Tag: relationship

‘Eating disorders are not lifestyle choices’: Why many people share a complicated relationship with food

Kritika Ghai was first diagnosed with binge-eating disorder when she was merely 12 years. Since birth, she had an enlarged adenoid that blocked her nose pipe, making her gain weight. Her suffering was further exacerbated by her inability to perform any kind of exercise, owing to her irregular breathing patterns. As such, as a child, she was put on various extreme diets to manage her weight. This forced her to eat large amounts of food — rapidly and secretively. “Not knowing what I was going through, eating became a way to validate my emotions,” she said, adding that the pandemic-induced anxiety only led to her eating even more food during stressful and lonely times.

Finally, she consulted a nutritionist who helped her develop healthy eating patterns. Ghai was advised to not curb her cravings and eliminate the difference between ‘good’ and ‘bad’ food in order to stop associating eating with guilt and shame. “I started seeing my body as a structure that supported me and this perspective enabled me to develop a healthy body image,” she said. Finally, after years of battling with this binge-eating disorder, she has developed a healthy relationship with food by eating regular meals, exercising and food-mapping, a technique which involves charting your daily meals in a journal to keep a track of what you’re eating.

Similarly, Pranshu Mishra developed binge-eating disorder due to polycystic ovarian syndrome (PCOS), stress, and an excessive study load in eleventh grade. “You just don’t stop at one single serving; you just mindlessly eat even if you feel discomfort,” Mishra said, calling eating disorders “a tug of war between the stomach and brain”.

While eating her favourite food induced happy hormones in her body, she would feel immense guilt immediately after consumption, leading her to starve herself for hours before repeating the same cycle, she admitted.

Ann, on the other hand, developed bulimia — a serious eating disorder marked by bingeing, followed by methods to avoid weight gain — in 2007. “I have been a chubby kid all my life because of which I faced a lot of bullying. It reached a point where people made snide remarks like ‘do people in your house get to eat food or do you eat it all?’ or ‘go for a walk.’ This massively affected me, and I stopped eating in front of people,” she told indianexpress.com. Owing to her condition, she used to excessively work out which made her lose weight drastically. “I felt very weak and light-headed all the time,” she said.

To understand more about the mental and physical aspects of such eating disorders, we reached out to experts, who emphasised that these disorders are not lifestyle choices. Dr Aparna Ramakrishnan, Psychiatry Consultant, Kokilaben Dhirubhai Ambani Hospital, Mumbai said, “Eating disorders are complex disorders associated with significant disturbances in an individual’s eating behaviours and related thoughts, emotions and attitudes which impair their physical, psychological health and psychosocial functioning. They can often be life-threatening.” She highlighted that the exact causation is elusive, but eating disorders are caused by a complex interaction of genetic, biological, behavioural, psychological and social factors.

Agreeing, Dr Meghana Pasi, Nutrition Consultant, MyThali Program, ArogyaWorld said, “Societal and peer pressure to achieve unrealistic body standards as well as people with low self-esteem and impulsive behaviour are at risk of developing eating disorders.” The expert said that nutritional counselling, psychotherapy and medications are some available treatment options.

Implementing these, Mishra sought nutritional advice from a dietitian who asked her to eat at regular intervals and practise mindful eating, a technique which makes you pay closer attention to your food and how it makes you feel, thereby helping you distinguish between physical and emotional hunger. Alongside, she also included physical activities such as swimming, yoga, and exercise in her routine which made her feel better about her body. “Earlier, people used to body shame me and call me different names, but after developing self-confidence, I am able to ignore their nasty remarks,” she said.

As for Ann, running was what changed her life for the better as it became a mechanism for her to lose weight in a healthy way, helping her achieve mental peace.

Does social media affect eating disorders?

‘Eating disorders are not lifestyle choices’: Why many people share a complicated relationship with food Social media plays a huge role in our relationship with food. (Source: Freepik)

Talking about the same, Dr Ramakrishnan said, “Exposure to media like fashion magazines, television and social media mediate thin-ideal internalisation and can be associated with the development of eating disorders. More time spent or frequent use of social media means more exposure to images, messages and peer interactions which can propagate body stereotypes.” She further explained that inaccurate visual media representation like the use of filters on photos and videos can raise the risk of eating disorders.

Moreover, after analysis of videos and chat groups across social media platforms, there is a worrying presence of ‘pro-ana’ and ‘pro-mia’ content which focus on anorexia and bulimia being lifestyle choices (that are to be respected) rather than being categorised as disorders, Dr Ramakrishnan said. 

Agreeing, Dr Dinika Anand, Clinical Psychologist, BLK-Max Superspeciality Hospital said, “Social media plays a huge role in our relationship with food. On one end, social media projects the ideal body type and size, and on the other end, it glorifies and celebrates food through advertisements and food bloggers.”

The experts stressed that women are more likely to be affected by social pressure and unfavourable evaluations of their physical appearance. Moreover, gender stereotypes, especially the objectification and sexualisation of women, contribute to the emergence of eating disorders among them. Research published in The Journal of Treatment and Prevention in 2012 concurs with this claim as it showed that men are less likely to be diagnosed with an eating disorder even when they exhibit the same symptoms as women because eating disorders are considered generally ‘female’ disorders.

Here are some tips by experts that can help manage eating disorders:

*Keep meals on track
*Eat small portions of meals throughout the day
*Stop starving
*Do not restrict your urges
*Delete or limit the usage of food delivery applications
*Scroll through social media mindfully by engaging with body positivity and relatable content instead of unrealistic and curated feeds

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Primary care doctor: Why you should maintain a relationship



KHN
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When Claudia Siegel received a abdomen bug earlier this year, she reached out to her main care physician to prescribe something to alleviate her diarrhea. The Philadelphia resident was shocked when she obtained an on the web concept informing her that mainly because she hadn’t frequented her doctor in far more than 3 many years, she was no lengthier a patient.

And since he was not accepting new individuals, she would have to come across a new most important care doctor.

“I think it’s unconscionable,” Siegel reported, noting that many clients could have stayed absent from the doctor’s place of work the earlier number of several years due to the fact of the covid pandemic. “There was no notification to people that they’re on the verge of getting rid of their physician.”

Though it is dismaying to find out you have been dropped from a physician’s follow for the reason that a few decades have handed considering the fact that your past stop by, the method isn’t uncommon. Just how widespread the working experience is, no a person can say. But professionals also do this.

The argument for dropping the occasional patient helps make some perception. Since numerous major care physicians have a waiting listing of possible patients, eradicating individuals they hardly ever see opens up individual slots and increases entry for many others.

“Most principal care techniques are very fast paced, in portion because of to pent-up demand thanks to covid,” said Dr. Russell Phillips, director of Harvard Professional medical School’s Centre for Most important Treatment and a common internist at Beth Israel Deaconess Health care Middle.

“Even though continuity of care is essential, if the affected individual hasn’t been in and we do not know if they’re heading to come in, it’s hard to depart place for them,” he stated.

Individuals normally shift absent or discover a unique medical doctor when their insurance policy modifications with no notifying the observe, experts say. In addition, medical professionals may request to classify individuals they haven’t seen in a extended time as new patients since their medical, household, and social heritage may have to have a time-consuming update following a lengthy split. Client position is a person aspect that establishes how substantially medical doctors get paid out.

Continue to, the changeover can be hoping for sufferers.

“I can fully recognize the patient’s viewpoint,” stated Courtney Jones, a senior director of circumstance management at the Patient Advocate Basis. “You believe that you have a health care group that you’ve reliable earlier to help you make conclusions, and now you have to come across one more dependable staff.”

Siegel mentioned she rarely went to the medical doctor, adhering to her medical professional father’s counsel that people should not go except if they are ill. Despite the fact that she hadn’t been to her doctor’s business office in man or woman recently, Siegel explained she experienced corresponded with the practice team, which include holding them up to date on her covid vaccination standing.

Soon after receiving the on-line dismissal by way of the affected person portal for the Jefferson Health program, Siegel referred to as the family medicine practice’s patient line directly. They advised her 3 yrs was the protocol and they experienced to abide by it.

“I asked, ‘What about the individual?’” Siegel said. “They didn’t have an respond to for that.”

It was a month prior to Siegel, who has coverage under Medicare’s common price-for-provider system, could see a medical professional who was accepting new people. By that time, her belly virus signs experienced resolved.

Jefferson Wellness doesn’t have a policy that individuals get rid of their medical doctor if they are not found consistently, in accordance to a assertion from spokesperson Damien Woods.

However, he explained, “Patients not noticed by their service provider for three yrs or a lot more are categorised in the digital health care data as new patients (somewhat than proven individuals), per Middle for Medicare and Medicaid Solutions (CMS) advice. Every time doable, Jefferson will work with these individuals to continue to keep them with their primary care company and provides alternatives for new suppliers in sure circumstances.”

American Healthcare Association ethics recommendations suggest that doctors notify patients in progress when they are withdrawing from a scenario so they have time to locate yet another health practitioner.

But the corporation, which signifies physicians, has no direction about maintaining a panel of clients, mentioned AMA spokesperson Robert Mills.

The American Academy of Family members Physicians, which signifies and advocates for relatives doctors, declined to comment for this tale.

A main treatment physician’s panel of sufferers typically features people who have been witnessed in the previous two yrs, stated Phillips, of Harvard. Physicians may well have 2,000 or far more clients, studies clearly show. Preserving a workable range of clients is critical, both of those for efficient affected individual treatment and for the medical practitioners.

“Practices understand that a major contributor to health practitioner burnout is getting much more clients than you can offer with,” Phillips claimed.

Need for physician services is anticipated to continue on to outstrip source in the coming decades, as people today age and need a lot more care at the exact same time the amount of retiring medical professionals is on the upswing. According to projections from the Association of American Health-related Schools, by 2034 there will be a shortage of up to 48,000 principal treatment doctors.

Retaining a regular connection with a most important care supplier can help people today regulate continual problems and instantly recognize new concerns. Frequently examining in also aids ensure individuals acquire significant program providers these as immunizations and blood stress checks, claimed Dr. David Blumenthal, a former major care medical doctor who is president of the Commonwealth Fund, a exploration and coverage group.

Well being treatment organizations significantly concentration on demanding doctors to meet certain good quality metrics, this sort of as taking care of patients’ higher blood strain or supplying thorough diabetes care. In this natural environment, “it could be problematic for medical professionals to be accountable for the health of sufferers who do not see them,” Blumenthal mentioned.

Income also figures into it. Continual visits are great for a practice’s bottom line. Procedures may possibly also come to a decision to stay clear of new Medicare sufferers or people with selected types of insurance policies due to the fact the payments are far too reduced, stated Owen Dahl, a marketing consultant with Health care Team Management Association, an organization for wellbeing care supervisors.

In typical, medical doctors aren’t obligated to carry on viewing a client. A health practitioner may possibly dismiss clients simply because they are not next scientific recommendations or routinely cancel or miss appointments. Belligerent or abusive habits is also grounds for dropping a affected individual.

In certain scenarios, medical professionals may perhaps be legally liable for “patient abandonment,” a variety of medical malpractice. State procedures differ, but there are typical features. Individuals rules normally use when a health care provider harms a patient by dropping them abruptly at a critical stage of procedure. It would typically not utilize if a affected individual has not found the health practitioner for various years.

Even even though quietly dropping a seldom-viewed client might not have an instant health care consequence, clients ought to be educated, authorities explained.

“It’s really very good consumer service to clarify the situation,” mentioned Rick Gundling, senior vice president at the Healthcare Financial Management Association, an group for finance industry experts. As for Siegel, he mentioned, “This female must not be left hanging. If you’re the affected person, the doctor need to be proactive.”