Fat And Eww

We don’t want to talk about mental disorders let alone talking about eating disorders. A significant percentage of people suffer from eating disorders.

Eating disorders (ED) are all those disorders that include irregular or disturbed eating practices.

Skinny is not beautiful

Where ever we go there are images splashed all over; in the media, on hoardings, in magazines. and 24/7 glaring back at us on our phone screens.

We are constantly confronted with impossible beauty ideals in advertising, branding and beyond.

In addition to this bombardment, disturbing pop culture trends promoting “thigh gaps” and challenges like the belly button challenge on social media are setting unreal ideals for the youth and old equally to the extent that men and women scrounge on their eating and exercise far more than they should.

The Body positivity movement began as a powerful antidote to the media’s obsession with a reel like models and airbrushed glamour dolls and is steadily growing. Yet the body shaming continues.

The pressure is insurmountable. Which is leading to eating disorders in many cases.

Eating Disorders

Bulimia nervosa is an eating disorder.

Senior Psychiatrist Dr Sanjay Chugh explains that “It is characterised by frequent binge eating which is followed by compensatory behaviour which could include throwing up, inducing vomiting and or excessive exercise in a bid to burn off the calories that have been consumed. Patients sometimes take Laxatives to forcibly induce loose motions in the hope that if they will induce loose motions the food will not be absorbed. The patient could be using diuretics increases urination which leads to water loss thereby leading to weight decrease. The patients feel a lack of control over these episodes.

Most of the people with anorexia nervosa, which is another eating disorder see themselves as overweight, even when they are clearly underweight. Eating food and weight control become obsessions for them. They usually stand on the scales weigh, repeatedly, hugely focus on portion food, and eat very little amounts of only certain foods. Some of the common signs of anorexia nervosa include extremely low body weight, severe food restriction, overwhelming fear of gaining weight and lack of menstruation in girls and women. If the disorder persists other symptoms and medical complications may emerge, including thinning of bones, brittle hair, mild anaemia, muscle wasting, weakness, sever constipation, lethargy, infertility etc.

People with bulimia nervosa unlike anorexia nervosa, usually maintain what is considered a healthy or normal weight, while some are slightly overweight. But like people with anorexia nervosa, they often fear to gain weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Usually, bulimic behaviour is done secretly because it is often accompanied by feelings of disgust or shame. Other symptoms of bulimia nervosa include electrolyte imbalance, sore throat, severe dehydration etc.

Eating disorders can start at any age and be triggered by a variety of reasons. 

Whilst a host of reasons can be responsible for precipitating eating disorders etiologically- Biological or Hormonal factors are common but societal factors or environmental factors have a very significant role to play. 

According to Dr. Chugh, “The way society or the people around you, your family or peer group looks at you creates what is called your body images or self-image, if the image that has been created is negative. repeated shaming or ridicule- either real or percieved leads to problems with self-identification, self-identity and self-esteem and some linkages take place inside the electric circuitry of the brain which starts to associate a positive self-image with loss of weight or looking good. Which may or may not have been the original content of the sarcasm that the person was subjected to, but this becomes the endpoint.” 

He further emphasises that “The person begins to think that, ‘if I lose weight I will become thin which is socially acceptable, then my needs for social approval are going to be met. My needs for attention are going to be met if I manage to lose weight.’ “

Chugh highlights that “Children who have been brought up in families where there is a lot of dysfunctionality in the dynamics of the family are expected to grow up to have some eating disorder or the other. Because eating food is the one thing that they can control irrespective of what is happening to them and around them. Children who are victims of social abuse physical abuse during childhood are also likely to bulimic or have one of the eating disorders. Professions where looking thin is the norm for example modelling acting etc. Anything to do with your aesthetics with appearance there the incidents of eating disorders especially bulimia is very very high.  There are some sports that demand you be very thin. The lower the body weight the better you would be as a sportsman. For instance, Horse riding rowing cycling and similar sports these athletes are likely to develop eating disorders because of the pressures that are imposed on them.”

With the concept that "thin is beautiful" being hammered into young minds, eating disorders such as anorexia nervosa and bulimia nervosa -- virtually unheard of only a decade or so ago in India -- are becoming serious issues of concern.

Over 25% of teenage Indian girls suffer from eating disorders. Which is a scary statistic?

Multiple eating disorders can, and often do co-exist.

What is of huge concern is that these disorders often go unrecognised and, therefore, undiagnosed. Probably so as they fit unreal stereotypes around body shape and beauty standards. That is until they metamorph into mental disorders that can have morbid physical implications.

Various treatments are available, but in Chughs opinion best results are obtained when a combination of all three- psychotherapy, medication and RTMS (Repetitive Transcranial Magnetic Stimulation) are administered. 

It is, therefore, imperative that we be cognisant of the words we use when talking about food in front of children. 

And be kind when speaking to others about their appearance.

We should use our words carefully.