2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
Eating disorders are mental disorders. They are, relatively speaking, with a minus sign and with a plus sign
With a minus sign - lack of appetite, suppression of desire to eat, anxiety about weight and body shape - anorexia nervosa.
With a plus sign - a very strong appetite, excessive concern about weight and body shape, when a person eats a lot, and then, due to feelings of guilt and shame, can compensate for gluttony with strong physical exertion, causing vomiting - this is bulimia.
In 2014, the American DSM-5 mental health guideline introduced another plus-sign disorder, binge eating, which is not yet in our reference literature.
During such an attack, a lot of high-calorie food is eaten (4000-6000 calories), but at the same time there is no compensatory behavior (strong physical activity to burn calories, induce vomiting, etc.).
Orthorexia is also worth noting - a manic desire to lead a healthy lifestyle, eat clean and healthy food.
Until recently, anorexia and bulimia were called "American diseases." How did it happen that in our country they also became widespread enough?
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 rectors were wary of such asceticism.
There is practically no statistical data on the disease in Ukraine, so you have to rely on the data from the United States, where people are asked for help more often. Anorexia suffers, according to various sources, from 1 to 4, 2 percent of the population, bulimia - from 4 to 10 percent.
Doctor of Medical Sciences Galina Pilyagina once said that "in psychiatry there are only two zones that border on death - suicide and anorexia." Is it really that serious?
Anorexia is the leading mortality 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 on a female example, men with this disease are less common).
A girl can eat half an apple, a few tablespoons of oatmeal all day, and that's it. An incredible deficiency of trace elements occurs, hypocalcemia begins, hair, teeth, nails, skin suffer, and bones become brittle. Metabolism slows down, a person is constantly freezing. The nervous system, the heart begins to suffer, because it needs potassium and magnesium.
In fact, at the age of 15, a girl has all the signs of menopause … And this is scary … 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 do it - the brain starts to work differently.
Are adolescent girls or adult women in danger of anorexia too?
The most vulnerable category is, of course, adolescents, because they are 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 suffered from anorexia for several years, while she constantly worked, sat on antidepressants, which she prescribed for herself.
It always amazes me, where do anorexic patients have the strength to go to work every day?
There is an interesting evolutionary theory that anorexia was beneficial for human survival. What does a hungry person feel? He wants nothing, feels weak, headache, stomach cramps.
If a person has a genetic predisposition to anorexia, he feels a surge of energy, he has an elevated mood. Imagine: the tribe lies exhausted from hunger, the anorexic is awake and finds food, saves everyone, but soon dies himself.
Are those at risk for eating disorders with a genetic predisposition?
If there is no genetic predisposition, then you cannot get sick with an eating disorder. But how to check whether there is this predisposition or not? Alas, in Ukrainian laboratories, such analyzes are not yet done.
Mom's example plays an important role. If she constantly sits on strict diets, the child will adopt this model and consider that severely restricting herself in nutrition is the norm.
The risk group also includes those who are brought up in overly controlling, caring families, perfectionists, who need to do everything as best as possible or not do it at all. By the way, a father who trains endlessly can also become a "trigger" of the disease.
Bulimia can be triggered by psychotrauma, including of a sexual nature, some kind of severe stress. Often outwardly bulimics are quite successful people, they look good, they earn good money. And they rarely seek help out of shame. We can remember the example of Princess Diana, who suffered from bulimia.
How do you 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 making plans for purchases, finding the “right” foods and preparing them correctly, this is already a frustration.
All this cannot be done without prejudice to social life. Such a person retires, because others 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 a funny and at the same time sad case. Recently, a girl wrote to me that she wants to lose weight, but it is difficult for her to stick to a diet. It turned out that she ate only 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 was on such a "diet", experiencing a constant feeling of hunger.
Who is most likely to suffer from orthorexia?
Among orthorexes, there are a lot of both women and men. In 2015, I conducted a study of the need-motivational sphere of persons with orthorexia in order to understand
what motivates these people to behave this way.
It was believed that this behavior is inherent in people who are intimidated by the world around them, but my research showed that the leading need for people with orthorexia is self-affirmation.
A person with orthorexia thinks something like this (exaggerating, of course): “I eat wonderfully, and therefore I live better than you; I am pure, correct, and therefore I can teach you."
Is there any way to test yourself for the first signs of an eating disorder?
The following methods will help to check a person's relationship with food: the EAT-26 test, the Dutch eating behavior questionnaire, the Roman ORTO-15 questionnaire will help to understand whether orthorexia nervosa is present.
All these techniques can be found and passed on the Internet without any problems. Examples of behavior that should alert you: drastic weight loss, constant dissatisfaction with your appearance.
During a meal, everything is divided into very small pieces, chewed very slowly and washed down with plenty of water.
Separate advice for teen moms: respect personal boundaries (knock before entering, close the door to the child's room), ask why he is depressed, and do not demand from him to be
the best of the best are simple but important things.
Because often parents bring an already exhausted child to a psychotherapist. And you understand that the moment of the initial stage has been missed. And treating any eating disorder is expensive and difficult.
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 fund such psychotherapy, and there are very few specialists specializing in the treatment of ERP and having real specialized training. Therefore, it is so important to be attentive to yourself and your loved ones!
The article first appeared in the "Health" section, "VESNA" magazine, issue of June 12, 2018
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