A disrupted state of mental health

2014-10-09 00:00

THE month of October has been declared Mental Health Awareness month in South Africa, and seeks to highlight an often avoided topic of discussion.

The World Health Organisation constitution states that “[h]ealth is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”. An important implication of this definition is that mental health is more than just the absence of mental disorders or disabilities.

Mental health is a state of wellbeing in which an individual is able to cope with the normal stresses of life, can work or study productively, and is able to make a contribution to his or her community. Eating disorders involve xtreme emotions, attitudes and behaviours towards weight and food, and frequently (if not always) disrupt mental wellbeing.

More so than ever before, we are surrounded with delicious foods of all varieties from myriad cultures and countries. Supermarkets are crammed with an array of foods for every taste, and food is an integral part of most social gatherings.

Imagine, then, the distress and anxiety of a person who is terrified by the very thought of having to eat, and believes that enjoying just one small mouthful of food is tantamount to being sinful.

People with eating disorders live in this state of panic and constant fear. They use extreme self-discipline to ignore natural desires stimulated by the delicious smells of even healthy meals, and ignore the natural hunger-appetite response.

An eating disorder is marked by extremes. The most common tell-tale signs are a person experiencing severe disturbances in eating behaviour (which can be extreme reduction of food intake or extreme overeating), or feelings of extreme distress or concern about body weight or shape.

Generally, eating disorders involve self-critical, negative thoughts and feelings about body weight and food. Eating disorders disrupt normal body functions and daily activities.

The two most common eating disorders are anorexia nervosa and bulimia nervosa. A third category is “eating disorders not otherwise specified”, which includes several variations of eating disorders, such as an obsession with eating only healthy food (often organic and raw foods) to the exclusion of all other foods.

Eating disorders appear most commonly during adolescence or young adulthood, but they can develop during childhood or later in adulthood.

Children as young as eight have been diagnosed with eating disorders, which are usually associated with traumatic life events.

While eating disorders are more common among girls, boys are also affected. Men and boys account for an estimated 5% to 15% of patients with anorexia or bulimia.

In the U.S., anorexia is the third-most common chronic illness in adolescents. Unfortunately, many children and teenagers successfully hide eating disorders from their families for months or years.

Eating disorders generally have complex underlying psychological causes.

They frequently co-exist with depression, substance abuse or anxiety disorders. People with eating disorders can also suffer from other physical health complications brought on by the disorder, such as heart conditions, kidney failure, reproductive disorders, and even death.

In almost every case, distorted body image is present. Body image is the mental picture we have of how we think we look. Positive body image is feeling comfortable about how we look, while negative body image is when we feel uncomfortable with how we look.

Often this perception is distorted — specifically in those with anorexia nervosa. They will see themselves as fat regardless of how skeletal their body actually is.

The way adults perceive themselves is very influential on children and adolescents.

If a parent is often talking about being fat, or frequently going on a diet, the child will learn body-image distortion and assume that focusing on body shape or food is normal and acceptable. It is always best to emphasise health, rather than weight or body shape. Make sure your child/friend/girlfriend/family member knows that you love them for who they are, not how they look.

Over the next few weeks, we will take a detailed look at the specific conditions of anorexia nervosa and bulimia nervosa, and discuss how we as parents, teachers and friends can support those around us who have a dysfunctional relationship with food and body image.

• Sharon Hultzer is a consulting dietitian. She can be reached at eatsmart@ iburst.co.za


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