How to live if your relationship with food has become unhealthy? "Klops" listened to the story of a young woman who could have died of bulimia and spoke with an eating disorder psychologist.
"You live like a drug addict, every Monday you try not to do it anymore."
Ekaterina E., 29, fell ill as a teenager. How the 14-year-old girl learned that it is possible to eat and "cleanse" with the help of vomiting, she no longer remembers. But how the idea got stronger, he knows for sure: as a schoolgirl, she gained up to 60 kg with an increase of 158 centimeters, then diets and "cleansing" began. The girl lost weight up to 42 kg in a short time. At that moment, the fear of gaining extra pounds grew into bulimia.
This all happens so hidden from the eyes of other people that it is almost impossible to notice. When I lost a lot of weight, my mother noticed, because my critical days were gone, and I was taken to the gynecologist. He said to eat more. Mom didn’t know what it was, she didn’t understand the scale of the problem. They also took me to a therapist, they told me something, and at home they thought that everything was over. And it didn't end for another 13 years."
At the age of 16, Catherine was already studying at the university and lived alone. The same thoughts were constantly spinning in my head: I want to lose weight, I don’t want to be fat, I don’t want to be ashamed of my body.
I looked in the mirror, compared myself to other people, compared the size of my thighs to the legs of other girls. When you have an eating disorder, around a friend who has something like this. Not necessarily bulimia, but worrying about your body. Then it turned out that two of my good friends had this very disorder. It was revealed at a more conscious age."
After university, Ekaterina got a job, and friends of "similar interests" made up there. The girls compared their hands, feet and constantly focused on this: "Oh, you got better! Oh, you better not eat anymore." Going on a trip together, the friends decided that they would not eat after 17:00 until the morning.
This disorder is scary because the person most often looks normal, there are no signs. Cleansing does not happen every day, sometimes once a week. You live like a drug addict, every Monday you try not to do this anymore, because you understand that it is unhealthy. You want to finish this, but you can't. Although I read the articles and confessions of bulim women, for some reason there was no thought that it could be cured, I did not think that there were specialists. Then psychotherapy was not popularized."
Catherine's "cleansing" rarely happened in public places. At parties, the girl said that she was on a diet, then came home and "relieved stress."
There was some shame, I don't want to seem strange. I ate at home and then cleansed myself. I lived alone, no one could control. In American films, I've seen girls do it even in a bucket right in the room."
Sometimes she forgot about bulimia for a month, and sometimes it happened every day. The first three years at work, she completely immersed herself in business, there was no time to think about internal conflicts. But as soon as she went freelancing, it all came back
I always knew that it was not healthy, that something was happening to me. But at the same time, there was a parallel fear: if I do not do this, I will gain weight. I tried to stop it, but it didn't work. Then she resigned herself."
The girl told her boyfriend about bulimia only two years later.
Even my boyfriend was obsessed with food, we counted calories, how much we ate. This is also a disorder, a violation.I talked in such circles, where everyone was on diets, monitored nutrition and thought about weight."
Ekaterina did not know where to turn. She understood that in an ordinary clinic they would not help, and pills could not cure her.
Once I read about esophageal cancer due to bulimia, I got scared. I was 25 when I found out that bulimia can be cured. I came to a psychologist with a prayer to get rid of all this. I’m tired of thinking about weight eating away at me. We started therapy."
The only breakdown happened in the first week after the session with the psychologist. There were overeating, but no cleansing.
When chips were banned all my life, but here you can, of course, you will not stop at one pack. Then I even lost weight and was able to calm down."
Now Catherine's values and perception of herself have changed.
I haven’t weigh myself for two years now, I just don’t care. It seems that she gained five kilograms. Previously, the extra 300 grams spoiled the whole day. I was recently sent a video from three years ago, then I thought I was very fat. Now I look and think: some kind of skeleton. The connection with reality in terms of the perception of one's body was completely erased."
Ekaterina recalls that all the women in her family were concerned with losing weight. A mom who is fanatical about calories may not notice the child's illness.
Then my life was full of sparkling, I traveled, had relationships, but inside of me everything was bad, constant anxiety. When traveling, you don't think about the sights, but about what to eat - what if you get fat, but what do you look like? It irrevocably removes from "here" and "now".
"Food takes a lot of thoughts and feelings"
The specialist who helped the girl to cope with the disease was Kaliningrad psychologist Sergei Leonov. He works with eating disorders with clients from Kaliningrad, other cities in Russia and abroad.
- What is an eating disorder?
- This is a type of mental disorder in which a person has an extremely strong anxiety and obsession with food and their appearance. With anorexia, a person eats very little or does not eat at all and catastrophically reduces weight. This is a life-threatening condition. With bulimia, uncontrolled overeating occurs, followed by compensatory behavior: a person induces vomiting, drinks laxatives, or uses excessive loads, which also affects health negatively. With binge eating disorder, a person also overeats uncontrollably, but often can also gain weight.
Other disorders are less common. For example, a food refusal or food restriction disorder is more common in young children, but sometimes in adults as well: a person eats a very limited range of foods, as a result of which there is a serious health risk.
- How to understand if this is a problem for a child or not? For example, a kid wants only buckwheat and eats it for breakfast, lunch and dinner …
- Each disorder has its own clear criteria. For example, in the context of this disorder, an important criterion is weight loss, micronutrient deficiency, which manifests itself in a decrease in energy, a decrease in social functioning: the child does not eat anything in the kindergarten, the parents cannot go on vacation and visit. If this is just a feature, the picky about food that many children have, it goes away with age. And the disorder can remain and bring serious discomfort to both the child himself and those close to him.
Observation by a pediatrician is important. If the baby does not gain weight, there is lethargy, fatigue, you can suspect that something is wrong.
- Do you work with clients all over the country, what is the most frequently addressed?
- As a rule, it is either bulimia or overeating, less often anorexia. There are still many situations when one cannot say that this is a disorder, but there are eating disorders. A person is constantly worried about what and how much he ate, counting calories.
- How do you know that something is wrong in your relationship with food? Are there any bells?
- It is important to distinguish between eating disorders and eating disorders. How to suspect that a person, in principle, has a violation? When he has a lot of thoughts and feelings about food. When he thinks what to eat, how much to eat, he gets anxious. This is not the norm.
How to suspect a disorder? These are major changes in weight. This is overeating when a person cannot control them. We can all overeat for the holidays, this is not a violation or a frustration. If this systematically brings discomfort, you may suspect that something is wrong.
- Is the transition from disorder to disorder noticeable?
- This is a somewhat formal border. If we take 100% of people with eating disorders, most of them will be with unspecified disorders. Compare with another problem, such as aerophobia. Sometimes a person is not very comfortable flying on an airplane, but he does fly. A person with a phobia generally avoids flying, or each flight may be accompanied by a panic attack. That is, the degree of severity is significantly higher. When I’m abused, I can worry about overeating, and when I’m bulimic, I’m vomiting.
"You are the most beautiful with us, you are so slim"
- If a person counts calories - is it bad? The same athletes constantly count them …
- Athletes are a separate story. According to research, among dancers and athletes, the percentage of people with RPD is above average. You have to look a certain way there, that's part of the job. This is a factor that will contribute to the development of the disorder. When an athlete is counting calories, it is not part of a healthy eating behavior.
- And if an ordinary person begins to count the daily calorie intake?
- To better understand the answer to this question, one can draw the following analogy. The child feels well that he is hungry or already full and talks about it. If you give a child a choice, he usually understands that he loves more and what less. These are the principles of healthy eating behavior.
For many adults, it persists. They don't count calories, they don't weigh themselves. If a person suddenly decided to count calories, it is worth asking the question: "Why?" This is not required to maintain a healthy weight and a healthy relationship with food. In the process of evolution, thousands of people maintained their weight without counting calories, grams, proteins, fats, carbohydrates.
- What is the cause of eating disorders?
- There is no one reason. There are genetic factors. 15% of people experience hunger as pleasant, this can be a factor in anorexia. The family's food culture influences how parents relate to food. The state of health affects. Social factors influence. Why does ERP manifest more often during adolescence? Because of the increased attention to their appearance, peers become more significant.
- With genetics it is more or less clear, let's talk about the culture of eating behavior in the family. What can influence the development of the disorder?
- These can be a variety of factors. For example, a client says that his childhood fell on the 90s, when his parents tried to earn money, there was a shortage of food, malnutrition. And the child felt malnutrition for a long time, he had a fear of hunger. As he grew up, somewhere on a deep level, fear persisted. Because of this, he, in particular, can start to overeat, buy any food that he sees. Some part of him says: "Look, you'd rather overeat than starve."
Another example. Parents said that some foods are right and others are not. The child was forbidden to do something, but he could not resist his parents. Now he has grown up and begins to overeat, and then limits himself and goes on a diet. That is, already within himself he begins to limit himself in some kind of food, and at the same time to want it.
- For some, it can lead to frustration, but for others - not?
- Yes, under the same conditions, one will develop a disorder, and the other will not.
- How should mothers and fathers behave so that the children are in order with their eating behavior?
- It would be nice if the parents themselves had a healthy relationship with food. If we are talking about appearance, and all RPP are tied to it, there is no need to evaluate the appearance of the child - neither negatively nor positively. No need to say: "You are the most beautiful with us, you are so slender." Such assessments overly fix the child on the appearance. The child gets the feeling that this is very important. And then there may be anxiety about losing it. There should be a neutral attitude to the body. Everything related to the body is natural: it is better to broadcast such an attitude.
- If I eat a cake and cannot stop, although I understand that I am full, is this a problem?
- Without knowing the broad context, one cannot say for sure. On the one hand, it may just be some kind of norm, if this is rare. This can be a variant of a certain violation, when it happens once a week. Or it may be a disorder when a person does it every day, and even then causes vomiting or begins to consider himself a complete insignificance. The frequency and severity of discomfort plays a role.
- Is it possible to help yourself? Or do you have to go to a specialist?
- I would recommend looking for diagnostics to see if there is a problem. In addition to psychotherapy, there are options for self-help, but a specialist must tell the person about this, taking into account his unique situation, so that it is safe.
- Why doesn't it work with overeating, as mom advises: "Well, take it and just stop eating"?
- People who have not experienced RPE assume that eating is just a matter of conscious control and willpower. It works differently in people with disabilities. A person is not always able to stop, not because he lacks willpower. For example, if it is emotional overeating, the person experiences severe anxiety and does not know how to deal with it. He has an idea to eat. A person may understand that he is not hungry now and his body does not need food, but if we put this understanding on the scales and the fact that a cookie will now help to cope with severe anxiety, then the second will outweigh. Teaching such a person to deal with anxiety without food can help.
There may be physiological reasons when a person has not eaten banally during the day, accumulated hunger, in the evening he has food. He eats everything that is not nailed. It's like trying not to breathe for a minute and then trying to breathe normally. You will begin to breathe more intensively, the body will replenish the oxygen deficiency.
"Some kind of objective beauty"
- Do diets lead to RPP?
- There are many studies showing the harm from dieting in general. For example, one of them showed that within 24-48 hours from the start of any diet, the level of metabolism decreases by 15-30%. That is, if your body spent an average of 2,000 k / k per day, then after starting the diet it will spend 1400-1700.
A Harvard alumni health study found that those who lose and gain at least 5 kg in ten years live less than those who maintain a stable weight. According to another study, those who use a diet to regulate weight as adolescents are eight times more likely to have eating disorders later.
A Framingham study of 3,000 men and women over 32 years found that regardless of weight, smoking, physical inactivity and other risk factors, those whose weight constantly changes are twice as likely to die from cardiovascular disease.
Most people return to their previous weight five years after the diet, and 40% return to even more weight. Initially, diets were designed to help with specific diseases. In other cases, they only do harm. Their benefits are fleeting.
- There is an opinion that the effect of diets does not persist. Why? How it works?
- According to the WHO, 95% of people who are struggling with weight through dieting gain it again. Dieters do not consider how the psyche and our body work.One of the important laws is that any violent limitation of oneself in something will sooner or later lead to a breakdown. Healthy eating behavior is not artificially restricted. The person emotionally fails, and the body is deficient.
- On social networks there are many groups in which teenagers are sitting who dream of losing weight up to 40 kg. What do you think of such bands?
- There are scientific studies that show that participation in such groups, subscription to such bloggers is a factor in the development of RPP. Publics of this kind create the feeling that there is some kind of objective beauty that the majority have, but you do not. In fact, 3-5% of women can achieve the appearance they show there. This is an artificially created norm.
- What should parents do if they notice that a teenager has stopped eating, is fond of these groups on the Internet and is on diets?
- There are two extremes. The first is when parents do not pay attention or think that this is complete nonsense. Then there is a risk of missing the onset of the disorder. The second extreme is when they start to spread rot, scold, evaluate and prohibit. The teenager can close. The golden mean is to talk about it, ask correctly. If parents notice signs of trouble, consult a specialist. These signs will be unreasonable weight loss, deterioration in physical well-being, deterioration in academic performance.
- How exactly to talk about this with a child? What should I tell him?
- First, parents can always share their feelings. Mom and Dad may say, "We notice that you are losing weight, you are looking paler. We are concerned about this, we want to understand what is happening. Could you share?" For some teenagers, this is already enough to tell them themselves. It all depends on what kind of contact was originally, confidential or not. A parent may suggest, for example, to go to a psychologist: "I am not a specialist, but sometimes this is a symptom of a dangerous disease. Let's go to a specialist?"
- And if the child lies and does not open?
- This may be, therefore, the parent needs to notice objective signs: exhaustion, weight loss for no reason, lethargy, fatigue, learning impairment and changes in eating behavior: before the girl ate with everyone, but now she goes to her room, eats alone. It is better not to wait and not waste time, but go to a specialist.
One mother described her daughter's condition to me over the phone. I understand that this already looks like a severe form of anorexia and I say: "You need to see a psychiatrist and you may have to go to the hospital." Gave her the doctor's contacts. A few days later I ask: "Did you call?" And she says: "My husband and I are thinking: suddenly put in a psychiatric hospital, it's still serious." That is, the mother is worried about how it will all look, although in reality the question is the child's life. Let me remind you that 10 to 20% of people die from anorexia within ten years from the onset of the disease.
Parents are often out of tune. Not because they are bad or do not want to help the child, it is just that there is little education in this area.
- Tell us about the consequences of anorexia.
- Anorexia is a disease with the highest mortality rate of all mental disorders. The average age is shifting down, the bulk of the sick - from 12-13 to 17 years. Sometimes they come when it is no longer possible to help: the weight is reduced so much that physiological changes occur. Of the reversible, it can be loss of menstruation, feeling unwell, and cognitive decline.
If we talk about bulimia, the girl developed a disease, and against this background, esophageal cancer. This, fortunately, does not happen often, but it does happen.
- If you need help, how can you explain it to your loved ones?
- If this is an older adolescence, you can look for information yourself, and then connect your parents. It happens that parents do not see the problem or begin to condemn: "Why are you fooling around, just singing." A teenager can write to a specialist to talk to his parents.When we talk about RPP in adolescents, it is very difficult to help without parental involvement.
- If there is no trusting relationship with loved ones, how can you protect yourself from criticism from them?
- Build a border through which accusations will not fly if it is not possible to find out through an open dialogue. It is necessary to increase the distance in communication, communicate less often, not share significant topics. It is difficult if you live with people in the same space. And all the more you depend on them materially.
- Is RPP contagious?
- No, but it's important to understand: if a teenage girl has a friend who starts counting calories and dieting, this can also affect her.
- So, how to eat right?
- I am for conscious eating, an alternative to diets. When a person regulates nutrition not through restrictions and violence, but through the development of the ability to listen to himself, to the signals of his body, in particular, the signal of satiety and hunger. When he learns to choose the food after which his body will feel as good as possible. When there are no prohibited, "harmful" foods in his diet, and, accordingly, there are no "right" ones. So, in fact, almost all small children eat. And many adults too.
About how parents to cope with children's tantrums and when it is definitely worth showing the baby to a psychologist - in the material "Klops".