I saw a video on Weibo some time ago of some people with anorexia trying to get themselves something to eat.
Most of them eat and cry uncontrollably.
For example, if you just bite into a small bite of bread, you will burst into tears…
(Source: Weibo@watch me wink and act well video clip)
When eating fries, the hand holding the fries trembled…
(Source: Weibo@Watch me wink and act well video clip)
A bite of food, only to collapse so suddenly that it is difficult to swallow.
(Source: Weibo@watch me wink and act well video clip)
In the comments of this video, many people feel distressed and do not understand why people with anorexia are so painful to eat?
Today, we take you into the world of people with anorexia.
Most people with anorexia don’t have no appetite and don’t want to eat, but fear of getting fat so they don’t dare to eat. Only a small number of patients with anorexia have real “anorexia” because of malnutrition and weakened digestive function.
Even if they look amazingly thin, they go on uncontrollable diets, vomiting, laxatives, and exercising to make themselves thinner.
But this is not hypocritical, smug, but a mental illness, a type of eating disorder.
And anorexia is the highest-mortality psychiatric disorder, with a mortality rate of 5.1%, higher than depression [1].
Image source: Zhanku Hailuo
As a healthy person, is it hard for you to imagine that in today’s material abundance, there are so many people waiting to starve to death.
Fear of obesity is one of the important influencing factors of anorexia [2].
Foreign studies have shown that the prevalence of anorexia in women is between 0.9% and 4%, and the prevalence in men is about 0.3%. The rate is much higher than that of men [3].
Look at these real reviews first.
A4 waist, right-angled shoulders, clavicle raising goldfish, backhand touching the navel… These “body standards” that are popular on social media seem to have been conveying a concept – thin = good-looking, fat = Ugly.
(Source: Internet)
The social culture’s over-respect for “thinness”, and the ridicule of people around them for their body, make more and more people – especially those immature girls in adolescence – choose extremesto lose weight and suffer from anorexia.
There are also some people because of professional needs, such as models, ballet dancers, actors, gymnasts… They have been on long-term diets in order to maintain a slim body, and there are not a few people suffering from anorexia.
Image source: Zhanku Hailuo
The most striking example is American actress Rachael Farrokh.
She suffered from anorexia for 10 years, was 1.73 meters tall and weighed only 18kg at her lightest. Not only can I continue to work, I can’t even walk.
“The ancestors left a greeting, did you eat, and since then, people have started to live to eat. And we, with a hunger strike to resist the world.“< /p>
In a corner where someone with anorexia congregates, this passage has always been in the forefront.
Family environment is also one of the important factors affecting the occurrence of anorexia [2].
For example, if a parent is too controlling over a child, the child may express his resistance by refusing to eat; for example, in a rigid or broken family, the child may go on a hunger strike to gain attention .
This is also related to personal personality. Generally speaking, most patients with anorexia have the characteristics of perfectionism, low self-evaluation, abnormal sensitivity, and withdrawal from social behavior [2].
Image source: Zhanku Hailuo
In the movie “To the Bone” based on a true story, the protagonist Alan experienced a series of blows such as his parents’ divorce and his mother coming out of the closet when he was 13 years old.
She is sensitive and artistically gifted, a well-known illustrator who protects herself by appearing inattentive, indifferent and mean to others.
(Source: To The Bone)
Fatigued and numb to life, Allen memorized calorie charts, dieted, and exercised frantically to get thinner and thinner.
She also knew that being skinny was not beautiful, but she couldn’t control herself. For Ellen, restraining the desire to eat was the only thing she could control.
(Source: To The Bone)
In general, anorexia, as an eating disorder, has a very complex etiology and is affected by a combination of biological, psychological and social factors[4].
Nausea, nausea, depression…these words are used by people with anorexia to express how they feel when they eat.
Swipe up to view full image
In the beginning, it was just a deliberate diet. Later, when I saw the food, I felt sick, I couldn’t swallow it when I chewed it in my mouth, and even my stomach protested the food, and I ate a little bit. Things feel “full”.
Image source: Zhanku Hailuo
One apple, 50 calories, one egg, 70 calories, oneA cup of skim milk, 150 calories… They memorized the calorie chart and kept counting how many calories they were taking in when they ate.
In the eyes of people with anorexia, food is not a tempting delicacy, but a devil with an implied price.
After swallowing these foods, what you get is not a feeling of fullness, but the fear of gaining weight, as if you are the powerless, inferior, out-of-control, “ugly” person again.
First of all, prolonged dieting and malnutrition will make the body use protein as the main energy source, resulting in the rapid atrophy of muscles and organ tissues, resulting in the following series of consequences [2]:
Menstrual disorders or even amenorrhea in women, and decreased testosterone in men;
Heart damage, slow heart rate, blood pressure, and even sudden death;
Dry skin, hair loss on the head, and regrowth of fine, soft fetal hair on the body;
Long-term dieting can also affect the function of the digestive system, resulting in a shrinking stomach, slower gastric motility, and delayed gastric emptying. Therefore, patients with anorexia often experience abdominal distension and constipation.
Image source: Zhanku Hailuo
If this process is accompanied by emetic behavior, there will often be acid reflux, nausea, and even esophageal bleeding and reflux esophagitis, increasing the risk of esophageal cancer.
Nourishment can also cause brain shrinkage, leading to unresponsiveness, lethargy, and poor concentration and memory in people with anorexia.
As the condition worsens, depression, anxiety, obsessive thinking, and even suicide may occur.
If you or someone around you is prone to anorexia, be sure to find out and seek medical attention in time.
Having said so much, how can we find out in time the anorexia tendency of ourselves or those around us?
We can see if there are any of the following typical and easy-to-detect symptoms from three aspects: physiology, psychology, and behavior [2,6].
Physiological abnormalities
01
■ Significant weight loss and extreme thinness;
■Stomach pain, bloating, hair loss, dry skin, cold;
■Irregular or even cessation of menstruation in women, and incapacity in men.
Psychological abnormalities
02
■Depression, anxiety, irritability, insomnia;
■A narrowed attention span and reduced social skills.
Unusual behavior
03
■Restrict or refuse eating;
■Inducing vomiting, taking laxatives, exercising too much;
■Weigh repeatedly to check your body in the mirror.
Once you or your relatives and friends have these symptoms, you must go to the hospital for professional diagnosis and treatment.
People with anorexia often have a strong sense of stigma, are afraid to seek help, or don’t know they have the disease.
Image source: Zhanku Hailuo
But we need to know that anorexia is not hypocritical, nor is it simply not wanting to eat, it is a disease, and it is a mental disease with the highest mortality rate.
Unfortunately, due to the extremely complex etiology of anorexia, there is currently no effective medical method to prevent anorexia, and no special drugs to cure it [6].
Physicians often work with a dietitian to start nutritional therapy for people with anorexia to restore normal weight and eating patterns.
During this process, symptomatic treatment is provided for physical complications such as constipation, amenorrhea, and abnormal liver function.
< i class="desc">Image source: Zhanku Hailuo
When the physical condition of patients with anorexia is relatively stable, if symptoms such as depression and anxiety are still obvious, doctors will consider using psychiatric drugs [7].
Psychotherapy should also be used throughout the treatment process to allow them to change their misperceptions about their weight.
In addition to medical means, we would like to say that the prevention and treatment of anorexia is related to everyone.
In 2008, the French National Assembly passed a bill prohibiting people from publicly promoting the idea of being thin as beauty; Israel also enacted legislation in 2012 that banned underweight models from appearing. in advertising.
(banned ad, image source: internet)
It might be “I think plump looks good,” or it might be the same kindness for being fat or thin, or it might be saying “No to things that tend to trigger appearance anxiety.” “In this way, there may be fewer people who dare not eat when they are hungry, fewer people who cry and induce vomiting in the sound of running water, and fewer people who hate themselves in the dark…
Don’t let weight become the footbinding culture of this era.
Reviewer: Song Chongsheng| Deputy Chief Physician, Department of Psychiatry, Huilongguan Hospital, Beijing
References
[1]Arcelus J, Mitchell AJ, Wales J, Nielsen S. Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders: A Meta-analysis of 36 Studies. Arch Gen Psychiatry. 2011 ;68(7):724C731.
[2] Zhang Darong. Counseling and Treatment of Eating Disorders [M]. Beijing. Peking University Medical Press, 2011.36-39.
[3] Watson, H.J., Yilmaz, Z., Thornton, L.M. et al. Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa. Nat Genet 51 , 1207C1214 (2019).
[4] Pu Jiajia, Todd Jackson. Bio-psycho-social model of anorexia nervosa [J]. Advances in Psychological Science, 2016, 24(012):1873-1881.
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[5] Chen Jue. Eating Disorders [M]. Beijing: People’s Health Publishing House, 2012.
[6]https:https://www.mayoclinic.org/diseases-conditions/anorexia-nervosa/symptoms-causes/syc-20353591
[7] Kong Qingmei. Interpretation of Chinese guidelines for the prevention and treatment of eating disorders [J]. Chinese Journal of Psychiatry, 2018, 51(6):355.
*The content of this article is for the popularization of health knowledge and cannot be used as a specific diagnosis and treatment suggestion, nor can it replace the face-to-face consultation of a licensed physician, and is for reference only.
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