Eating disorders are mental disorders. They can be, so to speak, with a minus sign and with a plus sign.
With a minus sign - lack of appetite, suppression of the desire to eat, anxiety about weight and body shape - nervous anorexia.
With a plus sign - a very strong appetite, excessive concern about weight and body shape, when a person eats a lot, and then, due to feelings of guilt and shame, can compensate for gluttony with intense physical activity, inducing vomiting - this is bulimia.
In 2014, the American manual of mental disorders DSM-5 added another disorder with a plus sign - binge eating ("overeating in fits and starts") - it is not yet included in our reference literature.
During such an attack, a lot of high-calorie food is eaten (4000-6000 calories), but there is no compensatory behavior (intense physical activity to burn calories, inducing vomiting, etc.).
It is also worth noting orthorexia - a manic desire to lead a healthy lifestyle, to eat clean and healthy food.
Until recently, anorexia and bulimia were called "American diseases." How did it happen that they also became quite common in our country?
Alas, this is a sad popularity. In fact, these diseases have always existed. The first case of anorexia, which is described in literature, is the story of Saint Catherine - Catherine of Siena (14th century). She ate so little that even church abbots were wary of such asceticism.
There are practically no statistics on the disease in Ukraine, so we have to rely on data from the United States, where people seek help more often. According to various sources, from 1 to 4.2 percent of the population suffers from anorexia, and from 4 to 10 percent from bulimia.
Doctor of Medical Sciences Galina Pilyagina once said that "in psychiatry there are only two zones that border on death - suicide and anorexia." Is it really that serious?
Anorexia is the leading mental illness in terms of mortality. The reason is not only death from cachexia (exhaustion), but also a high risk of suicide. Let me just tell you what anorexia does to the body (I will tell you using a female example, men with this disease are less common).
A girl can eat half an apple, a few tablespoons of oatmeal all day long - and that's it. There is an incredible deficiency of microelements, hypocalcemia begins , hair, teeth, nails, skin suffer, bones become brittle. Metabolism slows down, a person is constantly cold. The nervous system and heart begin to suffer, because they need potassium and magnesium.
In fact, at 15 years old, a girl shows all the signs of menopause... And it's scary... It's important to understand: if a woman suffering from anorexia says that she will stop fasting when she reaches a certain weight, then, alas, having achieved what she wanted, she can no longer do this - the brain begins to work differently.
Is it teenage girls who are at risk, or does anorexia not spare adult women either?
The most vulnerable category is, of course, teenagers, because they are experiencing a hormonal surge. The body changes dramatically, and they do not understand what is happening to them.
I remember a 22-year-old girl who weighed 37 kilograms. By the way, at that time my 12-year-old son weighed more... The girl suffered from anorexia for several years, while constantly working, was on antidepressants that she prescribed for herself.
I always wonder where anorexics get the strength to go to work every day?
There is an interesting evolutionary theory that claims that anorexia was useful for the survival of humanity. What does a hungry person feel? He does not want anything, he feels weak, has a headache, and has stomach cramps.
If a person has a genetic predisposition to anorexia, he feels a surge of strength, he has an elevated mood. Imagine: the tribe is lying exhausted from hunger, the anorexic is cheerful and finds food, saves everyone, but soon dies himself.
Are people with a genetic predisposition at risk for eating disorders?
If there is no genetic predisposition, then it is impossible to develop an eating disorder. But how can one check whether there is such a predisposition or not? Unfortunately, Ukrainian laboratories do not yet perform such analyses.
The mother's example plays an important role. If she is constantly on strict diets, the child will adopt this model and consider that severely limiting oneself in nutrition is the norm.
Those who are brought up in overly controlling, overprotective families, perfectionists who need to do everything as best as possible or not do it at all are also at risk. By the way, a father who trains endlessly can also become a "trigger" for the disease.
Bulimia can be triggered by psychological trauma, including sexual trauma, or some kind of severe stress. Often, bulimics are quite successful people on the outside, they look good, earn good money. And they rarely seek help because of a sense of shame. We can recall the example of Princess Diana, who suffered from bulimia.
How can we find the line between a truly healthy lifestyle and the eating disorder orthorexia?
In fact, this line is very thin. When a person devotes all his time to making shopping plans, searching for "those" right products and preparing them correctly - this is already a disorder.
All this cannot be done without damaging one's social life. Such a person becomes isolated because those around him do not understand what he does and why it is so important to him. In fact, arugula or broccoli becomes a friend of orthorexes .
I'll tell you a funny and sad story. Recently, a girl wrote to me that she wanted to lose weight, but she was having a hard time sticking to a diet. It turned out that she was only eating boiled and slightly salted broccoli (!) and washing it down with water.
To be honest, at first I thought it was some kind of trolling. It turned out that the person really was on such a "diet", experiencing a constant feeling of hunger.
Who is most likely to suffer from orthorexia?
among orthorexes . In 2015, I conducted a study of the needs and motivations of people with orthorexia to understand
What motivates these people to behave this way?
It was thought that this behavior was typical of people who were afraid of the world around them, but my research showed that the leading need of people with orthorexia is self-affirmation.
A person with orthorexia thinks something like this (I'm exaggerating, of course): "I eat wonderfully, and therefore I live better than you; I am clean, correct, and therefore I can teach you."
Is there any way to test yourself for early signs of an eating disorder?
The following methods will help to check a person's relationship with food: the EAT-26 test, the Dutch questionnaire of eating behavior, the Rome questionnaire ORTO-15 will help to understand whether there is nervous orthorexia.
All these methods can be easily found and completed on the Internet. Examples of behavior that should alert you: sudden weight loss, constant dissatisfaction with your appearance.
When eating, everything is divided into very small pieces, chewed very slowly and washed down with plenty of water.
A special piece of advice for mothers of teenagers: respect personal boundaries (knock before entering, close the door to the child's room), ask why he is depressed, and do not demand that he be the best of the best - these are simple but important things.
Because often parents bring an already exhausted child to a psychotherapist. And you understand that the moment of the initial stage is missed. And treatment of any eating disorder is an expensive and difficult process.
Since there are practically no specialized departments and clinics in our country, such patients are treated either in gastroenterology or in psychiatric departments of hospitals. There are no state programs that would finance such psychotherapy, and there are very few specialists who specialize in the treatment of eating disorders and have real specialized training. Therefore, it is so important to be attentive to yourself and your loved ones!