It’s OK To Talk About Eating Disorders

Eating disorders are a lot of things to a lot of people- a way to lose weight, to cope with a body image problem, a cry for help ....but for a psychiatrist, they are a serious mental illness that can kill, and do so without making too much of a noise. 

Even I almost jumped out of my skin when I read recently that the mortality rates associated with eating disorders are higher than any other mental illness, including depression!

And yet here we are literally faced with an epidemic of eating disorders (EDs), and not doing a thing about it- not talking, sharing, finding solutions and offering help…

In the absence of an engagement with eating disorders, these illnesses continue to strike at will and across age groups. Anorexia used to be regarded as an early –teen and adolescent problem and so was bulimia. Not anymore! While girls as young as seven are being treated for ED, middle-aged women are bringing up the rear and becoming the fastest growing segment of the population being diagnosed with eating disorders.

But look at the irony of it all….34 % of adults worldwide are unable to name a single sign or symptom of an Eating disorder, and most, if not all, think that eating disorders are just a passing phase and not a serious mental illness, and they affect someone who has taken dieting too far.

Hence, in this blog post, we will use ‘fact bombs’ to spread awareness about EDs- the red flags that you should be looking out for and tips for recovering from perhaps the most terrible mental illness of all time.

Eating Disorders- About More Than Food

The Big three eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorders. They are less about a sufferer’s relationship with food and more about their relationship with themselves, and how they perceive themselves to be.

These eating disorders share a number of similarities, even though they are inherently different.

Anorexia Nervosa- This involves a restriction of food on a chronic basis leading to an extremely low body weight. The sufferer wants to lose weight all the time, even if they are super-skinny, because of an intense fear of gaining weight. Models are said to be suffering from this disorder a lot, and so do many girls who want to be accepted by their loved ones. 

Extreme anorexics refuse to eat at all and have to be hospitalized for forced-intake of nutrition intravenously. A failure to do so can be fatal.

Bulimia Nervosa- In this, the sufferer eats food compulsively and excessively when they are hungry and later purge to get rid of it due to pangs of guilt associated with over-eating. The methods of purging can include diet and water pills, laxatives, even exercise.

Bulimia is also the easiest to hide as the sufferer looks normal and is not as thin as a patient suffering from anorexia nervosa. 

Deliberate vomiting by bulimics, however, can lead to Cachexia, a type of wasting syndrome, and excessive fat, protein and muscle loss.

Binge Eating Disorder- This is basically repeated episodes of binge eating caused by any kind of stressful event like failing a test and this can lead to unhealthy withdrawal from ordinary life. 

And that’s not all, eating disorders have evolved in recent years. Twenty years back, it was all about classic anorexia or bulimia but, today what we see are the more complex eating disorder called  Avoidant Restrictive Food Intake Disorder in which a sufferer eats only a specific type of food leading to deadly nutritional deficiencies, orthorexia- an obsession with healthy food, and disordered eating.

Signs of an Eating Disorder

Research indicates that the early detection of eating disorders and early treatment can save the life of your loved one of these mental illnesses damage more than mental health, but also vital organs forever.

But, how do you know if your friend, daughter, sister or mother has an eating disorder? 

The earliest and most prevalent sign of an eating disorder is chronic dieting.

Here are a few other red flags that can signal an eating disorder early-on:

• The person has an obsession with weight and food. Only thinks and talks about food, fat, calories.
• Exercises all the time, even when she’s sick or exhausted.
• Avoids eating with family. 
• Switches to wearing big or baggy clothes as a way to hide her body and shape.
• Goes on extreme or highly restrictive diets like a raw diet, cuts food into tiny pieces, moves food around on the plate instead of eating it, and is very precise about how food is arranged on the plate.
• Competes with others about how little he or she eats.
• Goes to the bathroom a lot, especially right after meals or vomits after eating.
• Always talks about how fat she is, despite losing a lot of weight, and focusing a lot on body parts she doesn't like.
• Appears to be gaining a lot of weight even though you never see her eat much. Faints and bruises easily, is very pale or complains of being cold more than usual and is severely dehydrated from the purging of fluids.

How to Help an Eating Disorder Sufferer?

No matter how a sufferer gets there, or how long it takes, the idea of recovery is probably the most freeing feeling one can possibly experience. 

Acting quickly is key to recovery. Eating disorders do not resolve themselves.  If you dawdle in taking a loved one or even yourself to a psychiatrist or a clinician, you may be letting them or yourself down in the worst possible ways.

Bulimia is easier to treat than anorexia, as anorexics tend to hide their condition a lot and are usually in denial that they have a problem. Bulimics are acutely aware of their problem and are therefore probably more open to therapy. 

Effective help is present in the form of family-based therapy, cognitive-behavioural therapy, and anti-depressants.

Finally, it’s important to remember that just curing the symptoms does not necessarily end the fight against eating disorders. Recovery is a gradual process, and relapse may be lurking in the shadows, even after decades.  Eating disorders are not just about a bad relationship with food, they are basically about other psychological conditions like poor body image and low self-esteem, and these do take longer to iron out. 

Just remember, your loved one needs to know that you are there long after the eating disorder appears resolved.