Monday Mind Talks: Here’s how eating disorders harm your mental health

Eating disorders constitute a group of conditions wherein individuals have abnormal eating habits which impairs their health and psychosocial functioning. It is important to identify and diagnose individuals with this disorder in view of its effect on mental and physical well-being. Dr. Suchismitha Rajamanya, Consultant in Internal Medicine, Manipal Hospital Whitefield, is here with us today to provide some insight into the many types of eating disorders and how they may have a detrimental influence on our mental health.

The number of cases in India seems to be under-reported either due to the lack of awareness about this condition or the stigma associated with the mental disorders. Various studies, conducted in small populations, report the incidence, ranging between 4- 42%. The disorders include conditions like anorexia nervosa, binge eating, rumination disorder avoidant/restrictive food intake disorder, bulimia nervosa and pica.

Patients who are at increased risk of eating disorders, include:

1. Patients with a history of:

•Adversity during childhood

•Trauma

2.  Young adults

3. Females

4. Transgender individuals

5. Athletes

6. Anxiety disorders

7. Depressive disorders

8. Rigidity

9. Perfectionism.

There is an increase in the number of eating disorders, especially in young females, thanks to the unhealthy trend of ‘being thin’ or achieving ‘size zero’, the unrealistic expectations, the pressure of keeping up appearances in social media. These disorders are almost always associated with an underlying psychological issue or mood disorder. Numerous personalities, like Lady Gaga, Jessica Alba, Princess Diana, Elton John have all suffered from Eating disorders and have opened up about it.

Doctors and families can suspect the presence of eating disorders by enquiring whether the patients have any concerns about the patient’s weight, body shape, body image, or eating behaviors. Also, short and easy-to-interpret screening questionnaires are available, which may help identify patients who need further evaluation. Eating disorders should be suspected in anyone having a voluntary drastic weight loss or inappropriate weight gain, fear of eating food or eating very less, choking or vomiting food, binge eating, or eating ‘ abnormal ‘ substances. They could have consequences on physical health like weak bones, poor immunity, abnormal menstruation, excessive hair falls, anemia, low BP, and heart rate.

Below are some of the commonly seen eating disorders: –

1. Anorexia nervosa is a condition wherein individuals have a fear of gaining weight and have an abnormal perception of their body weight and shape.

2. In Avoidant/restrictive food intake disorder, patients lack interest in food or develop a conditioned negative response to food intake like choking or vomiting.

3. In Binge eating disorder, patients tend to eat more rapidly than normal, eat unusually large quantities of food till they feel uncomfortably full, feel disgusted with oneself, depressed, or guilty after overeating.

4. Bulimia nervosa is a condition where patients binge eat and later try to compensate for their behavior by self-induced vomiting, misuse of medications such as laxatives, diuretics, insulin, or thyroid hormone; fasting, or excessive exercise.

5.PICA is characterized by the condition of eating ‘abnormal ‘ substances which are not nutritional like chalk, sand, clay, raw rice, cement. It is usually associated with iron deficiency anemia and mood disorders.

6. In Rumination disorder, patients repeatedly bring out the food, which may be chewed and swallowed or spat out.

These disorders can be life-threatening due to general medical complications associated with malnourishment and the possibility of suicide. Also, patients often refuse treatment.

With the mainstay of the treatment being psychotherapy, pharmacotherapy and nutritional rehabilitation, a multi-disciplinary approach, including a psychiatrist, psychologist, physician and dietitian is required for the overall management of such patients. The stigma of eating disorders to an extent is linked with dysfunctional thoughts that may perhaps interfere with the treatment process. Education of patients and their families that includes biological explanations goes a long way in reducing this stigma. Nurturing a healthy social environment and discouraging unhealthy beauty trends will ensure that young, impressionable minds do not succumb to eating disorders and other mental illnesses.

Also Read: No-Nonsense Guide To Fighting Emotional Eating