What sort if a yerso gets tfie eating dlsonier, known as anorexia netVosa? Most if tfiem areirfs under twenty, bright and energetic
Jrom we C-to-aoJamifies. Gooa in studles ana Jl0rts, the anorexic rise to c0"!petitionana achievements. She is senaer, usua attractive. But she worries too much about fier figure? Is SHe gettingJat? Wouan't she look better!f she ost just a
Jew more kios? She is constantfy dleting, becoming tfiinner ana tHinner SHe talks about it a the time. SHe exercises fiara. Active a aay, she cjten skY's meafs.
As late as the mid-80s, the noted Indian epidemiologist Sridhar Sharma had found a very low prevalence of the disorder in India. Now anorexia nervosa is a significant presence in the country. On the top of it, we have our unique traditions of religious fasting and protest fasting.
Although, the prevalence of anorexia nervosa has increased worldwide in recent years, the numbers suffering is still not large in absolute numbers. But given the age and potential of the population that is afflicted, it represents a serious and often devastating affliction, with tragic implications for the young sufferer and her family. .
Anorexics often grow in families in which there is an extraordinary emphasis on achievement, external appearance, and weight control. The mother-daughter bond in these families tends to be unusually intense, with the mother commonly seeing in her daughter's success some compensation for her own disappointments in life. They are often compliant children who have a powerful need to "be good". Underneath a facade of good behaviour, they typically feel weak and unworthy. So when they encounter any serious stress such as a failure to live up to their academic expectations or rebuffs in personal relations,
18111 they try to salvage self-esteem through concentrating on the body, mostly in the shape of thinninl! it.
BEAUTIFUL YOU
Anorexia nervosa often begins with a decision to diet, which seems innocuous enough. However, given the anorexic's peculiar developmental vulnerabilities, diet! ing begins to yield a sense of control, coupled with the initial"high" of fasting. In a culture that values thinness, achieving a thin body repre
sents a triumph. Again the anorexic derives certain satisfaction from increased attention from the family; the refusal of food. always evokes a strong response from the near ones.
Once set in motion, anorexia nervosa has its own characteristic development as a disease. As dieting is transformed into fasting (and finally into wilful starvation), the anorexic typically withdraws from ordinary activities and relationships. She ruminates endlessly over her food intake and engages in highly ritualistic eating behaviour, such as cutting food into small bites. She starts monitoring meticulously her caloric intake. And she will typically intensify an already excessive exercise regime.
Once an anorexic has lost a significant amount of weight and the illriess has progressed to a certain point, she will typically defend her lost weight by all means, such as disposing away food secretly, or hiding her emaciation under loose clothing. She not only deceives others, she deceives herself into thinking" all is well". Probably no disorder other than alcoholism is so invariably accompanied by denial.
By the time the anorexic comes to the attention of clinical professionals, the disorder has in most cases progressed considerably. In the early stages - inherently difficult to recognize - family members cling to the hope that the change that has come over their offspring is a "passing phase". And in a few cases it may turn out true; the developin'g anorexic able to extricate herself from the downward course. But the same doesn't happen in many other cases.
As the disorder advances, the anorexic starts experiencing faintness and fatigue. Menses stop and interest in sex declines. She can suffer from heart irregularities.
Osteoporosis, the brittleness in bones, can set, in. Over a range of studies, anorexia nervosa is' known to have a fatal outcome in about 10 per
cent of treated cases.
Despite the proliferation of treatment approaches in recent years, there is no universal agreement as to the optimal mode of intervention. In general, there is consensus that both the physical and psychological aspects of the disorder must be addressed through a combination of nutritional rehabilitation, weight restoration (patients tend to approach their ideal bodyweights much more efficiently in an inpatient setting) and psychotherapy. As anorexics commonly suffer from depression, the psychotherapy sessions can be usefully supplemented with anti-depressant drugs like Prozac.
"You can never be too rich or too thin" the famous (and now notorious) dictum from the Duchess of Windsor. The thin body ideal is busily being marketed all around. How amazing that thinness in particular has become the dominant body ideal - so intensely sought after - for today's Woman! Our matrimonial ads,
flintaIiooim;a'riably seek for a "slim" bride.
With the globalisation of fashion, the norms of consumer culture have now a global impact. Well-known women's magazines with their worldwide coverage glorify thin fashion models. This globalisation of fashion is overwhelming even amongst cultures like the African where female plumpness was prized. The Euro-American body ideals of body image (currently a thin female body with narrow waist and hips) are penetrating various other countries and cultures, and in turn leading to eating disorders.
lbs. The fear of fatness motivates them to fad'
diets and the punishing exercise regie so typical of anorexia nervosa. Many take to vegetarianism; meat becomes an object of particulal\'avoidance, since animal fat is, in the mind
of the norexic, immediately and magically
, I, transforD;}e4/nt,o body fat.
Actuall'9derate degree of overweight (up to 15 pent over the statistically normal weight for one' seight) poses no known health risks. An9,;n;iqre so for women, whose
weight accumulaii.)s distributed subcutane
ously, unlike meri with the dangerousi
trunkweight. On the ''top/.,. for women the
growth of fat tissue at puberty is critically connected with the emergence of the reproductive cycle. Yet the social bias against obese women is much greater than it is against men. In the prevailing global culture, there operates a strong prejudice against obese women.
Anorexics are particularly vulnerable to cultural messages about dieting, which offer the promise of taking control of one's life through the alteration of body shape. For them dieting becomes the disease, with diet books a breeding ground for the same. And there is consistent evidence that dedicated dieting puts one at risk for an eating disorder.
There are male anorexics, too but they form a small minority. The politics of eating disorders primarily revolves around the politics of gender. The current epidemic of these conditions is a reflection of the ambiguities of female identity in a period of change and confusion. Perhaps eating disorders will sharply decline in incidence, as women will be able to achieve real power in the world. Then the size and shape of their bodies are no longer taken tQ be the measure of their worth. There is even speculation that the crest of eating disorders in the western world has passed. And other countries, such as ours, should follow suit as
women there make gains in empowerment.
For anorexics, the fear of weight gain operates as the spectre of the ultimate catastrophe. Many make out that they would rather die than cross their magical figure of 90 lbs or 100 |
