These - among others - could be signs that your loved one is suffering from an eating disorder (ED), said Dr Sarvani Pather, a psychiatrist at Akeso Crescent Clinic in Randburg.
Speaking in light of National Nutrition Week, observed from October 9 - 15, Pather said eating disorders affected people across the board, irrespective of age, sex or race.
She said they often negatively impacted on their mental and physical health, productivity and relationships.
“In the absence of epidemiological studies, the prevalence of eating disorders in South Africa is largely unknown. But it has been argued that Western ideals of thinness in females play a major role in the development of pathological eating disorders,” she said.
According to research, eating disorders have historically been described as illnesses affecting young, white, educated girls and women with high socio-economic status.
“In South Africa, where there is a multicultural society, women living in communities where there is a culture that highly values thinness may be at higher risk of developing anorexia nervosa (AN) than women living in a communities with a high prevalence of HIV/Aids, where thinness may be associated with and stigmatised along with the virus,” Pather said.
The South African Depression and Anxiety Group (Sadag) said that eating disorders were not due to a failure of will or behaviour - but were real, treatable medical illnesses.
“Today, teenagers in particular are under increasing pressure to conform to strict social ideals, especially those relating to an acceptable physical appearance.
“Most fashion trends and magazines, sales campaigns and even some activities and professions greatly promote an extremely lean, sometimes medically unhealthy body weight.
“Compounding this problem is the fact that the teen years are usually quite emotionally turbulent, with many body image issues arising,” Sadag said.
Highly competitive sports activities in which leanness is valued, such as gymnastics, horse racing (jockeys) and ballet may also lead to ED, Pather pointed out; adding that the development of an ED may also be an effort to cope, to communicate other problems.
“When people believe that they have no ability to make choices in their own lives and lack control over things happening in and around their lives that distress them, ED helps them to establish a sense of control, power, provides worth and numbs pain or releases anxiety or anger,” Pather stated.
But eating disorders can be treated.
A combination of medication, medical management (if necessary) and psychotherapy improves outcomes.
Medical stabilisation, weight restoration and nutritional rehabilitation are important as the state of being underweight is associated with depression, poor concentration and irritability.
The patient must be able to concentrate during the psychotherapy, as monitoring is an important part of cognitive behaviour therapy (CBT).