Food plays an important part in our life. Eating can make us happy as we bond over meals at home, workplace, luncheons, dinner and coffees. Healthy eating and regular exercising is easier said than done in today’s extremely fast-paced workaholic and stressful life. Food and weight can have a problematic relation and can be a malady of sorrows for some as they see scales showing increasing weight gain tendency.
Problems in eating on a psychological level exist for many people yet it is frequently ignored. Many inadvertently become emotional eaters, who may eat excessively to fight away stress, painful emotions and anxiety without even being aware of it entirely. Many wilfully starve frequently by depriving themselves of basic energy and nutrients for that elusive figurine.
Eating disorders can occur in both men and women. Nowadays, this trend is on a rise in youngsters and adolescents as well. There may be an overlay of peer pressure, society perceptions, ideal body image, one’s psychological development, family history, stress, psychiatric and medical co-morbidity towards development of a significant eating disorder.
List of symptoms of possible eating disorder is very long:
- Eating unusually excessive amount of food in short periods
- Not able to control overeating
- Eating compulsively despite being full
- Eating excessively to cope with negative feelings of loneliness, sadness, unpleasant emotions
- Eating lot of junk food frequently
- Skipping meals frequently, hiding food and throwing it secretly
- Refusing to eat, vomiting immediately after eating, eating impulsively and randomly without healthy routines
- Exercising excessively beyond regular regimen to cope with guilty eating spells or after frequent spells of consumption of high caloric food
- Perceiving one’s self to be fat despite being objectively thin and underweight
- Not able to stop disordered eating patterns despite developing medical complications related to eating disorder
- Feeling sad and distressed because of eating problems
Types of eating disorders
Anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder NOS are various types of eating disorders. Individuals suffering from anorexia nervosa can have a morbid fear of becoming fat and may restrict excessive food intake or use measures such as vomiting, laxatives to lose weight and a body image distortion of being fat despite being objectively thin.
Bulimia nervosa can have symptoms such as eating excessively, emotional eating, feeling guilty about eating pattern, compensatory excessive exercising to lose excess intake.
Binge eating is characterised by eating excessive amounts of food in relatively short periods very frequently. There are standard diagnostic criteria in psychiatry classification such as DSM- 5 and ICD-10 which enable psychiatrists to clinically interview the patients and diagnose the conditions based on symptoms.
Untreated eating disorders can have implications on physical health leading to complications such as loss of menses, osteoporosis and fractures, GIT disturbances, electrolyte disturbances, dental problems, cardiac problems, among others. Eating disorders can also have co-morbid psychiatric disorders such as depression, OCD, anxiety disorder, substance abuse and personality issues.
How to get treated?
If your loved ones have symptoms of eating disorder, it is advisable to consult a psychiatrist at earliest, who will do clinical evaluation, understand pattern of eating disorder, rule out co-morbid depression, stress or anxiety-related disorder, provide counselling and cognitive behaviour therapy for eating disorder.
The psychiatrist may also suggest psychological assessments if perceived necessary to understand problems with eating and may suggest some medications for your pattern of eating disorder based on clinical expertise.
You may be suggested some references to other specialties such as medicine, paediatrics, endocrinology, neurology, surgery, gynaecology and others based on symptoms and complications.
Out-patient or in-patient based treatment setting for eating disorders depend on diagnosed condition, its severity, co-morbid medical problems, school of training and guidelines.
Multidisciplinary approaches consisting of psychiatry, clinical psychology and nutritionist counselling may be helpful in holistic management of eating disorders in collaboration with concerned specialties.
The author is a psychiatrist at Satguru Mind Care Centre, Sion