It’s as though her hands move on their own, bypassing any reservations her mind may have. The food piles up, then disappears in chews and swallows. When she’s happy, she eats. When she’s miserable, she eats. When she’s bored, she eats. When she is sleepy she eats. Time ticks by and the mirror begins to validate her fears – she’s getting obese. When she’s outdoors – people look at her with worry, concern or scorn. The clothes are getting tighter and she’s already an XL. She’s so stressed … she eats.
‘She’ has a binge eating disorder. ‘She’ is part of the nine per cent of the global population who suffer from eating disorders. Sometimes, this disorder is hidden behind normal body mass indexes; other times, it’s on full display, either way, it’s a dangerous disease to suffer from – US-based National Association Of Anorexia Nervosa And Associated Disorders (ANAD) explains 10,200 deaths each year are the direct result of an eating disorder—that’s one death every 52 minutes.
Types of eating disorders
Anorexia Nervosa: Twins Clare and Rachel Wallmeyer, who died at age 42 in 2012 in a house fire in Australia, were known for their skeletal frames – a result of this disorder which kept them from eating anything except an occasional bit of watermelon around the time of their death. This disorder is a body-ravaging disease of the mind, which prods the sufferer into eschewing food for they consider themselves fat and have a great fear of putting on weight. People with Anorexia starve and purge – often using laxatives – to keep their weight down.
Bulimia: There’s lots of food on the plate. People with this disorder eat, and eat and eat – until they make themselves sick; puking it all out. The eat-purge cycle may be caused due to stress or anxiety. Often, suffers have a normal body-mass index, making it difficult to identify the trouble. Because it means retching and the throwing up of stomach acid, these patients often end up with a damaged oesophagus, bad breath and melting back teeth.
Binge eating disorder (BED): While all of us binge at some point or the other, people with this disorder will eat huge amounts of unhealthy food, even when they are not hungry. There’s no puking involved here, so they just end up putting on tonnes of weight.
Other disorders: There are of course other eating disorders such as Avoidant / Restrictive Food Intake Disorder (AFRID), where a person will only eat the foods on a ‘safe list’. However, explains ANAD, atypical eating disorders, can resemble other forms of eating disorders but do not meet the exact requirements in order to receive a formal diagnosis.
Dr Waleed Ahmed, Child, Adult and Forensic Psychiatrist, with a specialisation in eating disorders, from Priory Wellbeing Centre, Dubai and Abu Dhabi, explains: “Eating disorders, especially anorexia, and bulimia are complex mental health disorders. Their causes are not fully understood but studies have shown that there are a few biological and psychosocial risk factors that can play a part in their development. Also, disordered eating is rarely about food per se, but a maladaptive way of coping with difficult emotions. Food becomes a ‘crutch’ to manage difficult feelings.”
Eating disorders, especially anorexia, and bulimia are complex mental health disorders ... Food becomes a ‘crutch’ to manage difficult feelings.
What causes a child to fall into the food restriction trap? And how can a parent help?
A number of things help a child form – and corrupt – a relationship with food. Nadia Brooker, Counselling Psychologist at Priory Wellbeing Centre, Dubai, explains: “Kids can be influenced by a whole range of things, such as culture, media, parents, peers and past experiences - all of which can impact how they feel they should look or present themselves to others.
A child’s body image can also be shaped by their parents’ own body image. Therefore, it is important that caregivers are conscious of the comments and behaviours they make around their children. Parents should not be projecting any of their own negative body image issues onto their children.
“Parents can influence their children’s thoughts and opinions through their own expectations. For example, children whose parents often criticise their appearance and weight, or have strict rules regarding food, can significantly – and negatively - impact their child’s relationship with food, their peers and self-esteem. Furthermore, a child’s body image can also be shaped by their parents’ own body image. Therefore, it is important that caregivers are conscious of the comments and behaviours they make around their children. Parents should not be projecting any of their own negative body image issues onto their children.”
Abuse may play a part: Mai Elsayed, Clinical Hypnotherapist, says: “A very common trigger of anorexic behaviors is being abused, especially sexually and at a young age. During therapy clients who suffer with anorexia who have experienced sexual abuse say things like, ‘I wanted every part of me, that he touched’, to dissolve.’ This is extremely sad because at a young age, when an adult tells you that something is right, as a kid you simply believe them. In almost every case of anorexia nervosa, individuals report feeling that they do not deserve to live and their food restriction in a type of self-punishment that they engage in.”
The peer effect: What’s in vogue – a rail thin body or a voluptuous or muscular one? “How children’s peers talk about body image can also play a vital role. Peers who focus heavily on dieting, weight or engage in talking negatively about their appearance can potentially lead children to negatively evaluate their own body image as well. Therefore, it is important for children and young people to try to cultivate friendships that encourage and support each other and help them to feel good about their bodies and themselves generally,” Brooker adds.
A very common trigger of anorexic behaviors is being abused, especially sexually and at a young age.
Striving for gold: Are we growing a generation that’s destined to excel, and in doing so, destined to have body image issues? It could be argued that we are. “Certain activities such as gymnastics, dance or modelling can cause children to have a heightened focus and awareness of their body size, which may increase unhelpful behaviours to try and control their weight and shape,” explains Brooker.
“Taking time to reflect and process past experiences to help us understand the impact these experiences have had one our current body image is recommended. As such, being able to process these experiences through reflection can help to stop these experiences from continuing to negatively influence one’s body image,” she suggests.
Media matters: Brooker believes that two of the most influential factors on body image in today’s society are culture and media. “Studies show that exposure to images of idealised beauty and unrealistic standards can lead to an increase in body dissatisfaction, increased depression and low self-esteem. In particular, research commissioned recently by Priory Group highlighted how almost half of parents questioned (49 per cent) said that their child worries about his or her appearance as a result of the internet and social media (49 per cent). Images of thin or highly toned individuals on TV, in advertisements or social media for example, can lead to a highly distorted view of the world and cause us to have negative feelings about our bodies, or act to reinforce existing negative feelings we already have,” she adds.
“It is important for kids to be educated about the media and for them to be aware of the prevalence of editing photos to look ‘perfect’. Also decreasing a child’s media consumption and increasing body positive media is helpful. Particularly with the increase of Instagram and its associated ‘influencers’, it is helpful to follow more positive accounts and stay away from social media that focuses on unrealistic standards and expectations of body image, eating and exercising.”
• Notice the positives in yourself every day – we can easily get caught up in the things we’re unhappy with or think we should improve on, and often forget the things we have achieved or enjoyed.
• Listen to your body – pay attention to what makes you feel good.
• Surround yourself with people who support you and make you feel good about yourself.
• Be critical of the media that you see and always be wary of false comparisons.
• Try to engage in mindful eating and healthy physical activity.
• If you’re struggling, talk to someone about it and access professional support.
Things you must not do if someone has an eating disorder
If your child is suffering from an eating disorder, don’t try to push them into eating, says Dr Waleed Ahmed, Child, Adult and Forensic Psychiatrist, with a specialisation in eating disorders, from Priory Wellbeing Centre, Dubai and Abu Dhabi. “It’s probably best not to pressure kids to eat or punishing them if they don't. This could make them actively dislike foods they may otherwise like. Also, parents should try to avoid using food as a reward or restricting food as a punishment. Children may inadvertently associate negative feelings around food.
“Parents have a role in a child modelling a positive relationship with food, and trying new things and being adventurous, rather than being unnecessarily restrictive in food choices. There may be a role for support for parents to address these issues in the first instance and help build their confidence, before addressing these in their children,” he adds.
Signs and symptoms of a food disorder
ANAD lists the following emotional and behavioural cues:
- Weight loss, dieting, and control of food are primary concerns
- Food rituals
- Social withdrawal
- Frequent dieting, body checking
- Extreme mood swings
It lists the following physical manifestations:
- Noticeable weight fluctuations
- Gastrointestinal complaints
- Dizziness upon standing
- Difficulty concentrating, sleeping
- Issues with dental, skin, hair, and nail health
A four-pronged solution
Dr Ritu Manchanda, a Senior Homeopathic Doctor at German Medical Center and NMC Medical Centre, whose patients include young people with eating disorders, says, “There are four components towards healing someone with an eating disorder:
Blood test: This will rule out any deficiencies or thyroid issues that may be triggering the disorder.
Psychological: A thorough examination of the psychological state of a child can help the psychologist determine the type of disorder – anorexia, bulimia, etc. – that the child is suffering from. By engaging a clinical psychologist who specialises in eating disorders one can help the child rehabilitate more easily.
A thorough examination of the psychological state of a child can help the psychologist determine the type of disorder – anorexia, bulimia, etc. – that the child is suffering from. By engaging a clinical psychologist who specialises in eating disorders one can help the child rehabilitate more easily.
Dietician: A dietician can evaluate the nutritional needs of a patient and craft a menu accordingly.
Physical training: When a person has an eating disorder it ravages muscle mass – having someone help with redevelop lost muscles is essential to future well-being.”
Elsayed, meanwhile, says: “Cognitive Behavioral Therapy has been proven to be extremely successful in helping sufferers to overcome their illogical thought patterns and break their anorexic habits, [and] hypnotherapy doubles the success rate when employed.”
*Learning to recognise one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
*Gaining a better understanding of the behavior and motivation of others.
*Using problem-solving skills to cope with difficult situations. Learning to develop a greater sense of confidence in one’s own abilities.
CBT treatment also usually involves efforts to change behavioral patterns. These strategies might include:
*Facing one’s fears instead of avoiding them.
*Using role playing to prepare for potentially problematic interactions with others.
*Learning to calm one’s mind and relax one’s body.
Source: American Psychological Association
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