Eating disorders are not limited to anorexia and bulimia, but include many conditions that affect both the relationship with food and the perception of one’s own body and each one has its different characteristics,” he explains. Monica Marazuelafull academician of Endocrinology, Metabolism and Nutrition of the Royal National Academy of Medicine of Spain (RANME), on the occasion of the International Day to Fight Eating Disorders (TCA) which is celebrated this Saturday, November 30.
The majority of ED cases are diagnosed in women, who represent approximately 85-90% of cases of binge eating disorder, anorexia and bulimia“although a significant increase in prevalence has been observed among men,” he acknowledges. «Binge eating disorder is the most common because it affects up to 3% of the population and can contribute to the development of obesity, although the greatest risk of mortality is anorexia nervosa, followed by bulimia nervosa,” says Marazuela, who is also head of the Endocrinology and Nutrition Service at Hospital de la Princesa and professor of Endocrinology and Nutrition at the Autonomous University of Madrid.
In fact, he adds Celso Arangoa full academician in Psychology at the RANME, “EDs can become chronic and even lethal, because one in ten people with a disorder such as restrictive anorexia will lose their life as a consequence of this serious illness.” «I have seen patients die in the ICU after many years with a restrictive eating disorder, with 22 or 23 kilos that are bone and skin, and that are still there. absolutely convinced that they are overweight of the buttocks, legs or arms. This is because not only do they have a pathological fear of weight gain, but they also suffer from a cognitive distortion of their image and an inability to perceive their body objectively,” laments Arango.
«Another aspect to highlight is that we are increasingly seeing more children between 6 and 11 years old with eating disorders, when before they appeared from the age of 12; In this type of disease, the earlier they appear, the better prognosis they have, but if they are not treated in time, in the case of girls “They won’t even be able to have their first period,” reveals this expert who is also director of the Institute of Psychiatry and Mental Health and head of the Child and Adolescent Psychiatry Service at the Gregorio Marañón General University Hospital in Madrid.
On the other hand, what is increasing among boys is vigorexia. «It is not an eating disorder per se, it is a variant, but it is a distortion of the body image and it causes a obsession with having a ‘bodybuilder’ body, “They don’t want to be thin, but very strong, and everything revolves around this, it becomes an addiction to the gym,” explains Arango.
How do EDs appear? «They tend to be perfectionist, meticulous, obsessive, self-punitive, self-demanding, rigid people… and perhaps the trigger is being a little overweight and suffering bullying because they are insulted with something. derogatory name in relation to your weight or, simply, in other cases, they suffer from a virus or infection that makes them lose weight and they realize that they can control it with their intake, they lose more and more until it gets out of hand and the pathological fear of gain weight and suffer cognitive distortion,” says this academic, who recalls that EDs are associated with a series of systemic diseases, cardiac arrhythmias, hormonal problems and problems of all organs (thyroid, liver, kidneys, etc.), which end up causing that 10% of deaths.
Keys to a good relationship with food
Maintaining a good relationship with food is essential to prevent and treat eating disorders. «To achieve a healthy relationship with food, it is recommended to maintain a balanced and varied diet, “eat consciously, enjoying what you eat, without rushing or guilt, avoiding very restrictive diets and learning to listen to the body’s hunger and satiety signals,” says Marazuela, who highlights that “accepting the body as it is and avoiding comparing yourself constantly with others is essential.
«Patients with eating disorders will need the help of different professionals to carry out a combination of psychological therapy, nutritional counseling, medical intervention to prevent and treat possible complications especially in severe EDs, treatments in support groups and, in some cases, drugs that help them establish a healthy relationship between food and the body,” he points out.
Likewise, Arango advocates for a «social-emotional learning in schools where emphasis is placed on values that have to do with the person, not with what they appear to be or how they are seen by others. «The problem is that many adolescents become obsessed with what others may think of them in relation to their physique or the likes they have on social networks, they are not able to value themselves for their intelligence, their kindness, their aptitudes and values, “But they remain superficial,” says this psychiatrist.
And he continues: «I ask many of my girl patients who have ED: How would you like your partner to be? very thin or good person? very thin or smart? Very thin or with a sense of humor? And they always answer me the second. To which I answer: And why do you think that they are going to value you the opposite of what you value others?
«This universal primary prevention based on values and helping adolescents to count with good self-esteem “It is the future to reduce the prevalence of eating disorders that have increased significantly after the pandemic, without ever forgetting the importance of always involving families,” concludes Arango.
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