Sun, 24 Nov 2002

Eating disorder sufferers dying for 'perfect' body

Maria Endah Hulupi, The Jakarta Post, Jakarta

Her friends were surprised to see Tina (not her real name) continually stuff her mouth with all the food served during their latest gathering. Right after the meal, when everybody was still chatting, she excused herself to go to the bathroom.

One of her friends, who was also in the bathroom, heard her vomiting. She began to get suspicious as Tina was so sensitive to her questions and said she was neither sick nor pregnant.

Another girl named Lala (not her real name) was rarely seen eating at her school's canteen and always avoided food and drink with calories.

Despite her skinny body, Lala always seemed to be on a constant and strict diet and at the same time overactive.

Family and friends watched her wilt and suffer hair loss and dry skin as she shed more and more kilograms.

Both Tina and Lala suffer from eating disorders which can be classified as:

* Anorexia nervosa It is characterized by life threatening self-imposed starvation, leading to significant weight loss, a refusal to maintain even minimal body weight, calorie and fat gram counting, excessive exercise to burn calories. This can lead to amenorrhea (absence of menstruation), osteoporosis, anemia, stunted growth, digestive problems and nerve damage.

* Bulimia nervosa It is repeated binge eating, followed by purging through induced vomiting, excessive exercise and laxative and diuretic abuses in a bid to rid the body of the food or to burn the calories.

* Binge eating It is eating an abnormally large amount of food. It can be with or without purging, with at least 10 to 15 percent of the sufferers becoming obese.

Although an unaware public may perceive an eating disorder as a dangerous weight concern, it is actually a complex emotional issue and whatever the type a person has developed, he or she is likely to suffer alone.

Eating disorders, somehow, relate to the public's perception of the ideal body shape. Since the public have been incessantly exposed to slim and gorgeous looking models in the mass media, many people, mostly women, set their standards on what the ideal body shape is like.

A psychiatrist at the Siloam Gleneagles Hospital, Tangerang, W.M. Roan, said people with eating disorders had developed a serious distortion of their body image, which was considered a personality disorder.

People at high risk were mostly teenagers who possessed rigid, often misleading definitions about the ideal body shape, Roan said.

"These people usually have low self-esteem and often consider themselves fat although they have normal weight or even lower," Roan said, adding that most of the sufferers were intelligent.

Siloam's nutritionist, Endang Darmoutomo, said organic problems which affected the hypothalamus in the brain could desensitize a person to signs of hunger or satiation.

Due to their abnormal eating habits, anorexia and bulimia sufferers deprived their bodies of the important nutrients they needed, while those who binge eat were especially prone to cardiac problems, high blood pressure, cholesterol, kidney problems and strokes, she said.

Unlike stick-thin anorexics, Endang said bulimics were usually unnoticed as their body weight tended to be normal. Though they showed signs of malnutrition and other similar health problems, it was not as severe as anorexics.

"Bulimics are also prone to developing rotten teeth and gum problems caused by the acid in the stomach when they vomit. Apart from that, they may also develop inflammation of the throat due to repeated manipulation of the area and swollen cheeks because of repeated vomiting," she said.

Though these people needed professional help, their distorted body image would make it difficult for others to provide help and discourage themselves from seeking help.

"They think they are fat so discussing a plan for weight gain can have a devastating effect on them. But it can seriously affect the function of body organs, which are likely to worsen into life-threatening conditions," Endang said.

"Family members have to be creative in persuading their loved ones to eat properly. It's worth telling them that hair loss and dry skin are not included in the definitions of looking good."

Prevention is more important and parental guidance plays an even more important role. Before a harmful eating habit ravages their loved ones' health, parents have to observe any irregularities regarding their children's eating habits.

"Parents must encourage their children to adopt a healthy diet once they notice them avoiding food or an obsession with it," Roan said.

If these efforts fail, professional help from psychiatrists or nutritionists was needed.

"They may need to take medication to improve their appetite and mood. This will help them open themselves for treatment or counseling," Roan said, adding that counseling for parents was also needed to avoid themselves pushing their children to attain the "ideal" shape.

Besides, parents and the public also needed to learn that there had been a shift in the ideal body shape perception from stick-thin Twiggy to slim supermodels Naomi Campbell and Cindy Crawford to curvy toned singer/actress Jennifer Lopez.