An eating disorder is a term that covers a range of psychological conditions associated with improper or disturbed eating habits. Eating habits can be pathologically changed in anyone, from children and adolescents to the elderly. However, most often, adult young women who are obsessed with certain foods, their weight or shapes are involved in various types of this ailment. These violations often pose a threat to health. Here are some common symptoms that might suggest this disorder:
Constant switching between periods of gluttony and starvation;
Strict lean diets without medical indications;
Obsession with calories and fat in foods;
Weight fluctuations;
There are rituals in nutrition: for example, only liquid or only green food, in small pieces or exclusively in its original form. Eating alone;
Increasing depression, avoidance of friends and family.
Any kind of disorders and addictions to food is based on a disturbed psychology of perception of the shape of one’s body and weight. At the same time, scientists do not single out any one main reason. Disturbances usually begin unnoticed – a person eats a little more or a little less food than usual. The desire to change the diet becomes more and more pronounced until it becomes the goal of existence. It is believed that the cultural environment plays an important role, as people, especially women, are forced to conform to an ideal of beauty, which is largely determined by weight. Families also contribute. Adults who emphasize appearances, encourage or criticize the bodies of their children, and teenagers in particular, may be more likely to raise a child with an eating disorder. Other circumstances are also taken into account; conditions can be caused by stress, communication difficulties, loneliness, depression, other unpleasant emotions, or the diet itself.
Biology and genetic predisposition also play a role. Controlling appetite and regulating food intake is very complex, with many hormones in the brain and body signaling hunger and satiety. Often such hormonal changes are accompanied by metabolic syndrome. This syndrome is called a companion of obesity, since it is based on insufficient sensitivity of cells to insulin and related metabolic disorders of fats and carbohydrates. Thus, not only eating disorders lead to obesity, but vice versa, obesity is the cause of some types of disorders, even with psychological well-being.
What are the disorders?
Eating disorders can be very different, experts identify the most common – anorexia nervosa, bulimia nervosa and compulsive overeating. Surely you have seen the classic anorexia patient on TV or in magazines: the topic receives quite a lot of attention in the media. People with this disease completely avoid food or eat a strictly limited amount of only a certain product, as a result of which they become extremely malnourished, but still consider their weight to be overweight.
Bulimia nervosa has recurrent, uncontrollable episodes of eating unusually large amounts of foods. This type of overeating is accompanied by compensation: forced vomiting, subsequent fasting, laxatives or diuretics, inadequate debilitating physical activity.
With compulsive overeating, similar to bulimia, a person loses control over food. This is the most common type of disorder, often left unattended by a specialist. The disorder is incredibly common among overweight people, with researchers citing a proportion of up to 60%. These “gluttony attacks” are not accompanied by any compensatory action, except for incredible self-disappointment and shame. People with this disease eat large amounts of food quickly, in secret from family members, despite the fact that they do not experience hunger. The result is overweight or obesity. It’s normal that you remember how you once “stuck” stress, loneliness or frustration. The key point in the diagnosis of the disease: frequency. At least once a week for at least 3 months.
In modern life, many of us snack on the run. With such a diet, most people do not pay attention to the signs of hunger and satiety, not to mention the taste, appearance and smell of food. For many, the bad habit of automatically taking too much is part of a vicious cycle that begins with a strict eating plan. Diet itself may not be the cause of the disorders in question, but it is often a precursor, a specific marker. Up to a third of dieters eventually acquire a pathological “diet mindset”. Focusing on counting calories and grams of fat, charting weight loss – all this can be a “perfect” escape from true emotions and problems.
Dissatisfaction with the weight and size of clothes leads to an extreme diet, which is very difficult to adhere to. At a critical moment there is a breakdown, then comes guilt and shame and a new diet. Worst of all, these diets don’t work. They make you lose weight very quickly, but at the same time slow down your metabolism. The pounds come back like a boomerang (you may have heard of the yo-yo effect), sometimes you gain more than before. This cycle can be very difficult to break.
Most people blame themselves for being weak when they don’t diet. It really has nothing to do with willpower. To a greater extent, the body reacts to hunger. The metabolism in the body slows down, and the craving for “fast” calories – sweet and fatty only intensifies. This is the natural setting for not dieting. The decrease in metabolic rate during fasting is an attempt by the body to conserve energy and the body burns calories at a slower rate. After all, it’s too hard to fight nature. People can’t stay on a diet forever, and when the restrictions end, real gluttony sets in.
Is there any prevention and treatment?
You may not have one type of true disorder, but overindulging in useless strict diets and being overweight puts you at risk. Treatment and prevention begin with identifying inconsistencies in the perception of food, stress, own weight and body. The severity of the disorder and any accompanying symptoms will determine the initial level of therapy needed. Hospitalization is usually required for life-threatening conditions: acute weight loss (15-20% in 3 months), abnormal ECG and blood biochemistry parameters (electrolyte imbalance, severe hypoglycemia), exacerbation of mental illness. While many people with food addiction recover completely, relapse is common and can occur months or even years after therapy.
In the treatment of anorexia, the first step is to restore normal body weight. The greater the patient’s weight loss, the more likely the patient will require hospitalization to ensure adequate food intake, including force-feeding through a gastric tube if necessary. It is prescribed from small meals, gradually increasing calorie intake, this can take several years.
With bulimia, hospitalization is required much less frequently. A meal plan is also developed, it is often necessary to keep a food diary. With this disease, group forms of psychological support are most effective.
For any type of disorder, work is carried out in tandem with a psychotherapist, drugs that relieve anxiety can be prescribed. There are several therapies in the arsenal of doctors that change the psychology of eating disorders, they allow you to better cope with conflicts and stress. All types of cognitive-behavioral therapy are actively used, which allows you to identify problematic beliefs, as well as select healthy ways to cope with emotions. Dialectical Behavior Therapy also combines cognitive and behavioral methods as an approach to coping with painful emotions. Suitable for people who react to emotional circumstances unnecessarily extreme. Acceptance and Commitment Therapy is another effective form of help that helps you develop a healthier relationship with your emotions and intellect, recognize thoughts and urges associated with illness, and help you understand your own impulses. The direction of interpersonal psychology helps to resolve the subjective problems that are responsible for low self-esteem and anxiety, provoking the desire to eat. Family therapy is important for people with eating disorders, especially children and adolescents, as it promotes healing for the entire family and can be helpful in dealing with life-threatening situations. Psychotherapy teaches you to recognize and work out the following questions:
Am I really hungry right now?
Am I enjoying this dish?
Would you like to eat something else?
What could make my lunch more enjoyable at this moment?
Do I think about today’s stressful situation while eating?
What external factors influenced my food choices today?
In the case of overeating, obesity therapy and the correct exit from a series of ineffective diets with long-term retention of results are crucial. The work of drugs is based on blocking the absorption of fat (for example, Listat, Orlistat), or to reduce appetite (for example, Goldline Plus).
Orlistat is a substance that is included in several weight loss drugs that are sold under different brand names. It is able to block the absorption of up to 30% of dietary fats, thereby reducing the total caloric intake. Since orlistat acts only in the intestinal lumen, it has a good safety profile, which allows it to be taken continuously for up to 4 years. However, undigested fats are excreted unchanged in a natural way, which leads to such side effects as flatulence, abdominal pain, steatorrhea, which limits the use of orlistat in people who lead an active lifestyle. The exception is Listata, where gum arabic is introduced as an auxiliary component, which emulsifies fats and minimizes these side effects.
Another well-known drug for the treatment of obesity, Goldline Plus, has a fundamentally different mechanism of action. It suppresses appetite, reduces the attractiveness of even the most beloved dishes. Often, by the end of the first week, it becomes clear how excessive the food was, which greatly spurs willpower and self-confidence. Portion volume decreases, accompanied by a conscious feeling of hunger and becomes a healthy habit. The formation of proper eating behavior contributes to the long-term preservation of the results achieved after drug withdrawal. Goldline Plus can be safely used up to 2 years, including chronic diseases such as diabetes. In addition, cellulose, which is part of Goldline Plus, serves as an enterosorbent, normalizes the intestinal microflora and has a detoxifying, that is, cleansing action from toxins.
It’s worth remembering that weight loss medications are meant to be used with diet, exercise, and behavior changes, not in place of them. Because of the vast amount of misinformation about eating disorders, these serious illnesses are often misunderstood, oversimplified, or generalized. It is not uncommon for a person to be considered a glutton without willpower, instead of lending a helping hand. Few people know that a series of diets is not only ineffective, but also dangerous to health. Drug therapy and specialist support, timely diagnosis and prevention of obesity are the key to breaking the vicious circle.