Eating disorders , namely anorexia nervosa, bulemia nervosa and binge eating disorder are much more common that one would beleive. A prevalence of about 1-5% would imply that, in India alone upto 65 crore people could be suffering from eating disorders. Upto 25% of those who are obese are said to be suffering from binge eating disorder. Eating disorders if not identified and managed, can be very damaging to both body and mind. Genetic factors, bioligical factors (such as leisons in the caudate lobe or hypothalamus), diminished noadrenaline ( a chemical in the brain ) turnover, endocrine abnormalities and psychological factors such as preoccupations with body image & misconceptions about self esteem and validation. The physical and psychological consequences of eating disorders may be far reaching and can affect occupational and social functioning. It is essential that these disorders are identified and treated as early as possible.
The most well known eating disorder, thanks to movies and novels. Anorexia nervosa translates to loss of appetite, a misnomer in itself. It involves, self induced starvation, a desire for thinness and the presence of medical complications resulting from a grossly inadeqate diet. Thinness is sometimes considered the sole source of self esteem. With an age of onset in the late teens, it has the propensity to cause long standing damage to a child's development. A BMI of lesser than 17 in the presence of above features indicates anorexia.
Anorexia nervosa can cause long standing morbidity and a number of physical complications if not identified and treated appropriately. Effective treatment modalities are available, ranging from psychotherapy, behavioral interventions and medications.
Bulemia translates to ox-hunger and for some it may be considered a lesser form of anorexia. Despite the underlying misonceptions about thinness, patients with bulemia do not reach dangerously low body weights. They also indulge is impulsive binge eating and compensatory purging or excessive exercise. Impulsivity, substance abuse and behavioral disturbances are commoner than in comparison to the general population. People with bulemia are less likely to seek help when compared to those with anorexia. Binges and purges often occur in secret further delaying help seeking. It becomes essential for parents and teachers to be able to identify bulemia. Like in most mental illnesses, earlier the intervention better the prognosis.
People suffering from binge eating disorder often eat an abnormally large amout of food over a relatively short period of time. Unlike in bulemia, there is an absence of compensatory behaviour ( purging and exercise), leading to a gain in weight. 50-75 percent of those with a BMI of over 40 fulfil criteria for the diagnosis of binge eating disorder. There is usually a feeling of loss of control during these binge episodes. Binging is often associated with an extroverted and impulsive personality types. All of us know the dangers of obesity and its consequences.
Certain behavioural methods, drugs that reduce cravings and thought restructuring have been found to be effective in managing binge eating and obesity.
Psychiatry is a medical speciality, like surgery, general medicine and paediatrics. It involves the study, diagnosis and management of mental illnesses and distressing conditons, pertaining to both the mind and body. Misconceptions about psychiatric illness and treatment have some how prevented help seeking behaviour in those who need it the most. This Wall has to go, wherin visiting a psychiatrist should no longer be taboo, and people should be able to openly and freely discuss mental health issues.
Dr Vikas Prabhav is a psychiatrist in chennai, he runs The Vivid Mind mental wellness clinic in Anna Nagar. We aim at providing holistic, multimodal care for those suffering from mental illnesses and adjustment issues. We offer effective management strategies for depression, anxiety, unexplained physical symptoms, addictions, child/adolescent problems and other behavioural issues.The information provided in this website does not substitute for a medical consult.