‘You look anorexic!’ Is not really a compliment but used so often for somebody who looks very thin. You may have tried dieting or maybe you lose all control when you see gulab jaamuns, is this enough to believe that you have an eating disorder? Well, no.
Eating disorders are characterized by ‘severe disturbance in the eating pattern’. There are around ten million women and one million men who have eating disorders.We can see that the number of female patients is significantly higher than the male patients because of obvious societal norms of beauty that we tend to follow. But this article isn’t about sexism, it is about two of the eating disorders that are prevalent and rising at an alarming rate. Both Anorexia nervosa and Bulimia nervosa cause an ‘intense fear of becoming fat and/or overweight’
The Diagnostic and Statistical Manual of Mental Disorders(DSM) is the standard classification of mental disorders used by mental health professionals in the United States. This manual has been used to list out the symptoms.
- Anorexia Nervosa
Anorexia nervosa literally means ‘lack of appetite induced by nervousness’. People suffering from anorexia deny that they have lost significant amount of weight,they do know that they’re losing weight and are secretly proud of it but for others they conceal it. They will wear baggy clothes,drink a lot of water to show higher weight and if people ask them anything,they will simply deny everything. Generally affects people aged 15-19.
According to DSM IV, anorexia is diagnosed if these symptoms are found:
- Refusal to maintain a body weight that is normal for the person’s age and height. (i.e. reduction of body weight to about 85% of what would normally be expected)
- Distorted perception of body and size.
- Intense fear of gaining weight or becoming fat even when they are underweight.
- Absence of at least three consecutive menstrual periods. (Diminished sexual appetite for men)
There are two types of anorexia,i.e. two ways in which the patients maintain low body weight.
- Restricting type anorexia:
The person limits their calorie intake and control their diets. If they are in a social setting,they might throw the food secretly to make people believe that they’re eating ‘normally’.
- Binging/Purging type anorexia:
The person eats as much as they want to, consume food without limits (binge) and then remove it from their bodies so the calories don’t affect them (purge). The method of removal could be self induced vomiting, usage of laxatives etc.
If not paid attention to, people suffering from anorexia may suffer from brain atrophy or commit suicide eventually due to lack of purpose. People suffering from anorexia may be unaware too,but mostly they are in denial.
Anorexia is one of the most lethal psychological disorders. The people generally look ‘unwell’, their nails and hair goes brittle, skin gets dry and pale and they also have low blood pressure.
Causes of death of anorexic people include heart arrhythmias (irregular heartbeat), low potassium count, kidney failure and renal failure.
Most of us ignore anorexia and presume it is ‘just a phase’ but it isn’t. It not only results in a painful death but also a life where the person is constantly dissatisfied with themselves. We need to look around for the signs and help them.
- Bulimia Nervosa:
Bulimia generally involves people binge eat. This means, they have hunger of large proportions and they eat on and on. This looks similar to purging type anorexia but it is different as patients may not be underweight. Both anorexia and bulimia cause the fear of ‘fat’. Bulimia is generally diagnosed in people aged 20-24.
According to DSM IV, bulimia is diagnosed if these symptoms are seen:
- Eating in a fixed period of time,amounts of food that are far greater than anyone might eat under normal circumstances. Lack of control on the amount of food consumed. Unable to stop.
- Recurrent and inappropriate efforts to compensate for the effects of binge eating. (Self induced vomiting,laxatives,excessive exercising)
- Self evaluation excessively influenced by weight and shape.
People suffering from bulimia are generally average weight or even over weight at times. The beginning of bulimia is when person starts dieting,they restrict themselves and make sure they eat low calorie food. But this resolution soon erodes, they not only start eating the ‘forbidden foods’ (soft drinks, sweets, fried food etc) but also eat in huge amounts. They may consume as much as 5000 calories in a day. (Johnson et all. 1982). To compensate for this,they either;
- Purge (Purging type bulimia)
This happens in 80% of the cases.
- Don’t purge (Non-purging type bulimia)
They fast or go on crash diets or exercise excessively.
People suffering from bulimia are aware of their condition. They know that there’s something ‘wrong’ with them. But they can’t stop themselves. There is a feeling of helplessness,shame and guilt. Bulimia is not as lethal as anorexia. Physical problems include Hypokalmia (less potassium), calluses on the hands,mouth ulcers,swollen salivary glands and puffy cheeks.
Since people who have bulimia nervosa are aware of their condition,it is easy to see if somebody around you is suffering. Even though bulimia doesn’t often result in death,we can’t deny that it is a serious condition. Their self deprecating attitude makes them feel worse about themselves and we all know how difficult it is to live like that.
- Causes of eating disorders :
Surprisingly enough, eating disorders can be inherited or be a part of your genetic makeup. According to several studies, relatives of people suffering from anorexia have 11.4% higher risk of developing an eating disorder. Relatives of people suffering from bulimia have 3.7% higher risk.
- Serotonin levels:
Serotonin is a neurotransmitter that affects our behavior and controls obsessionality, mood patterns and impulsivity. Eating disorders may be caused if serotonin levels are disrupted.
- Peers and media influence:
The magazines since 1960s have promoted thinness as the beauty ideal this has affected the general perception of people towards the society as well as themselves. To prove this effect, Becker conducted a study in Fiji. In Fiji, fat was equal to good. After they got the facility of televisions,they started watching shows like 90210, Beverly Hills and ‘realized’ that the western concept of beauty was pressurizing thinness. So they started dieting and exercising. All of us have been in this position. So we cannot deny that yes,this is true.
‘Dysfunctional families’ are the cause for 1/3 Anorexic patients. According to Strober (1997) rigid,overprotective parents or parents who believe in the thin ideal are the reason for eating disorders,mainly anorexia. In 1997, Fairburn concluded that bulimia was generally the result of ‘appearance anxiety’.
After looking at all the causes, the only one we can control is the media peer influence. There has been a recent increase in campaigns that promote ‘self love’ and propagate the idea that being yourself is beautiful not just being thin. There are also ads that show how every body and everybody is beautiful.
But can we just blame the society? A thin loving society is not the only reason for disorders. Had that been the case,all of us should have some eating disorder. It is people who internalize the thin ideal and believe that thin is attractive who suffer. Dieting,body dissatisfaction and perfectionism are the major propagators of eating disorders.
So, love yourself. Be healthy; enjoy your life as it is. You don’t have to be thin, or fat or voluptuous. You don’t need to fit in the society. While we blame the society, we need to realize that we are the society, let’s not judge so quickly. Be happy and let others be happy.