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Eating disorders are mostly a combination of physical and mental health conditions wherein people wilfully restrict food intake or eat more than required. Such people are usually preoccupied with food and are over-conscious about their body weight. Usually, women tend to suffer from eating disorders more than men, but as teenagers, both boys and girls suffer from such aberrations. Various studies have shown that disturbed eating attitudes and behaviours affect about 25 to 40 per cent of adolescent girls and nearly 20 per cent of adolescent boys in India.
Common eating disorders
Anorexia nervosa, bulimia nervosa, and binge eating disorder are the three most common types of eating disorders. The other less prevalent forms include avoidant/restrictive food intake disorder (ARFID), pica, and rumination. Eating disorders are often manifestations of psychological distress. Mental health conditions that are often co-occurring disorders commonly found with eating disorders include anxiety, depression, substance abuse, borderline personality disorder (BPD), and/or obsessive-compulsive disorder (OCD). A person is diagnosed with anorexia nervosa when they weigh at least 15 per cent less than the normal healthy weight expected for their height. The characteristic signs of the disorder include limited food intake, fear of gaining weight and becoming fat, and problems with body image. As they refuse to eat normally, people with anorexia nervosa are unable to maintain a normal weight. Besides, they often exercise obsessively and may force themselves to vomit or use laxatives to lose weight. If continued for a longer duration, anorexia nervosa may cause signs of starvation, such as halt of menstrual periods, thinning of the bones osteopenia or osteoporosis) due to loss of calcium, brittle hair and nails, dry and yellowish skin, mild anaemia, wasting of muscles, including that of heart, severe constipation, slowed breathing and pulse rates, falling blood pressure, depression and lethargy.
Those suffering from bulimia nervosa may frequently diet and vigorously exercise, but still can have weight anomalies — they can be underweight, normal weight, overweight or even obese. Patients with bulimia nervosa binge eat frequently, and an astounding amount of food in a short time. They eat very rapidly, sometimes gulping down food without even tasting it. However, stomach pains and the fear of weight gain are common drivers that make them throw up or use a laxative to get rid of the calories. This cycle is repeated several times a week or day and remains hidden as overeating is not considered odd in the Indian setting and vomiting or purging happens in private. Since they do not become drastically thin like someone who suffers from anorexia nervosa, their behaviours may go unnoticed. Watch out for people who have chronically inflamed and sore throat, swollen salivary glands in the neck and below the jaw, puffy cheeks and face, decaying teeth from exposure to stomach acids, gastroesophageal reflux disorder causing vomiting, irritation and intestinal problems due to laxative abuse, severe dehydration, and kidney problems. Bulimia can also lead to rare but potentially fatal complications such as gastric rupture, oesophagal tears, and cardiac arrhythmias.
Binge eating disorder is marked by episodes of binge eating in which the affected person consumes large quantities of food in a brief period but unlike people with bulimia nervosa, do not try to get rid of it by inducing vomiting, fasting or laxative abuse. Binge eating is chronic and can lead to serious health complications, particularly severe obesity, diabetes, hypertension and cardiovascular diseases. In addition to frequent overeating at least once a week for three months, along with lack of control, binge eating disorder will have three or more of the following:
Eating until feeling uncomfortably full.
Eating large amounts of food when not feeling physically hungry.
Eating more rapidly than normal.
Eating alone as one feels embarrassed by portions.
Feeling disgusted with oneself, depressed or very guilty afterwards.
Avoidant/Restrictive food intake disorder (ARFID) is a condition where the affected person is heavily obsessed with weight and may avoid getting their daily nutrition, resulting in other medical complications.
Pica, a comparatively rare type, may see a person like to eat non-food substances such as clay, soap, mud or paper because they like the taste or flavour of these items. On the other hand, rumination is a condition when the person regurgitates the food and then chews or swallows it.
(The author is a mental health expert.)