Interview about Eating Disorders, taken from Maryam Usman

Following is an interview taken by Maryam Usman, who had done BS Honors in Food and Nutrition from the University of Home Economics Lahore, and is planning to do a Post-graduate Diploma in Dietetics.

Q. Can you briefly explain what eating disorders are?

Eating disorders are characterized by a persistent disturbance of eating or eating-related behavior that results in significantly impaired health and psychological functioning. They are a condition in which patient experiences disturbances in eating behaviors and related thoughts and behaviors.

The main types of eating disorders are Anorexia nervosa, bulimia nervosa, and binge eating. Anorexia nervosa includes persistent energy intake restriction and intense fear of gaining weight or becoming fat. It is a behavior that interferes with the maintenance of the appropriate weight. Bulimia nervosa includes recurrent episodes of binge eating followed by inappropriate compensatory behaviors in an effort to prevent weight gain and self-evaluation, which is usually influenced by body shape and weight.

Binge consumption is an episode of uncontrollable eating or an excessive amount of food.

The inappropriate compensatory behaviors include self-induced vomiting, misuse of laxatives and other medications, fasting, and excessive exercise.

Binge eating disorders are eating disorders that describe the eating disturbances of a large number of individuals who suffer from recurrent binge eating but do not regularly engage in compensatory behaviors to avoid weight gain.

Q. Is behavior-changing a symptom of eating disorders?

People with eating disorders may have behavioral changes including psychological and emotional problems that can lead to disorders. They may have low self-esteem, perfectionism, impulsive behaviors, and troubled relationships. People may skip meals or make excuses for not eating, make their own meals rather than eating what the family eats, withdraw from normal social activity, and frequently check in the mirror for body shape. They may also exercise excessively and eat in secret.

Q. Mostly women are the ones who reach out to get help from a doctor regarding eating disorders. Why do you think other genders hesitate in consulting a doctor?

Men hesitate in consulting a doctor as they may not want to be associated with a problem that primarily affects women. Moreover, eating disorders are considered to be a mental problem that only affects females, so men may be hesitant in admitting they suffer from it. That's why men are less likely to admit and seek treatment.

Q. How much do peer pressure and societal pressure influence the development of an eating disorder?

Peers have a significant influence on the development of eating disorders, especially during adolescence, when closeness in a relationship is important to win approval and esteem from others. Both direct behaviors and comments from peers related to difficulties with body image for adolescent boys and girls.

Societal pressures also contribute to eating disorders. The power of media has influenced the adolescent's definition of attractiveness. Mass media encourages an obsession with weight as those portrayed in it are often close to societal ideal body weight and size. Viewing ultra-thin models in magazines and television has contributed to negative influences on body image, and increased the development of eating disorders among young boys and girls.

Q. If we compare Pakistan with the USA, do you think its efforts are sufficient in handling an eating disorder?

In the light of researches, the presence of eating disorders in Pakistan cannot be denied. Unfortunately, very few cases have been reported to doctors or mental health workers as people are very reluctant to admit disordered eating as a problem. In addition, there is less awareness among the public of Pakistan regarding eating disorders and no attempt is being made to spread awareness among people. When we compare Pakistan with the USA, it is clear that western countries are handling eating disorders more effectively.

Q. What treatment do you think works best for patients suffering from eating disorders?

Eating disorders are complex psychiatric illnesses that require psychological and ongoing treatment. We need to first help patients understand and cooperate with their nutritional and physical rehabilitation. We should help them understand and change behavior and dysfunctional attitudes related to eating disorders. Improving interpersonal and social functioning can also help patients suffering from eating disorders. Proper rehabilitation programs are required to treat patients.

Nutritional treatment depends on the type of disorder. Patients with anorexia nervosa should include the appropriate amount of energy needed for the normal functioning of the body in their diet. Constant restrictory diets lead to a deficiency of essential fatty acids and fat-soluble vitamins. A proper diet that meets all nutrients must be prescribed. Patients with bulimia nervosa should adopt an eating pattern that is balanced every day. It will help them to maintain body weight and get rid of the eating disorder.

Q. What role does the family play in the treatment of eating disorders?

People who are working towards eating disorder recovery can greatly benefit from family involvement and support. The need for support extends to family members as they walk alongside their loved ones working towards recovery.