target of gaining 0.5-1 kg weight. The goal should be to recognise, address by improving their appetite thus healing them (including bulimia patients) physically and psychologically.”
The role of physiotherapy in an anorexic or bulimic person’s recovery is advisable yet optional. After one’s physical and mental well-being has improved, an individual can then opt for the assistance of a physiotherapist to help work through issues caused by muscle-wastage as well as to improve the overall quality of their bone health.
“Physiotherapy helps in recovering joint and muscle health. Consistent weight training using theratubes, body weight support exercises and dumbbells under strict supervision of physios helps improve both the strength and confidence in a patient,” informs Dr Charmie V Desai, a city-based physiotherapist.
“Girls and boys need to be aware of the changes their bodies go through during puberty and why, as well as, why they should feel proud of their bodies no matter what size or shape. The bottom line of everything is Eating Right and not eating light,” adds Soni.