Eating disorders impact people globally, irrespective of age, gender or socioeconomic background. They are more common among young people and can take many different forms, including binge-eating disorder, bulimia nervosa and anorexia nervosa.

Dr Suman Prasad Adhikari, a consultant neuropsychiatrist who works as an Assistant Professor of Psychiatry at the Nepalese Army Institute of Health Sciences, explains the disorder.

What are eating disorders and their types?

An eating disorder is a mental health condition which involves severe disruptions in eating behaviours, accompanied by unsettling feelings and thoughts. Unhealthy eating behaviours can include overeating, undereating, or constant worry about weight and body shape.

Eating disorders encompass a range of serious conditions affecting eating habits and mental health. Anorexia nervosa involves extreme food restriction and distorted body image. Bulimia nervosa entails binge eating followed by purging behaviours. Binge eating disorder involves uncontrollable episodes of overeating. Avoidant Restrictive Food Intake Disorder (ARFID) involves limited food intake due to sensory issues or fear.

What are some of the common underlying factors contributing to their development?

Eating disorders can affect individuals of all ages, racial or ethnic backgrounds, body weights, and genders. They often manifest during the teenage years or young adulthood but can also develop in childhood or later in life. These disorders result from a complex interplay of genetic, biological, behavioural, psychological, and social factors. Genetics is one such factor; individuals with a family history of eating disorders are more susceptible to developing them themselves.

Variations in brain biochemistry and structure may contribute to the onset of eating disorders. Neurotransmitters like serotonin and dopamine may be involved in their causation. Brain imaging studies are improving our understanding of eating disorders. For instance, researchers have observed differences in brain activity patterns between women with eating disorders and healthy women.

In what ways does the interplay between social pressures, cultural influences and individual psychology trigger eating disorders in an individual?

Personality traits such as neuroticism, perfectionism, and impulsivity are commonly linked to a higher risk of developing eating disorders. Additionally, exposure to media that promotes unrealistic body ideals, cultural emphasis on thinness, and perceived pressures to conform to slim standards contribute to the prevalence of eating disorders.

Psychological triggers play a significant role in the development of eating disorders. These triggers include low confidence and self-esteem, feelings of inadequacy or lack of control, fear of gaining weight, dissatisfaction with body image, and experiences of isolation and loneliness.

Interpersonal factors also contribute to the susceptibility to eating disorders. Troubled relationships, difficulty expressing emotions, a history of bullying or body shaming based on size or weight, and experiences of physical or sexual abuse can all contribute to the development of disordered eating patterns.

Social influences further exacerbate the risk of eating disorders. Cultural pressures that idealise thinness and prioritise achieving the perfect body shape, as well as societal norms that value individuals based on physical appearance rather than inner qualities and strengths, contribute to the pervasive nature of eating disorders in various communities.

What are some strategies for preventing the development of the disorders?

It's crucial to implement prevention strategies to address eating disorders. Creating awareness of warning signs, particularly among those with a family history of eating disorders, is vital for early recognition. Early intervention is essential to break harmful eating habits before they become entrenched. Seeking therapy for conditions like OCD, depression, and anxiety can reduce the risk of developing an eating disorder by addressing underlying mental health issues and promoting healthier coping mechanisms.

By recognising warning signs early and seeking appropriate support and therapy, individuals can mitigate the risk of developing eating disorders and foster healthier relationships with food and body image.

How can one treat eating disorders?

Psychotherapy, whether conducted individually, in groups, or with families, plays a crucial role in treating eating disorders. Cognitive-behavioural therapy (CBT) is particularly effective in addressing disordered behaviours such as binge eating, purging, and restricting. Through CBT, individuals learn to identify and modify distorted thought patterns contributing to their eating disorder.

In addition to psychotherapy, medications may be necessary to address co-occurring psychiatric or medical conditions. Antidepressants, mood stabilisers, or antipsychotics may be prescribed based on individual needs and underlying factors such as anxiety, depression or OCD.

Nutritional counselling, led by a dietitian, is integral to the treatment process. This involves educating individuals about proper nutrition and eating habits, as well as addressing any significant weight changes. The nutritional plan focuses on reducing anxiety about eating while promoting balanced consumption of foods across various calorie densities and regularly spaced meals. By integrating psychotherapy, medication management and nutritional counselling, treatment plans aim to support individuals in overcoming eating disorders and achieving overall well-being.