Fitness mantra
'Dying' to be thin
Nancy Sahni

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Oh my God, look at my paunch, it's so visible!" Or, "I have gained a lot of weight," "I am full to the brim, can't eat anything!" Or, "I want to eat and gain weight but my tummy has now become used to having less food, so it can’t tolerate more food!" Have you listened to these words from a reed-thin young female or a male? If so, then it is indicative of a serious problem, anorexia nervosa, an eating disorder characterised by an obsessive (extreme) fear of gaining weight. Persons with anorexia nervosa continue to feel hunger, but deny themselves all but very small quantities of food. The average calorie intake of a person with anorexia nervosa is 600-800 calories per day (the optimum calorie intake varies from 1800-2400 kcals approximately). Sometimes, an apple can last for them the whole day. It's an attention signal for parents of young teenage or post-teenage kids, especially girls. Anorexia nervosa occurs in females 10 times more than it does in in males, who often get swayed by 'zero-size' figures or who to begin with are a little plump but due to the quest for being perfect begin a rigorous diet and exercise schedule but end up counting every morsel of food that goes into their mouth and by the time relatives realise what is happening to their once cute little darling, she is at an advanced stage of the eating, making a 'U'-turn from where is a Herculean task, both for relatives and the patient. It might also occur in to-be married girls or just-married women who fear gaining weight after marriage or after conception.

• Refusal to maintain a normal BMI (wt. in kg/ht. in metres; the normal BMI range is 19-24)

• Amenorrhea: The absence of three consecutive menstrual cycles

• Obsession with calories and fat content

• Cuts food into tiny pieces; refuses to eat with others around; hides or discards food

• Purging: uses laxatives, diet pills, or water pills; may engage in self- induced vomiting; may run to the bathroom after eating in order to vomit and quickly get rid of the calories

• Engage in frequent, strenuous exercise, despite being thin

• Perceives herself to be overweight despite being told by others that they are too thin

• May frequently be in a sad, lethar gic state

• May avoid friends and family; becomes withdrawn and secretive

If your doctor suspects anorexia, he or she may use the SCOFF questionnaire. A "yes" response to at least two of the following questions is a strong indicator of an eating disorder:

• S: Do you feel sick because you feel full?

• C: Do you lose control over how much you eat?

• O: Have you lost more than 13 pounds recently?

• F: Do you believe that you are fat when others say that you are thin?

• F: Do food and thoughts of food dominate your life?

The most effective way to prevent anorexia is to develop healthy eating habits and a strong body image from an early age. Don't accept cultural values that place a premium on thin, perfect bodies. Make sure you and your children are educated about the life-threatening nature of anorexia.

Counselling for diet won't help much if it is not backed by psychological counselling and eliminating the root which led to the disease in the first place. Many times those affected with anorexia do not think they need any treatment. Even if they know they need treatment, anorexia is a long-term challenge that may last a lifetime. People remain vulnerable to relapse when going through stressful periods of their lives.

Involving the whole family concerned is recommended. Parents and other family members often have intense feelings of guilt and anxiety that they need to address. Family therapy is aimed, in part, at helping the parents or partner (in the case of an adult) understand the seriousness of this illness and the ways in which family patterns may contribute to it.

Cognitive behavioural therapy is one of the most effective therapies for anorexia. In cognitive behavioral therapy, the person learns to replace negative, unrealistic thoughts and beliefs with positive, realistic ones. The person is also encouraged to acknowledge their fears and develop healthier ways of solving problems.

• Establishing regular eating habits and a healthy diet

• Sticking to your treatment and meal plans

• Developing a support system and participating in a support group for help with stress and emotional issues

• Ignoring the urge to weigh yourself or check your appearance constantly

• Cutting back on exercise if obsessive exercise has been part of the disease.

• Stay away from several social influ ences that may make recovery difficult

Doctors may prescribe a daily multivitamin, containing the antioxidant vitamins A, C, E, the B-vitamins and trace minerals, such as magnesium, calcium, zinc, phosphorus, copper, and selenium, omega-3 fatty acids, such as fish oil, one to two capsules or one tablespoonful oil two or three times daily, to help improve immunity and probiotic supplement or eating probiotic-rich foods such as curd, for maintenance of immune health.

If anorexia nervosa is not treated, serious complications such as heart conditions and kidney failure can occur and eventually even lead to death. Don't you think a healthy glowing skin and a good physique is an asset? Even if you buy a diamond-studied dress, it will seem as if the dress has been hung on a hanger!

(The writer is a dietician at PGIMER, Chandigarh)

 

New way to pin anorexia Scientists have developed a new approach for diagnosing patients with anorexia nervosa, an eating disorder, which they claim could have a significant impact on the treatment and recovery of sufferers. A team at the University of Sydney, led by Prof Stephen Touyz, has advocated a move to diagnose anorexia nervosa in stages of severity, similar to the method used for diagnosing cancer, the Sydney Morning Herald reported. "At the moment, you can only diagnose anorexia nervosa if you have the illness quite severely already. By the time you have anorexia nervosa, and people can see that you've got it, you're an extremely ill person. This is an illness where 20 per cent of people who are diagnosed could potentially die," Touyz said. The proposed system of stages would introduce the diagnosis of stage one anorexia nervosa for patients who clearly already suffer from the illness but do not yet meet its official diagnostic criteria, say the scientists. The need for early diagnosis and treatment is particularly pressing given the severe lack of hospital treatment options for adults suffering from anorexia nervosa. "But if you pick up the disease early enough, you can receive proper treatment early on, have a better chance of overcoming the illness and avoid hospitalisation," said Touyz. The staging model would also improve public awareness and understanding of anorexia nervosa, say the scientists. "People who have symptoms of anorexia nervosa but don't meet the diagnostic criteria are currently described as having EDNOS, or "eating disorder not otherwise specified". If you tell people you have EDNOS, few people understand. But if you say you have stage one anorexia nervosa, people appreciate the seriousness of the condition," he said. — PTI