Eating disorders, such as anorexia nervosa, are mental illnesses with medical, psychiatric and family complications.
In this particular case, there is a distorted perception of weight.
“Those who suffer from these disorders have in common the difficulty to accept themselves and reach their maturity and full development.
The body dissatisfaction that characterizes them is a sign of a deep personal disqualification, as well as the fear of losing control (over food and their lives), and the rejection or shame of accepting their problem ”, declares Loreto Montero Soto, psychologist health and specialist in eating disorders at the Cláritas Psychological Institute.
Anorexia and bulimia show their bitter side during confinement
The pandemic triggers cases of anorexia in children and young people
According to Montero, “epidemiological data related to eating disorders had been indicating prevalences of between 1 and 10%, being among the 10 most frequent causes of disability among women and presenting the highest mortality rate of all disorders. mental ”.
“Recent studies show an increasing incidence, with a worrying increase in children under 12 years of age during the last decade.
It is estimated that 70% of adolescents do not feel comfortable with their body, and 6 out of 10 girls believe that they would be happier if they were thinner ”, explains the expert.
With data collected from the Spanish Society of General and Family Physicians (SEMGF), Montero points out that: “Neither age nor sex constitute a barrier to the appearance of eating disorders, although adolescent women are the sector of greater influence with an average age of 14 years ”. "From childhood to old age, the relationship with food can be an expression of an internal discomfort or with the environment," says the professional.
Puberty is a stage of biological, psychological and social changes.
"The apparent irreversibility of these changes, the ways of social pressure and the incorporation of the adolescent into the circuit of production and consumption of leisure, are the first problems that patients refer to in consultation," says the psychologist.
Montero shares three key aspects in patients with anorexia nervosa: they anticipate changes and prepare for them inadequately;
they face situations with scarce resources, usually: they work more, eat less and exercise, and they have a significant inability to cope with stressful situations.
The pandemic has shaken our personal well-being
The incidence of anorexia has increased in economic and social crises. The current health crisis is no exception. "Specialists in the field have noticed the devastating effect of Covid-19 with an overwhelming increase in patients demanding medical and psychological attention," says the specialist. “Anorexia nervosa has been diagnosed since the mid-nineteenth century. We can affirm that it arrived in Spain along with the rest of the alimentary pathologies in the decade of 1980. In 10 years it imbued all the social classes. The adolescent population became an object of advertising and consumption, ”says Montero.
The pandemic in which we find ourselves has impacted all areas of our lives, increasing levels of uncertainty, anxiety and stress. “The fear of contagion and contagion, the demand for responsibility, exposure to suffering, the cessation of collective activities, the transformation of academic life, the reduction of spaces of privacy, are some of the additional problems with which adolescent girls have been forced to deal with it ”, says the general health psychologist. “Family conflicts, probably aggravated by the current situation, can cause low self-esteem in children, which is usually accompanied by restlessness and sadness. These cognitions and feelings also contribute to the appearance of food symptoms ”, he clarifies.
Anorexia is a disease that, diagnosed and treated in its onset period and with the support of the doctor and family, has a more favorable course and a better long-term prognosis. “In recent decades, the social alarm created around anorexia nervosa and the greater and better information about it, have made possible positive changes, better clinical coping and recovered the figure of parents (who should support the treatment) as agents of health. Intensive programs and prolonged follow-up are added, a necessary condition in relapse prevention ”, emphasizes the expert.
“It is a constant fight against yourself. Food becomes the center of your life. You wake up thinking about her. Many times you even dream of her. You isolate yourself from the world. Now that I am improving, I have recovered a part of my personal relationships, but the struggle does not stop ”, expresses L. Fernández, user - who asks to remain anonymous - of the Association of Bulimia and Anorexia of the South-Ourense.
F. Reinuaba, a 20-year-old young woman from Chile, is undergoing professional treatment for anorexia. His family detected that he had a problem in confinement, although his particular ordeal began when he was only 13 years old, and secretly took him to confinement where, when he lived with other members of his family, they found that he did not eat. “Every day I look in the mirror and see an obese woman and it makes me want to vomit. I know it's a wrong thought, but for now I can't feel anything else. I must be stronger because taking a single step back can destroy me. I would like to tell mothers to listen to their children, because something superficial can mean much more ”, explains Reinuaba.
In the lines of work of the specialists with the patients, groups, workshops and debates are held to "study their defense or resilience mechanisms", and attend to: trying to understand and modify the mechanisms of diffusion of anorexia nervosa (social pressure slimming and the one that is transmitted in the school, the institute or the faculty); analyze the role of adults in the spread of the disease and identify the resources that adolescents have.
Health promotion is shown to date as the most effective formula to promote adequate prevention of anorexia. "The objective is to modify knowledge, attitudes and behaviors with the use of involvement techniques and an active, participatory and experiential pedagogical methodology," says Montero. “The studies that produce the greatest benefits are aimed at participants with a higher risk of developing an eating disorder, and are applied by professionals of the intervention. Half of preventive interventions (51%) reduce risk factors for eating disorders, and more than a quarter (29%) reduce current or future pathology, which constitutes encouraging results ”, says the expert in eating disorders. eating behavior. Montero ensures that:"The evaluation and detection of anorexia nervosa requires a comprehensive evaluation of the person, which is difficult to perform in primary care." And he adds that it is important to assess the nutritional status and a clinical interview after the screening that is contrasted with other people close to the patient, "something that will constitute the starting point of the therapeutic process."
“The therapeutic approach must be started immediately to ensure a better prognosis and be sufficiently intensive.
The therapeutic decision will range from medical monitoring for risky behaviors to hospitalizations in the most serious cases.
Whenever possible, the treatment will be carried out on an outpatient basis ”, declares the professional.
Montero explains that the objectives of the treatment will seek to: "Normalize the biological alterations, and treat the psychopathological ones that originate and maintain the disorder."
Adolescents, for their part, must work to achieve:
Develop a satisfying and realistic body image.
Achieve independence from their parents, and achieve the adequate ability to take care of themselves and regulate their actions.
Extend adequate social relationships outside the family.
Gain control, adequately express emerging sexual and aggressive urges, and consolidate personal identity.
Develop a moral code, and make plans to achieve occupational and economic sufficiency objectives.
Executive functions are affected by malnutrition, something that worsens stress management in patients with anorexia nervosa.
"Even in the incipient stage, the disease generates in the patient a feeling of discomfort that accentuates the impression of failure by not achieving the established objectives", concludes the psychologist.
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