Eating Disorders in Pakistan and Their Health Consequences

by Maria Amir
Eating Disorders in Pakistan and Their Health Consequences

Long before I had known what eating disorders are, this is what a casual me in my late teenager years would spend a weekend late evening like. 

Tiptoeing towards the fridge and fishing it thoroughly to find ‘processed, junk food’ to satiate my taste buds and cravings. Little did I know I was drawn to a vicious cycle of unhealthy eating patterns that continued for the next couple of years until it took every ounce in my body and soul to come face to face with it? 

An eating disorder is not a careless, irresponsible, or less-disciplined trait. No. it is rather a cry for help. Why? Because somewhere in you, food is providing you the comfort you need, or seeing it as an impairment for your body. So before you proceed with this piece, I want you to put your guilt consciousness away for 2 minutes and read without being tough on yourself. 

You are NOT THE PROBLEM. A SET EATING PATTERN IS. 

Here is how. 

Eating disorders – scientifically also known as anorexia- have been in us (and with us) for centuries. The first eating disorder dates back to medieval times (5th-15th century). Therefore, given the current fixation of how ‘eating disorder’ is just a modern escape for lazy lifestyle habits is eliminated when you explore historical pieces of evidence. We have been socially conditioned to look at food a particular way, and this is why knowing about eating disorders is even more important. 

What is Anorexia?

Eating disorders or anorexia are much more serious than having ‘food issues’. The reason a certain eating pattern is called an order signifies that it is a complex health condition that requires proper medical treatment with often an intervention of a psychological expert. 

One easier way of looking at it is to think of it as an obsession. People with eating disorders are very ‘passionate’ about a certain body look, the idea of weight loss, or particular food groups. Their passion leads to an unhealthy form of obsession and this is where some serious health consequences start pouring in. 

How does it look and then feel like?

Having an unhealthy pattern of eating can be seriously detrimental to your overall well-being. 

Understanding that an eating disorder will affect your mental health first (and in some cases, it may also contribute to a mental disorder), is extremely crucial. 

An experimental study was conducted in 1948 by Ancel Keys that was later famously known as “The Minnesota Starvation Experiment” on eating disorders. The study focused on how many symptoms of an eating disorder are that of starvation and how adverse it is for mental health. The study uses an intriguing model to demonstrate how malnourishment, extreme weight loss, and restricted eating can eventually alter your brain chemistry. As a result, there are increased chances of depression, anxiety, poor decisions, problems and regulating their emotions. The Minnesota experiment also reported the re-feeding phase. During this period, participants felt anxious, and then also felt the loss of control leading to binge and overeating episodes. 

The experiment as a whole highlighted the importance of a strong correlation between food and cognitive abilities. For a person to be highlighted as a healthy individual, there must be a healthy balance between the right nutrition and eating patterns. 

Note: you may not be calorie deficient yet still experience physical, emotional, and mental fatigue. What is the science behind it? Keep reading to find out more about it. 

Following the Minnesota experiment, multiple inquiries were made into eating patterns and disorders. One such study done Much later in 2017 by the World Health Organization showed how eating disorders are very much real and how it has drastically increased over the years as more social pressures have formed on people. 

Now that we have established what is an eating disorder. We can now look at how it is identified, what eating disorders’ causes, symptoms, and what kind of treatments are available today to help an individual. 

Remember! HELP is very much POSSIBLE and NEEDED during eating disorders. 

Types of Eating Disorders

Disordered thoughts about food, body image, and weight are something we all have experienced at least once in our lifetime. It is very much a normal part of the human experience. However, with an eating disorder, these thoughts become persistent, suffocating, and at one time demanding to be executed in the form of action. These thoughts become so strong that it becomes impossible to redirect and ignore them. People going through this experience start seeing themselves, distorted and inadequate in pictures. 

Educating oneself is very important in eating disorders. Let’s begin with the types of common eating disorders that are found in Pakistan. 

  • Anorexia Nervosa
  • Bulimia Nervosa
  • PICA
  • Rumination

1. Anorexia Nervosa 

Anorexia (pronounced as an-o-REK-see-uh) is a form of eating disorder, where an individual has an extreme fear of gaining weight and will starve themselves to achieve abnormally low body weight. People with anorexia nervosa will control their food portions. To achieve their perception, they will opt for fad diets, laxatives, diuretics and may even induce vomit after eating anything. They will also exercise excessively to achieve their set body image. The worst part about this disorder is that despite the extreme weight loss, the person will continue to fear weight gain and keep up with the unhealthy practices. Eventually, in extreme cases, body failure follows that may cripple the individual for life. 

Symptoms of Anorexia Nervosa 

The symptoms are very similar to that of starvation. It is also impossible to do an early diagnosis of anorexia based on symptoms only. However, the following are some major symptoms of an underlying development of anorexia nervosa. 

  • Extreme weight loss 
  • Obsession with a thin appearance 
  • Hair fall or hair thinning 
  • Restlessness and fatigue 
  • Dizziness and finding 
  • Skin is easily bruised 
  • Discontinuous menstrual cycle (for women)
  • Discoloration of skin 
  • Severe dehydration 
  • Eroded teeth and calluses due to induced vomiting 
  • Emotional and Behavioral Symptoms 
  • Restricting any food intake through dieting or fasting 
  • Exercising for long periods 
  • Self-induced vomiting to get rid of food 
  • Being overly rigid about certain foods that are low in calories 
  • Overly conscious of self-image
  • Lacking emotions 
  • Insomnia

2. Anorexia Bulimia 

Bulimia is an eating disorder where an individual develops an extremely unhealthy relationship with food. In bulimia, a person will binge eat and then develop the fear of gaining weight. People with anorexia bulimia have episodes of weight gain and loss that put them at major risk of low immunity. People with bulimia also have a lot of anxiety.  

It is important to look out for someone who is experiencing bulimia. Here are some symptoms specifically to look for;

  • Excessive eating. To the point, it is causing discomfort to the person
  • Immediately going to the bathroom after eating 
  • Eating a lot in one sitting and then immediately exercising in hopes to compensate their eating
  • Avoiding eating in front of others 
  • Either restricting certain foods due to their low-calorie intake or binge eating a lot on some foods. 
  • Bulimia is more alarming as compared to Nervosa as some physical symptoms can be life-threatening. Some physical symptoms are;
  • Calluses, scars, and sores around the mouth
  • Mouth sensitivity 
  • Drastic gain and loss in weight 
  • Busting of blood vessels, especially in the eyes 
  • Swollen lymph nodes 
  • Hormonal imbalance 

3. Pica

Pica eating disorder is a compulsive eating disorder in which a person will excessively eat something that does not have a significant nutritional value, such as ice, dried paint, or scraps of metal. This disorder can lead to some serious health consequences such as lead poisoning. 

Pics are more common in children and women and are often a temporary behavior. It may persist for people with certain developmental disabilities which is why annual checkups are quite important. 

People who develop Pica mania eating disorder will eat non-food items such as;

  • Ice
  • Soap
  • Clay/Dirt/Sand
  • Hair
  • Glue
  • Chalk

4. Rumination

It is a chronic eating disorder. Rumination means an eating disorder in which the undigested food is brought back in the mouth again and again (regurgitate), yet it is not expelled out of the mouth the way it is in vomiting. This happens mostly in children and infants, however, it is also found in adults. 

Regurgitation usually happens after 1 or 2 hours of eating. People with this condition will experience this almost every day and often after every meal. 

Some of the symptoms include:

  • Foul breath 
  • Sudden weight loss
  • Persistent stomach aches
  • Mouth cavities and tooth decay 

Please note that regurgitation is different from acid reflux and therefore should not be identified with it. 

Causes of Eating Disorders 

While it is not exactly clear why such eating disorders develop in the first place, there are still some factors that can be considered. It may be due to complex biological, psychological, and environmental factors. 

  • Genetics. According to research studies, if someone in your family had an eating disorder you are also likely to get one. There is also a strong correlation with some personality traits that can be contributors such as ‘perfectionism’. 
  • Trauma. People who have gone through trauma in their life are more exposed to such disorders. Feeling of stress and low self-esteem may as well contribute to such behaviors. 
  • Societal stigmas. The current ideal body image has distorted our realities and has been more detrimental than rather being a healthy standard of life. People commonly equate their confidence, their success with how thin they look. Even though we all have some insecurities, societal pressures will harness these insecurities even more.  

How are Eating Disorders Diagnosed?

There are multiple steps to diagnose eating disorders. The first and most important one is to take everything in your might to consult a doctor. You can do this now with the comfort of your home, with Healthwire. pk and book an appointment with a nutritionist first to get you started on a balanced diet first. 

Your doctor will also run some lab tests on you so that there is not any other underlying cause of weight loss. After these tests, the doctor also refers to therapy that is very important to come out strong out of this disorder. 

Eating Disorders Treatments 

There is no set cure but multiple mixes and match therapies, nutrition supplements, medications that are used to cure treatment. 

It is important here to understand that nutrition is very important. Earlier in the article, I hinted how despite having the right calories still physically and mentally draining. This is because you are lacking the right nutrients on your plate. 

Here is the rule of thumb to remember 

Calorie Dense = means high in energy and low in nutrients. With no minerals and vitamins, these are just reservoirs of processed fat that will eventually lead to health problems later in life. 

Nutrient-Dense = means more minerals, vitamins to nourish your organs, tissues, and metabolic processes that will not only provide you with energy but also elevate your mental and emotional health. 

Food Spectrum: Calorie Dense VS Nutrient Dense Foods
Food Spectrum: Calorie Dense VS Nutrient Dense Foods

How we can help people going through this? 

As a Pakistani society, we need to first acknowledge the catastrophic societal pressures we have put on men and women. We openly body shame rather than helping them direct towards a healthier lifestyle. All we need to do is opt for kinder words, sincere concerns, and more knowledge-based awareness. 

Few things to do for your loved one

  • Ask about their preferences in food. Offer them alternate food/snacks to binge eat. 
  • Try to educate them, not dictate them. You can do this by giving them books on nutrition and a healthy lifestyle. 
  • Encourage them to eat with you and repeatedly tell them that you are proud of them. 
  •  Accompany them to their therapy sessions to ease down their nervousness. 

Please know, no matter what you have been told. Beauty lies within. Confidence lies within. Health comes from within. 

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