Eating disorders may come with changing lifestyles

Eating disorders may come with changing lifestyles

By Monty P. Satiadarma

JAKARTA (JP): Turn on your TV today and you are likely to see
images of single, usually white (even if they are Asian), almost
always thin females.

Flick through a glossy magazine's pages and you will be
greeted with various women who are bound to be sleek and slim.

Some women may look at the images and want to be like the
slender ideal of womanhood.

But take a look at another example. A few years ago the
International Athletic Commission on Gymnastics became concerned
about an international Olympic gymnast who suffered from anorexia
nervosa, probably the most famous eating disorder.

The commission did extensive research and found the disorder
resulted from her past eating habits to keep thin to compete.

As a gymnast she had to maintain her weight and her body
proportion, and had been doing it since the age of about six.

Researchers concluded that restricting children from having
proper meals that complied with their natural needs might carry
possibilities of suffering from anorexia nervosa when they
reached adolescence and adulthood.

Another form of eating disorder, bulimia, affected Diana,
Princess of Wales, who said the problem resulted from her
stressful life.

Eating disorders became a greater concern to the public
after Diana's admission and the death of singer Karen Carpenter
after years of anorexia and bulimia.

Anorexia nervosa is a disruption in normal eating habits
characterized by an all-consuming fear of becoming fat. One who
suffers from it may lose more than 25 percent of his or her
normal body weight, all the time denying that he or she is
becoming thinner.

In short, people with anorexia can starve themselves to death.
Most anorexics are women but there are growing numbers of men.

Bulimia is a cycle of uncontrolled binge eating followed by
purging through vomiting or the use of laxative. In a severe
form, eating sprees and purging may occur ten or more times
daily.

People suffering from bulimia often are of normal weight or
are slightly overweight.

The physical effects however are damaging.

Frequent vomiting may cause tooth decay because the enamel
erodes. The worst possibility ranges from suffering kidney
problem, and electrolyte imbalances as a consequence of the
binge-purge eating habit can cause serious cardiac problems.

Multidimensional

Researchers still conduct extensive studies to find the cause
of the disorders. Most of them agree, however, that the sources
are multidimensional, consisting of biological, psychological and
social factors.

Deprivation of food during childhood is considered one of the
leading causes. Many experts also conclude that the phenomenon
stems from the effort to control oneself, whether in a physical
sense or psychological sense.

These people tend to have low self-esteem and feel a perpetual
disappointment over their personal achievement, even though they
may excel, so they try to take a grip on the whole life situation
in order to achieve better personal control.

The DSM IV (Diagnostic and Statistical Manual of Mental
Disorders - IV) classifies eating disorders as a form of mental
disorder experienced mostly by adolescents, and some will go
through adult years.

In some cases the disorders may be lethal following the
patient's decreasing health status from an improper diet. In the
recent years, however, there has been an increased number of
eating disorders experienced by children under 12 in Western
countries.

In these cases, research found that children raised in a
dysfunctional family or in a family where the parents are
preoccupied with appearance and weight have a greater possibility
of developing eating disorders.

Society as well as the mass media that emphasizes messages
about the importance and the needs for being thin may support the
growing number of eating disorders, including in children.

Lifestyle

What about Indonesia? Changes in eating patterns, particularly
in Jakarta, are more related to lifestyle, while eating disorders
may relate to depression and lack of attention.

As of today, while no exact information about eating disorders
in Indonesia, especially in Jakarta, is available, there may be
increased incidence of the problems in the rapidly changing
society.

Symptoms of anorexia nervosa include drastic weight loss,
fatigue, muscle weakness, complaints about being obese, seeking
excuses for avoiding meals; the symptoms of bulimia consist of
binge eating, secretive eating and bathroom visits after eating
(to purge).

In both cases the people normally develop need for self-
approval from other people. Depression, irritability and mood
swings accompany the symptoms.

There is no doubt that people who suffer from this disorder
are in a sense trying to kill themselves, and members of the
family may experience distress, guilt and confusion in trying to
help their loved ones.

In most cases, members of the family tend to force the
patients to stop their behavior through direct confrontation.

They may give comments such as: "You look terrible", "You are
running our family", "I'll help you fatten you up", "You've put
on your weight, you look great", and so forth. The approach is
actually counterproductive, because comments on appearance is a
form of torture to a person with an eating disorder.

People with eating disorders have an acute awareness of their
appearance. They are trying to gain composure while controlling
others and themselves. Comments tend to put the patients into a
deeper, more painful experience in being unable to control
themselves appropriately.

Physically trying to force the patients to stop their abnormal
eating habits may deepen the suffering and add more pain.

In most cases, help from a professional is necessary.
Professionals normally use reframing, thus allowing the persons
to see things from different perspective.

As the patients are normally feeling unworthy, they need to be
convinced that they are valuable and needed persons.

One with an eating disorder has the best chance for recovery
when he or she is surrounded by people that are loving and
supportive.

There is no single treatment for such disorders. Treatment
must involve individual, group and family therapy, support
groups, medical and nutritional counselors. The approach must be
based on a biopsychosocial approach together at once.

It is also important that the family gets support from
community groups because they can share their difficulties and
frustration. Unfortunately, there are few such groups at this
time in Indonesia.

The writer is a family counselor based in Jakarta