Anorexia, bulimia – more than nutritional problems

NUTRITIONIST Dr Heather Little-White has said that nutrition is secondary in the treatment of anorexia and bulimia, and can only come about after psychological treatment is administered.

The reality, she said, is that such conditions are more psychological than physical.

“A lot of it has to do with the mind and how persons perceive themselves,” she noted. “It really is about the psychological aspect. Some persons don’t want to eat, maybe as a result of low self-esteem because as a child they may have been told that they were fat and ugly.”

Bulimia and anorexia are eating disorders which involve either overeating, voluntary starvation, or both. No one is sure what causes these eating disorders, but researchers think that family dynamics, biochemical abnormalities, and society’s preoccupation with thinness may all be contributory factors.

“A lot of persons affected are young adults not wanting to be of a particular size. Sometimes it comes about as a result of problems in the home. Sometimes they are sexually abused and don’t believe they are worthwhile. That is why it is recommended that once persons suffer from these conditions, the home is the first place that is checked out,” Little-White said.

She added that while she has seen a number of cases, anorexia and bulimia are not conditions that are talked about much in Jamaica. So while parents may take their children to her because they are not eating, they are unaware of the severity of the condition.

“Education is not out there in the open,” she said. “People will hear the term, but do not know what it really is.”

Statistics show that young people are more likely than older people to develop an eating disorder, with the condition usually starting before age 20. Although both men and women can develop the problem, it is more common in women as statistics also show that only about five per cent of people with eating disorders are males.

According to general practitioner Dr Orlando Thomas, these eating disorders are considered serious and potentially dangerous.

“The conditions are serious health conditions that are treated with psychotherapy,” he said. “If persons do not respond to psychotherapy then certain drugs are recommended. So they also have to be treated by a general practitioner.”

Thomas, too, confirmed that the incidence of anorexia and bulimia is very low in Jamaica and when it is present, people tend to call it by other names.

“Within the last seven years I have seen about three to four cases. And those that I saw came not because they recognised that they had an eating problem, but because they had stomach problems as a result of the consequences of that condition,” he said.

However, Thomas said that what is rampant in Jamaica is the incidence of obesity – a condition which sees a large number of women rushing to doctors.

In treating obesity, the two most commonly prescribed drugs are Raductil and Dinintel, which help to reduce the appetite or to increase the body’s metabolism. Orlistat is prescribed to stop the absorption of fats in the bowel, thus reducing caloric intake.

While many people will turn to popular weight-loss programmes, like Herbal Life, Thomas said that these will work based on how long people are willing to stay on them.

“What you find is that persons will be on the programme, lose weight and then stop. So you find that the weight will come back on. Persons have to be prepared to stay on it for life, eat healthy and exercise – that is when they will keep off the weight.”

This also holds true, he said, for meal supplements.

ANOREXIA

People with anorexia starve themselves until they look sickly skinny. However, their self-image is so distorted that they see themselves as fat, even when they are emaciated. Some refuse to eat at all, while others nibble only small portions of fruit and vegetables or live on diet drinks. In addition to not eating, they may exercise strenuously to keep their weight abnormally low. No matter how much weight they lose, they always worry about getting fat.

BULIMIA

Bulimia is much more difficult to detect than anorexia as people will binge-eat (eat excessively) and then secretly purge themselves by vomiting or using laxatives. Many suffer from depression, repressed anger, anxiety, and low self-esteem, combined with a tendency toward perfectionism. About 20 per cent of bulimics also have problems with alcohol or drug addiction, and they are more likely than other people to commit suicide.

OBESITY

Obesity is an excess of body fat. Some doctors classify a person as obese whose weight is 20 per cent or more over the recommended weight for his or her height. However, this has been a source of debate over time.