Beyond anorexia and bulimia: Eating disorders are on the rise again after the pandemic | Health and wellness

Eating disorders are mental illnesses that involve food but are not the problem in itself. Recovery becomes difficult because in the face of addictions such as smoking or alcohol, you cannot give up food, you must live. There is still very little ignorance about these disorders, even in medical settings. The most famous are anorexia and bulimia, but even they are not free from myths. For example, bulimia is usually associated with vomiting, but there are people who have bulimia and do not vomit; they may use other means of purging or compensating.

Although the WHO is very concerned about the obesity epidemic and is warning us about it, the incidence of eating disorders (ED) continues to rise; and more since 2020 as a by-product of the pandemic. Due to incarceration, the number of cases increased by 20%, and social media subsequently exacerbated the problem. Epidemiological data showed that before the pandemic, 5% of the female population suffered from ED, now – from 8% to 10%. According to the most recent data, approximately 9% of the world’s population suffers from some type of these diseases, which is equivalent to approximately 70 million people.

There is atypical anorexia, which was written into the DMS-V (Diagnostic and Statistical Manual of Mental Disorders) to identify people with anorexia nervosa who are not significantly underweight. An atypical diagnosis is made when all the other criteria for anorexia nervosa are met: sufferers may be of normal weight (or even overweight, according to the body mass index (BMI)) and experience intense fear of gaining weight and restricting food intake.

Unknowingly, because we are obsessed with weight and BMI, many people suffer from anorexia, but because they are not underweight enough, they do not dare to seek help. They do not believe that they are worthy of it.

Anorexia without underweight

If family doctors and other professionals are not informed that eating disorders can occur in people of all weights, not just those who are underweight, the diagnosis is misdiagnosed and puts patients at risk. Most cases are not diagnosed or treated properly unless the patient has a body mass index of 17 or 16, which can make the situation worse and chronic for those suffering from an eating disorder.

For someone starting or experiencing an eating disorder, seeking help can be extremely difficult due to the shame they experience. These disorders begin in personal life, and the most problematic aspects are often hidden even from the people with whom they live. Added to this situation is that when they finally decide to seek help, either their doctor does not realize the severity of the situation due to their apparently normal weight, or their family, friends or partner do not realize that there is a problem. Both factors can contribute to the chronicity of the disease.

It is critical that health care providers recognize that eating disorders can occur in people of all weights and that assessment and treatment should not be based solely on BMI. Failure to recognize the severity of ED can delay appropriate treatment and worsen long-term outcomes for patients.

Eating disorders that result in significant weight loss usually require medical treatment for fear that the patient may go to the other extreme and binge eat or gain a lot of weight. This view can hinder recovery by maintaining restrictive behavior throughout the recovery process. What if someone gains weight during recovery? It’s okay for them because there will be no restriction or purging. No matter what your BMI says, it should be a weight that allows you to have the best quality and most fulfilling life.

Night eating syndrome

Pica is an eating disorder characterized by regular consumption of things that are not food. Up to age two, this is normal, as children usually put everything in their mouths. From age two onwards, if non-food items are consumed for at least a month, it is considered pica. They may eat chalk, pillow stuffing, or hair, as well as other things that are not harmful to their health in principle, but can cause obstructions and infections. It occurs more often in pregnant women.

Another little-known but very common eating disorder is night eating syndrome. These people consume the maximum amount of calories starting in the afternoon. During the day, they experience anorexia in the morning and hyperphagia in the evening. They suffer from depression and other related diseases, and at night they have attacks of overeating high-calorie foods, but without cleansing the body. They are associated with insomnia, dysregulation of circadian cycles, and the belief that if they don’t eat, they won’t be able to sleep. This ED occurs in overweight and obese people, but it is also common in people of normal weight.

The overemphasis on BMI as a measure of health ignores other important factors, such as overall mental and physical well-being. We need awareness and prevention. Eating disorders are not illnesses of moody people, they are serious diseases with high levels of suffering.

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