Eating disorders are a serious social problem whose conceptualization and recognition have experienced exponential growth in the last 10 years.
Today, anorexia nervosa (AN) and bulimia nervosa (BM) are not the only eating disorders that permeate the psychiatric field, as there is increasing social knowledge of others recently described, such as binge eating disorder (BED) or selective eating disorder (ARFID).
Calculating the prevalence of these physical and emotional imbalances is very difficult, especially due to the transitory and unnoticed nature of many of the conditions. For example, the long-term prevalence of anorexia nervosa in adolescents is estimated to be 0.3 to 2.2% and the one-time prevalence is 0.1 to 1.5%. As far as bulimia is concerned, the figures are similar: 0.1 to 2% of the young population.
As shocking as it may sound, as indicated by the British Medical Journal (the BMJ), anorexia nervosa is the psychiatric pathology with the highest mortality rate in the world. It is the first cause of serious weight loss in young women and also takes the podium in terms of the rate of admission to specialized centers. With this data, today we want to bring you an idea that should be more than clear: Willpower is not the solution to eating disorders.
Before entering into subjective terrain, it is necessary that we establish a series of bases at a diagnostic level.
An eating disorder is defined as a mental pathology dictated by dietary habits that negatively affect the physical and/or emotional health of the patient.
These include anorexia, bulimia, binge eating disorder, selective eating disorder, pica, rumination syndrome and other conditions. It should be noted that obesity is not included within this set of clinical conditions.
We are not going to describe the symptoms of each of the disorders, since it is not our intention to cover the spectrum of all eating disorders. Anyway, as an example, we present to you the diagnostic criteria followed by the Diagnostic and Statistical Manual of Mental Disorders (DMS-5) To identify anorexia nervosa:
According to the ICD-10 (international classification of diseases), for a person to be considered anorexic, they must have a weight that is 15% lower than expected for their condition and age, and have a Body Mass Index (BMI) of less than 17.5. , voluntarily induce their own thinness, exhibiting behaviors that show a distorted body image and suffer a series of characteristic endocrine disorders (in women, modification of the hypothalamic-pituitary-gonadal axis).
Can you deal with anorexia alone?
The answer is emphatic: no. We recover a piece of information that we have mentioned previously, but that should not be forgotten: Anorexia is the fatal disease with the highest mortality rate in the world, above schizophrenia and bipolar disorder, considered more “serious” by the general population.. Without treatment, up to 20% of people with eating disorders end up dying, while this figure drops to 2-3% with the relevant medical and psychological approach.
In addition to these data (which already speak for themselves), the study Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders stipulates that anorexia nervosa is a serious illness that must be taken into account. As a result of a meta-analysis that compared 36 different studies and various sources, it was discovered that only 46% of treated patients completely recover from the pathology, 33% reach a state of “normality” (with behavioral residues of anorexia). and 20% remain chronically ill in the long term.
Furthermore, it is estimated that Only 1 in 10 people with eating disorders receive treatment and, of all of them, 80% end with the clinical approach sooner than they should (they are sent home when it is not yet time). With these data we do not intend to discourage anyone, but rather to show how difficult it is to address this type of disorder. If it is already difficult to eliminate all traces of a disorder like anorexia after internalization and medical and psychological intervention, imagine the difficulty of facing such a serious condition independently.
The real treatment of eating disorders
We have already stipulated that willpower is not the solution to eating disorders, since up to 2 out of 10 people who decide to deal with them on their own end up dying. So, what to do?
You may be surprised to know this fact, but according to the scientific article Anorexia nervosapublished in the BMJ in 2007, It is estimated that anorexia and other disorders require an average recovery time of 5 to 6 years after diagnosis, which requires regular monitoring and, in many cases, consecutive interventions. 30% of patients do not fully recover at any time.
Furthermore, drastic hospital interventions that deprive the patient of all freedom and autonomy have been largely discredited: this is only carried out when the patient’s life is in danger. In the long term, family therapy in adolescents and cognitive-behavioral therapy in adults have shown good resultsalways emphasizing the normalization of ideal eating habits and promoting a change in the patient regarding their distorted thoughts around the image.
One of the greatest difficulties in the treatment of eating disorders is that many patients do not see their condition as a pathological condition, but as a choice and lifestyle. Vomiting food is an obvious sign of an illness, but selectively and obsessively choosing what to eat at all times or “stopping eating for a few days because I look fat” enters a gray area that, in many cases, is excused within of normality.
The reality is that no obsessive behavior is normal. If you count every calorie in every food, if you stop eating as soon as you gain a kilo of weight, if you are ashamed of your physical appearance or if you notice that your life revolves around a conflictive relationship with food, you need help. Anorexia, bulimia and other disorders have a solution, but only if the patient is willing to recognize their problem and decides to put themselves in the hands of a multidisciplinary team of professionals.
