Eating Disorders: What Happens When Stigma And Misconceptions Command The Health

As per the National Association of Anorexia Nervosa and Associated Disorders, (ANAD), worldwide, at least 9% of the population is affected by eating disorders. Eating disorders is a psychological condition that disturbs eating habits. Eating disorders affect thoughts and emotions, and the people with the disease become preoccupied with food, body shape and weight. 

Eating Disorders can cause emotional and physical issues in the person that may also lead to life-threatening complications. There are many misconceptions associated with eating disorders such as it is a disease related to women and rich people. In some cases, people also come to the conclusion that it is not a serious disease, it’s a way to gain attention and media & publication unnecessary gives coverage to the disease. However, it is a serious mental illness and irrespective of the gender, age, race, sexual orientation and background, anyone can have an eating disorder. It is most commonly observed in adolescents and young adults. As per the  Mental Health America, in the United States, “20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder or Eating Disorder Not Otherwise Specified (EDNOS) (EDNOS is now recognized as Other Specified Feeding and Eating Disorders (OSFED), other specified feeding or eating disorder, per the DSM-5)”. 

What factors influence eating disorders?

Some of the most common factors for eating disorders include –  

• Biological factors – Genetics, hormonal functioning, and neurotransmitters imbalance are biological factors for eating disorders. 
• Psychological factors – Negative self-assessment of the individual body shape and weight is one of the critical risk factors for an eating disorder. 
• Environmental/cultural factors – Nutritional deficiencies in food, childhood trauma, peer group, people from specific professions (such as athletes and veterans), low self-esteem are some of the most common environmental/cultural factors. 

What are the Warning Signs and Symptoms of Eating Disorders?

Various signs and symptoms mark an eating disorder. Generally, people with eating disorders get obsessed with fat content and calories in food. Along with these, the person also gets extremely critical about his appearance, body shape, weight, and sometimes gets upset or guilty about eating a particular type of food. Weight change, fatigue, concentration issues, frequent mood changes, anxiety, depression, negative feelings about food and body weight are some of the most common signs and symptoms of eating disorders.

Eating Disorders is diagnosed based on the physical exam conducted by the healthcare professional. In addition to it, a psychological evaluation is also done to evaluate the mental health of the person. If the eating disorder mains undiagnosed and untreated, it may cause complications in the cardiovascular system, kidneys, or digestive system. In some cases, a change in hormonal balances may also occur.

What are the types of eating disorders?

• Anorexia Nervosa – Anorexia Nervosa is one of the most common eating disorders that lead to weight loss due to dieting or exercise. People with Anorexia Nervosa fear about gaining weight or becoming fat. Anorexia nervosa is quite prevalent in younger generations, and people from specific professions or sports emphasise weight loss. 
• Bulimia Nervosa – Bulimia Nervosa is a binge eating habit followed by compensatory behaviours, such as self-induced vomiting, excessive exercise, and fasting to reduce binge eating. Abnormal hormone levels, trauma, depression and anxiety disorders play a crucial role in the Bulimia Nervosa. 
• Binge Eating Disorder (BED) –  Binge eating disorder (BED) is a mental condition marked by excessive overeating. People with this condition consume a high amount of food in a short period. The affected person is found to have an inability to control eating habits. Unlike Bulimia Nervosa, in Binge Eating Disorder, the person has no compensatory behaviour to lose weight.

Besides the above listed, Body Dysmorphic Disorder (BDD) and Rumination Disorder are some other eating disorders. 

What is the treatment option for eating disorders?

Being a mental health condition, eating disorders may require treatment to overcome its effects. If it remains untreated, it may negatively impact the health of the person. In some situations, it may lead to a life-threatening condition. The stigma associated with the disease creates challenges for the person to seek help. Dignity, self-esteem, lack of social and parental support, feelings of shame, negative remarks are the key barriers to effective treatment. Similarly, the Interpersonal relationships and the fear of being negatively evaluated by parents and social groups make the person reluctant to seek help. Several treatment options are available to address the psychological, biological, and cultural factors of eating disorders. The type of care may vary from person to person; however, in some situations such as severe weight loss and high nutrition deficiency, the patients may be required to get hospitalised or recommended speciality care. The most common treatment options for eating disorders include- 

• Nutritional Interventions – Nutritional Interventions ensures macronutrient intake in the body, restoring body weight and shape. Nutritional Interventions calculate and monitor weight change and emphasise different foods in the diet. 
• Medication – Medication helps to treat the mood or anxiety symptoms in the person. Apart from relieving symptoms, it aids in weight gain for the patients affected with Anorexia. Similarly, in the case of Bulimia, antidepressant and anxiety medication are recommended.
• Therapy – The support of the family and group counselling plays a vital role in managing eating disorders. Family and group therapy can make the recovery process easier for the affected person. The psychotherapy changes the thinking, beliefs, thought patterns and the behaviour of the person over time. 

Way ahead

Apart from physical and psychological health burden to the individual, the eating disorders can also result in substantial out-of-pocket expenditure on treatment. Eating disorders cause several disabilities and deaths worldwide every year, which directly affects the economy and society’s health. The burden of anorexia nervosa and bulimia nervosa is exceptionally high in the young females in high-income countries. However, it is observed that over the past few years, the burden of anorexia nervosa and bulimia nervosa has also increased in the low- and middle-income countries (LMICs). Cultural changes have directly influenced the eating disorder in LMICs. The stigma and misconceptions associated with eating disorders have a seriously negative impact on the affected individual.

However, increased awareness and education about the eating disorders, emerging treatment options, R&D in the diagnosis, and better health policy by the government will significantly impact the management of the eating disorders’ in coming decades.