February 3, 2005

Anorexia nervosa is a complex psychological disorder in which a person uses starvation to fulfill emotional needs, whereas bulima nervosa is characterized by binge eating, writes Tazeen Mohsin

In today’s world the idea of beauty is being bone thin, which most people are incapable of accomplishing through a normal healthy diet. This is espoused by skinny models, singers, and actresses seen on television and billboards.

From early childhood children are taught by society to be conscious of their looks. Television through its endless ads endorses weight loss and thin and beautiful bodies. Overweight characters are portrayed as lazy and having no friends. While thin, smart women are projected as the successful and popular.

It has been reported that the average female model weighs up to 25 per cent less than the average woman and maintains her weight at about 15-20 per cent below the healthy weight for her body type.

Ten million people, of both genders, are globally afflicted with some kind of eating disorder. One of them is anorexia nervosa which is a complex psychological disorder in which a person uses starvation to fulfill emotional needs. Eating very little those inflicted by it refuse to maintain the healthy weight for their age and height, failing to recognize that they are underweight.

Those who suffer this illness have low self-esteem. They often have a tremendous need to control their emotions. Focusing on calories and losing weight is their way of blocking out the emotional pain. They feel powerful and successful when they make themselves lose weight.

This eating disorder is a unique reaction to a variety of external and internal conflicts such as stress, anxiety and unhappiness. Such persons usually deny anything is wrong and seeking professional help is considered as forcing them to eat against their will. They make excuses to avoid eating, often hide food which they claim to have consumed, use diet pills to control appetite and attempt to expel food by self-induced vomiting or by taking laxatives.

There are many risks associated with anorexia. They include shrunken bones, hair loss, severe dehydration resulting in kidney failure, mineral loss, low body temperature, irregular heartbeat and development of osteoporosis.

If laxatives are continuously used they wear out the bowel muscles and hinder their full functioning. Women who are anorexic have trouble conceiving babies and those pregnant usually have miscarriages or their babies are born prematurely.

Bulimia nervosa means “ox-like hunger.” This is more prevalent than anorexia. It is characterized by a cycle of binge eating, rapidly consuming calories in a short time, followed by purging the body of unwanted calories by self-induced vomiting, laxative abuse, excessive exercise, fasting, use of diuretics, diet pills and enemas.

Bulimics are usually people who do not feel secure about their own self-worth. They strive for the approval of others while hiding their own feelings. Food becomes their only source of comfort. A sufferer will often hide or store food for later binges, and will often eat secretly. This may also be an outlet for anxiety, frustration, depression, loneliness, boredom or sadness.

Some of the medical problems associated with the disorder include dehydration, cardiac arrest and death, cathartic colon (caused by laxative abuse), oedema (swelling of hands and feet), low blood pressure, development of peptic ulcers, pancreatitis, gastric dilation and rupture, abrasions on back of hands and knuckles, parotid gland enlargement, erosion of teeth enamel and anaemia.

People suffering from compulsive overeating disorder are literally addicted to food. They use food as their coping mechanism for their emotional conflicts and stress. These people tend to be overweight and are usually aware of the fact that their eating habits are abnormal and are more likely to seek help unlike anorexia.

They generally feel out of control with their eating habits, consuming thousands of calories in one go. Words like “go on a diet” are as emotionally devastating to an overeater as “eat more” can be to an anorexic. The more weight these people put on the more they try to diet which leads to the next binge. This is followed by feelings of powerlessness, guilt, shame and failure.

Compulsive overeating is usually developed in early childhood when eating patterns are formed. Most sufferers never learn to deal with their emotions or problems in a positive way and use food to deal with it. Sexually abused persons sometimes use food as a protection, believing it would make them less attractive.

A person suffering from compulsive overeating is also at risk of having a heart attack, high blood pressure and cholesterol, kidney disease and/or failure, arthritis, bone deterioration and stroke.

The most common element surrounding all eating disorders is the presence of low self-esteem. In anorexia and bulimia, people tend to have distorted images of themselves. They may personalize everything around them and feel as if they are hated by everyone. Compliments are seen as negative remarks about themselves. They have a strong need to control everything around them; when they can’t, they think it as unfair and take it out on themselves.

There seems a direct correlation between physical, sexual or emotional abuse and eating disorders. According to studies a relatively high percentage of sufferers have gone through some sort of abuse in their lives. It is not uncommon to find other psychological disorders associated with people suffering from eating disorders. Sometimes, it is a secondary symptom to an underlying psychological disorder (such as multiple personality disorder), and in other cases, the psychological disorder may be secondary to the eating disorder (such as depression).

In countries like Pakistan, talking about puberty still remains a taboo. Girls and boys should be aware of the changes that take place at a certain age and that they should feel good about themselves no matter what shape or size they are.

People, unconsciously or consciously, endorse the importance of being thin through their conversations. For example, a wife may ask her husband “Do I look fat in this?” or on seeing a friend “You’ve gained weight.” This continuously places importance on how we look and not on what we are.

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