Eating Disorders: The Complex Interplay between Brain and Diet

Food, for many of us, is one of the many joys of life. It unites us. It excites us. It’s the source of nourishment for much of the world who have three meals a day. This zeal for food, however, isn’t shared by over 70 million people around the world who live with eating disorders (National Eating Disorders Association). According to the American Journal of Clinical Nutrition 2019, the prevalence of global eating disorders has increased from 3.4% to 7.8%, between 2000 and 2018. 

Firstly, it’s important to understand that eating disorders (ED) aren’t just about food, nor do they only affect people’s relationship with food. They have one of the highest mortality rates of any psychiatric illness. Psychologist Dr. Marcel de Roos shared, “eating disorders (for example: Anorexia Nervosa and Bulimia) have a huge psychological component where clients with these disorders have an enormous fear of gaining weight, and their feeling of self-worth correlates highly with how they are able to or unable to control their eating habits. It’s important to find out the root causes of these behaviours and treat these with psychotherapy.”

All eating disorders affect the sexual and reproductive health of women in particular. Speaking to us, Dr. Rashmira Balasuriya [MBBS BSc (Hons) PGCert (MedEd)] shared, “in addition to a low sex drive, all eating disorders (especially Anorexia Nervosa) can cause significant menstrual irregularities. The weight loss, low body fat percentage, abnormal eating behaviours and/or excessive exercising together with the psychological stress, can affect the functioning of the hormones that govern our menstrual cycles and libido.” 

People with ED also face challenges in other aspects of their life, such as:

Grocery Shopping: Anissa Sameer (27) who has experienced Bulimia shared, “there was someone I loved who constantly commented on their preference for thin women, and often commented on my weight and body parts I needed to work on. This is in spite of them knowing I was battling depression at the time. I had experienced weight gain as a side effect of certain medication I’d been prescribed. These comments exacerbated the issue. I felt an overwhelming sense of shame and hurt that I tried to stifle by controlling my food intake. Today, I’m fortunate to have a support system of empathetic, loving people, as well as access to professional help, to overcome this, but this isn’t the case for every ED recoverer.”

Clothes Shopping: Malithi Rajaratnam (22) who developed Bulimia after being constantly bullied in school over her weight shared, “I had PCOS as a teenager and was bigger than my other classmates. I was taunted by kids in the swim team I was in, who would make fun of how I looked in a bathing suit. Little did they know that, at the time, finding a swimsuit that fit me was hard. It was hard to find clothes that were my size and fashionable for quite some time after that. It felt dehumanising.”

However, there is a silver lining. Dr. Rashmira Balasuriya shared that while diagnosing eating disorders can be very difficult, if detected early by family members and friends, lives can be saved and serious health complications can be prevented.  She emphasised that the treatment of eating disorders requires a team of healthcare professionals capable of giving ED recoverers the multidisciplinary treatment they need.

Nadeesha Paulis, menstrual rights advocate, who currently has a loved one battling Bulimia and who has dedicated her Instagram page to addressing body image, shared some tips about how we can support those we love who are in recovery.

  • Refrain from “diet talk” i.e. talking about food in terms of good and bad, listing calories, promoting extreme workouts or recommending unscientific weight loss remedies.
  • Don’t give people unsolicited advice or comments on their appearance.
  • Unlearn anti-fat “compliments” such as “you’re not fat, you’re beautiful”, which implies that someone can’t be both.
  • Help create an emotionally safe environment for your loved one where they know they aren’t judged.
  • Focus on compliments that aren’t related to appearance because we are so much more than our physical bodies.
  • Don’t make oversimplified recommendations such as “why don’t you stop eating?” in response to your loved one divulging that they are struggling with their weight.
  • Connect them with a mental health professional who can help them with the recovery process.
  • Check in with your loved one. Just because someone is in recovery does not mean they’re “all better now.”

We won’t always know the right thing to say, and that’s okay! Many of us have unknowingly said things about our bodies and the bodies of others that were either unnecessary or unintentionally hurtful. The important thing is unlearning what our culture has taught us about beauty, diets and how we address people in general. Words, just like our actions, have power. Let’s keep that in mind and do what we can to eliminate potentially harmful situations for our loved ones with eating disorders. 

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Author: Anissa Sameer
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