Anorexia is not just underweight: how do you fight this terrible disease? | Israel Hayom

The death of Karin Bowman from anorexia shocked the whole country. The health of the former model was known for quite a few years, but something about her passing shook many, probably quite a few of whom do not really know what anorexia is.

Anorexia nervosa is characterized by a reduction in food intake leading to lower than expected body weight (depending on age, gender, developmental stage and physical health) due to fear of weight gain and body image disorder. The disease itself is divided into two subgroups: the first is characterized mainly by reduced eating and excessive preoccupation with sports, the second also includes binge eating (bouts of eating) and purifying behaviors (such as vomiting, use of laxatives or other weight loss agents).

Contrary to popular belief, anorexia nervosa does not have to be characterized by extreme underweight. Even considerable weight loss, from overweight to weight that appears normal on the surface, can be due to severe anorexia with real physical and mental consequences.

Can happen at any age and for anyone. Young by Weight (Illustrative), Photo: Getty Images

The disease can occur at any age, with peak occurrence in teens and young adults. The prevalence indicated in the literature is 1%-2% of the population. In recent years, we have seen a trend of rejuvenating the age of onset of the disorder and an increase in prevalence, while following the COVID-2021 pandemic there has been an additional and dramatic increase in prevalence. For example, in <>, the number of emergency and routine calls related to eating disorders doubled in the UK. In today's Israel, treatment centers for eating disorders are still overwhelmed by referrals with long waiting times (up to a year) until a place for treatment becomes available.

The disease is caused by a combination of factors, some genetic and some environmental, and a combination of them is required for the disease to manifest. That is, in order for anorexia nervosa to develop, it is necessary to be genetically vulnerable to the development of the disease and environmental components, including the influence of the media and the environment, by imparting social messages of striving for thinness as a desire for excellence and an ideal of beauty. When these two components are present in a person who experiences psychological or social difficulties and sees weight change as a solution to these difficulties, an eating disorder will develop.

In light of this, there are many who see great importance in the responsibility on the part of the media for all channels on television and social networks regarding the content published in them, both in presenting messages of striving for thinness as an ideal of life and in advertising the disease in a way that arouses over-identification (which can bring people with vulnerability to the disease to the point of active disease).

One of the causes of the disease is due to the reduction of food (illustration), Photo: GettyImages

How to identify and what to do?

So how do you know if you or someone you know might develop the disease? Well, there are behaviors that can cause concern and require evaluation. These behaviors include changes in eating patterns, reducing eating and skipping meals, reducing food variety and avoiding food groups, social seclusion and avoidance of situations that include eating, eating very slowly and with a tendency to crumble or spread food. In children, failure to gain weight or height as expected for age can be a sign, and in women – cessation or irregularity of menstruation.

If you suspect an eating disorder, it is recommended to contact a doctor in the community. Although an eating disorder is a mental disorder, by its nature it directly affects the physical condition, so first of all it is necessary to examine whether it is a physical emergency that requires immediate hospitalization in the pediatric ward / internal medicine department in order to stabilize the medical condition.

After that, it is recommended to contact a center specializing in eating disorders. Treatment of the eating disorder is first and foremost by returning to normal eating with weight correction, a healthy weight and emotional work both on the overwhelming anxiety from this process and on the causes of vulnerability that led to the outbreak of the disease. For this purpose, there is a need for a multidisciplinary team that specializes in the field and is able to support various aspects of treatment, from nutrition to emotional therapy.

A hard-to-reach beauty ideal (illustration)

Anorexia nervosa is a serious disease with up to 10% mortality. The earlier the identification and treatment, the greater the chance of full recovery, and therefore early contact and available medical services in the field are of great importance.

If you or someone you know suffers from eating disorders, you are welcome to contact the various treatment centers. For the full list click here.

The writer is the Director of the Eating Disorders Unit at Soroka Hospital, Clalit University Medical Center.

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