“You look fabulous," I said to an acquaintance at a social event comprised almost exclusively of women. I hadn’t seen this person in months and now here she was looking very thin and fit in a little black dress. I wasn’t the only one remarking on her appearance, a lot of ladies were handing out compliments. I admired her will power and dedication to the gym while at the same time admonishing myself for my own inability to maintain an exercise routine. As it were, I was wearing a dress I had bought two years ago for the first time. Back then it had fit perfectly, now I was feeling the squeeze, the zipper in the back straining to stay closed. Was it all the late night snacking and preponderance of “cheat” days to blame? Why couldn’t I eat mindfully and stick to a healthy meal plan? Weeks later I would find out it wasn’t my friend’s diet or zeal for exercise that was responsible for her weight loss; it was bulimia. And just like that, my admiration turned into shock and an upsetting revelation; she had an eating disorder and I was totally clueless. What circumstances led to her personal crisis? And did all the praise only encourage her to continue when what she really needed was help?
Anyone can develop an eating disorder although they often begin in teenagers or young adults. Genetics and family history, frequent dieting and other mental health issues can all increase one’s risk. Anorexia, bulimia and binge eating are the three most common eating disorders. All of them can seriously affect one’s ability to get proper nutrition and involve fixating on food, eating, weight and body shape. Symptoms of Anorexia (Nervosa) include low body weight, intense fear of weight gain, severely limiting food intake, eliminating certain food groups and relying on diet aids, laxatives, exercise and vomiting. Bulimia (Nervosa) involves episodes of binging on foods followed by episodes of purging. Limited intake of food leads to an increase in intensity of the binging/purging cycle. One is pre-occupied with weight and body shape and harshly judges his/her personal appearance. Binge-Eating Disorder involves consuming large amounts of food, past being uncomfortably full, in a short period of time. There is no purging but feelings of guilt, shame and disgust and lack of control over eating leads to further binging episodes.
Avoidant/Restrictive Food Intake Disorder (AFRID) is another more recent diagnosis that often develops in younger children, increasingly in boys. It involves limiting or not eating certain foods, avoiding certain colours, textures, smells and tastes and fears of choking, vomiting or stomach problems. While there is no aversion to weight gain, there is often a lack of appetite, denial of hunger and little or no interest in eating. Skipping meals, making excuses for not eating, fixating on eating healthy and making one’s own meals are all hallmarks of AFRID.
Complications of these eating disorders include physical harm, affecting the heart, digestive system, bones and teeth, as well as delayed growth and development. Furthermore, they are commonly linked with serious mental health issues, including substance abuse, depression, anxiety, self harm and suicidal thoughts.
Prevention includes eating a well-balanced diet, maintaining a healthy body image and being physically active. One should seek help from health care providers including your family doctor, a qualified nutritionist or a mental health practitioner. A counsellor, using Cognitive Behavioural Therapy (CBT), can help you address your emotional and psychological well-being and give guidance on handling stress and making healthy choices in your daily life. Family Based Therapy (FBT) is also an option for treating children with eating disorders and in both cases, one can learn how to monitor and improve eating habits and develop problem solving skills for a happier, healthier life.
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