Food for thought: How we deal with eat­ing dis­or­ders

The Irish Times - Tuesday - Health - - Health Nutrition - Michelle McDon­agh

Eat­ing dis­or­ders prey on vul­ner­a­ble peo­ple, who are, in turn, par­tic­u­larly sus­cep­ti­ble to the so­cial me­dia mes­sages around diet and ex­er­cise they are be­ing bom­barded with in this In­sta­gram age.

“Many eat­ing dis­or­ders start as a healthy eat­ing regime. Nobody goes on a diet when they are feel­ing good about them­selves, and eat­ing dis­or­ders prey on vul­ner­a­ble peo­ple who feel over­whelmed. Con­trol over food and eat­ing gives them an il­lu­sion of con­trol when the rest of their life is out of con­trol,” ex­plains Dr Col­man Noc­tor, child and ado­les­cent psy­cho­an­a­lyst at St Pa­trick’s Men­tal Health Ser­vices (SPMHS) and as­sis­tant pro­fes­sor at Trin­ity Col­lege Dublin.

“Young peo­ple to­day have an end­less tyranny of choice with the In­sta­gram­ma­tion of cul­ture. Through their on­line searches, they pro­vide tech­nol­ogy com­pa­nies with in­for­ma­tion about their vul­ner­a­bil­i­ties which al­lows these com­pa­nies to tar­get them with con­stant posts and no­ti­fi­ca­tions about di­ets, weight-loss prod­ucts, etc. This tends to be ‘lose-weight-fast’ fads and prom­ises of quick fixes, not sound ad­vice based around ex­er­cise and healthy eat­ing.”

How­ever, Dr Noc­tor is keen to stress that an eat­ing dis­or­der is a re­ally treat­able disease and when caught early, there is ev­ery chance a per­son can re­cover with the right treat­ment and sup­port.

Dr Noc­tor will be speak­ing at the SPMHS an­nual Founder’s Day Con­fer­ence on Fri­day. En­ti­tled Eat­ing Dis­or­ders in a Mod­ern So­ci­ety, the con­fer­ence, in col­lab­o­ra­tion with Body­whys (Eat­ing Dis­or­ders As­so­ci­a­tion of Ire­land), will bring to­gether top prac­ti­tion­ers with a fo­cus on re­search, on­line and so­ci­etal fac­tors, diet and treat­ments.

Noc­tor points out that be­fore the ad­vent of the in­ter­net, peo­ple with eat­ing dis­or­ders had lim­ited ac­cess to in­for­ma­tion on diet and weight-loss. “Com­pa­nies like Face­book, Google and YouTube are not con­cerned if you are a 14-year-old watch­ing videos back to back. There is nobody on the in­ter­net to say you are too young or have watched enough. This feeds into the ob­ses­sion­al­ity, de­sire and anx­i­ety of peo­ple with eat­ing dis­or­ders. The more vul­ner­a­ble or anx­ious you are, the more you search. The more you search and the more you re­veal, the more you can be tar­geted.”

Even more sin­is­ter, notes Dr Noc­tor, is the large num­ber of pro-anorexia (pro-ana) sites pro­mot­ing mal­adap­tive and dan­ger­ous meth­ods of weight-loss. He points out that try­ing to prevent young peo­ple from vis­it­ing these sites is al­most im­pos­si­ble, and a real chal­lenge to those work­ing in the area of re­cov­ery.

Eleanor Sut­ton, a di­eti­cian at SPMHS, sees first-hand how the on­line world drives eat­ing dis­or­der be­hav­iour. “I work with pa­tients in anorexia and bu­limia groups who are very eas­ily swayed by what they see and hear on so­cial me­dia. They are bom­barded with mes­sages about di­ets of ev­ery kind – ke­to­genic, low-carb, shake di­ets – all promis­ing a ‘get-skinny-quick’ fix.”

‘In­sta­gram photo’

“If they see an In­sta­gram photo of some­body thin and at­trac­tive eat­ing salad, they can be­come ob­sessed about eat­ing salad be­cause they think life would be per­fect if they were thin. They might be ob­sessed with nut but­ter one month and the next month it might be kale or some other ‘su­per food’ that’s in. There is such an ob­ses­sion with food and fit­ness on­line.”

Sut­ton points to the growth of the rel­a­tively new di­ag­no­sis, avoidant re­stric­tive food in­take dis­or­der (ARFID), which may be un­der­lined by fac­tors such as avoid­ance due to the sen­sory char­ac­ter­is­tics of food, a lack of in­ter­est in eat­ing or food, or wor­ries about the con­se­quences of eat­ing.

“There’s no need to be nut-free, milk-free or dairy-free to have a healthy diet. It’s okay to stir-fry car­rots or have a glass of milk. There is lots of strong ev­i­dence be­hind nor­mal ev­ery­day foods con­tain­ing pro­tein, carbs, dairy and es­sen­tial fats,” says Sut­ton.

She points to the avail­abil­ity of food and the re­lent­less ad­ver­tis­ing around junk food,

They are bom­barded with mes­sages about di­ets of ev­ery kind – ke­to­genic, low-carb, shake di­ets – all promis­ing a ‘get-skin­nyquick’ fix

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