Many of us have developed eating habits and a relationship with food that are linked to our mental health. Some of these relationships can be so unhealthy that they become destructive and toxic. Dr. Menna Abdel Nasser and Cairo West Magazine discuss what happens when an eating disorder takes over.
CWM: What is an eating disorder?
MN: Eating disorders are a group of mental illnesses, characterized by eating, exercise and body weight or shape becoming an unhealthy preoccupation of someone’s life. Eating disorders are usually under diagnosed and undertreated and among mental health cases, they have the highest mortality and morbidity rates.
Is there a specific age group affected?
Anorexia and bulimia affect primarily people in their teens and twenties, but studies report both disorders in children as young as six and individuals as old as seventy-six.
How are eating disorders categorized?
Eating disorders can take many different forms and interfere with a person’s day-to-day life. The Diagnostic and Statistical Manual of Mental Disorders (DSM) recognizes four eating disorders
- Anorexia Nervosa (when a person tries to keep their weight as low as possible; for example, by starving themselves or exercising excessively).
- Bulimia Nervosa; where a person goes through concurrent episodes of eating excessively (binge eating) followed by compensatory behavior in the form of vomiting, using laxatives (medication to help empty the bowels) or excessive exercise.
- Binge Eating Disorder (where there are episodes of a complete sense of loss of control of what the person eats followed by a feeling of guilt).
- Other Specified Feeding and Eating Disorders like (night eating syndrome and ARFID)
What are the primary causes of the main disorders?
Eating disorders are often blamed on the social pressure to be thin, as young people in particular feel they should look a certain way. However, the causes are usually more complex. An eating disorder may be associated with biological, genetic or environmental factors combined with a particular event that triggers the disorder.
Risk factors that can increase the likelihood of a person having an eating disorder include: having a family history of eating disorders, depression or substance misuse, being criticized for his/her eating habits, body shape or weight, being overly concerned with being slim, particularly if combined with pressure to be slim from society or for a job – for example, ballet dancers, models or athletes.
- Certain underlying characteristics – for example, having an obsessive personality, an anxiety disorder, low self-esteem or being a perfectionist
- Stressful situations – for example, problems at work, school or university or relationships.
How can eating disorders be managed or treated?
First of all, it’s a collaborative treatment between the psychiatrist, psychologist, nutritionist and physiologist. Services available for treating eating disorders can range from intensive inpatient programs (in which general medical care is readily available) to residential and partial hospitalization programs to varying levels of outpatient care (in which the patient receives general medical treatment, nutritional counseling, and/or individual, group, and family psychotherapy).
How often do eating disorders stem from childhood?
There is evidence that parenting and family dynamics influence the emergence, development, maintenance, and treatment outcome of eating disorders. Childhood anxiety (e.g. difficulties separating from caretakers), history of childhood trauma and neglect, including subtle degrees of psychological abuse, teasing, and other interactions that generate self-doubt may increase vulnerability. Moreover, negative maternal modeling; criticism of eating, teasing, and excessive expectancies may influence the eating-disordered behavior of their children.
What can parents do to instill a healthy attitude towards food in their children?
I believe that parents need to teach their children to accept themselves as who they are, and to learn that eating a balanced diet gives them more energy and makes them sleep better. It’s important for children to learn the benefits of every food they eat. They should also present food different in a way that’s attractive to kids.
How much impact do emotional states and stress play in the development of eating disorders?
Emotional states play a huge role in the development of eating disorders. It was noticed that individuals with eating disorders often lack vital coping skills and that eating disordered behaviors are often used as alternatives for these skills. People may use disordered eating behaviors to provide themselves with comfort, numbness, attention, tension release, identity, self-punishment, protection, or avoidance strategies, when more reasonable coping methods are not available. Disordered eating can also seem like a way to cope with developmental challenges, such as stressful changes (e.g. going to college), family conflict, and academic pressure.
Dr. Menna Abdel Nasser Omar, Master Degree in Neurology and Psychiatry
Faculty of Medicine – Ain Shams University, MB BCh
Faculty of Medicine – Ain Shams University.
Specialist in Al Mashfa Hospital