KIM’S KORNER: Food for Thought

[dropcap]E[/dropcap]ating disorders are a serious problem that are often misunderstood or may even go unnoticed, but they can have dire consequences. They can be a response to a traumatic event but sometimes there is no obvious underlying cause or trigger.  An eating disorder is more than somebody being picky with their food and may manifest as binge eating, anorexia nervosa and bulimia nervosa; each having its own unique symptoms.

Binge eating—episodes of over-eating—affects both males and females and is more than an occasional day of over-indulgence; it is often described as eating habits being out of control. Eating can even continue when full—people often eat until it becomes painful. In many cases binge eating is triggered by stress, anxiety, depression and even boredom. This can become a cycle because often binge eating leads to feelings of guilt and shame and these negative emotions can start the cycle of overeating all over again. Although some people hide their eating habits, it does not tend to involve other risky behaviours like purging, excessive exercise or fasting so there is a possibility of weight gain. The risks of this weight gain can lead to other health problems like diabetes, high blood pressure or heart disease. Remember, binge eating is not the only reason for being overweight; your diet, lack of exercise or maybe an underlying health condition may be responsible.

Diagnosis is often difficult and tends to focus on analysing eating patterns and weight gain fluctuations. Once binge eating has been confirmed, treatment may involve a combination of therapy (that looks at changing eating behaviours) and advice on nutrition. If depression is a factor, doctors may prescribe anti-depressants to lift the mood and break the cycle.

Anorexia nervosa—the fear of gaining weight—is more common in girls and young females but can also affect males. It is common amongst models, athletes and people in the spotlight but can affect anyone and may be triggered by a traumatic or life-changing event. It is more than excessive dieting; there may be an obsession with exercising or seeking methods known for causing weight loss such as taking diuretics (medication to increase water output of the body) and laxatives (to increase bowel movements).  People with anorexia nervosa may develop an unhealthy fixation on food, analysing the nutritional content, counting calories obsessively and may even weigh portions while actually eating very little. Despite being painfully thin, a person with anorexia nervosa may see themselves as fat and their weight loss may spiral out of control in the quest to have the perfect body. Symptoms often include brittle nails and hair, a sallow/yellowish complexion, a fine layer of hair all over the body, sensitivity to changes in temperature (especially cold), slow reactions and tiredness and, quite often for women, their periods will stop. As well as symptoms of depression and anxiety, it also has long-term consequences leading to anaemia, thinning bones, heart damage and, in extreme cases, organ failure.

Diagnosis is made, after ruling out any other factors, bodyweight dropping below 85% of what is considered normal or if there is an obsession about gaining weight. The key to treatment is to first address any health problems related to low weight and then therapy that focuses on reaching a healthy weight, treating any underlying psychological issues, changing thought patterns and behaviours that may lead to a relapse and education about food and nutrition.  As well as therapy and education a doctor may also prescribe medication to treat any mood issues and depression that may slow down recovery.

Bulimia nervosa This tends to follow a pattern of binge eating followed by purging. It affects both males and females at any age but is more common in teenagers and young adults, and research has shown that around 85% of sufferers are female. Again, it can be triggered by stress or a traumatic life event, but even social pressure to be perfect can lead to bulimia. The cycle tends to start with over-eating followed by purging the food that has just been eaten either by vomiting, or taking a laxative to force a bowel movement; there may also be a tendency to exercise excessively. The outward signs are harder to recognise, as people tend to be close to normal weight but may have a distorted body image. The cycle of bingeing and the need to vomit or take laxatives can lead to various symptoms and long-term health problems, such as a chronic sore throat, damage to tooth enamel, heartburn, constipation and digestive problems, dehydration, irregular periods and a change to the body’s electrolytes (that can cause heart problems).

Diagnosis often relies on the person being honest with their doctor and treatment is a combination of education and counselling about nutrition and managing stress alongside medication to treat the emotional causes.

If you or anyone you know suffers from an eating disorder, it is important to contact a medical professional who can help on the road to recovery.  So next time, before you judge somebody for being too skinny or overweight, stop and consider the consequences of your words.

Kim Jackson is a UK-trained physiotherapist with over 20 years’ experience. She specialises in musculoskeletal pain and dysfunction including back pain and sciatica, stroke and other neuro conditions plus sports physiotherapy, having worked with local, regional and international athletes and teams treating injuries and analysing biomechanics to improve function and performance. She is registered with the Allied Health Council and is a member of PASL. She currently works at Bayside Therapy Services in Rodney Bay, tel. 458 4409 or 284 5443; www.baysidetherapyservices.com