Gayathri's close friends have been noticing that of late, she has started to continuously worry about how "fat" and "ugly" she looks, when in reality she has always been admired for her proportionate body and good looks.

At lunchtime, she has been eating unusually large portions and has been stuffing herself needlessly with chocolates and ice cream, only to spend an unusually long time in the bathroom soon after.

Her close friend walked into the restroom today and was shocked to see her trying to deliberately vomit out all that she had eaten during lunchtime.

Eating Disorders are potentially serious medical, emotional and behavioral problems that occur when food becomes a compulsive mechanism for coping with life's overwhelming challenges.

An Eating Disorder is Present when a Person:

• Is constantly thinking about eating or not eating
• Feels out of control around food, uses food to meet needs other than hunger. For e.g. someone going through tremendous work pressure, may binge-eat to feel relaxed as opposed to meditating, exercising or listening to music.
• Becomes obsessed about food, weight and body shape to an unrealistic level.

Causes:
Eating disorders are a complex condition that may arise from a variety of physical, emotional, social and familial issues. On the surface, the desire to be thin appears to be the cause of the disorder, but food is not the real issue.

The real issues are underlying fears, doubts, insecurities, low self-esteem and anxiety. Someone grappling with an eating disorder believes that the use or control of food is necessary for relief from uncomfortable moods and feelings.

Often negative self-image is created by specific traumatic events or memories in the individual's growing up years. Parents may play an important role in inadvertently nurturing a negative self-image in the individual.

Interpersonal factors such as troubled family and personal relationships, difficulty expressing emotions and feelings, history of being teased or ridiculed based on size or weight etc. can contribute too.

Additionally, cultural pressures that glorify "thinness" and place value on obtaining the "perfect body" along with cultural norms that value people on the basis of physical appearance and not inner qualities and strengths also play a role in perpetuating a negative body image.

Eating Disorders can take the form of:
 

ANOREXIA NERVOSA - It is characterized by self imposed starvation and excessive weight loss. Such a person may refuse to maintain normal body weight appropriate for his/her height, body type, age and activity level. There is intense fear of weight gain or being "fat", despite dramatic weight loss.

BULIMIA -  It is characterized by a secretive cycle of binge eating (intense overeating all at once, beyond what is required) followed by purging (artificially expelling any food or drink consumed). Bulimia includes eating large amounts of food - more than most people would eat in one meal - in short periods of time, then getting rid of the food and calories through vomiting, laxative abuse (laxatives and enemas are otherwise medically used to artificially expel residues in the colon, in cases of constipation or other bowel malfunctions), or over-exercising.

BINGE EATING DISORDER or COMPULSIVE OVEREATING - It is characterized primarily by periods of uncontrolled, impulsive, or continuous eating beyond the point of feeling comfortably full. While there is no purging, there may be sporadic fasts or repetitive diets and often feelings of shame or self-hatred after a binge.

Body Image:
People with negative body image have a greater likelihood of developing an eating disorder. They tend to have a distorted perception of their body shape, and tend to perceive parts of their body unlike the reality of their size. They are convinced that only other people are attractive and that their body size or shape is a sign of personal failure. They feel ashamed, self-conscious, and anxious about their body.

Health Consequences of Eating Disorders:
A cause for concern with Anorexia, Bulimia and compulsive over-eating, is that there are serious health effects that accompany them. With self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences, like abnormally slow heart rate and low blood pressure, thus increasing the risk for heart failure. Severe dehydration is another possible consequence, which can result in kidney failure. Dry hair and skin; hair loss is common. Also, gastric ruptures during periods of bingeing are high as well; the esophagus could even rupture from frequent vomiting.

How to Help a Friend who May be Suffering from an Eating Disorder:
In a private and relaxed setting, talk to your friend in a calm and caring way about the specific things you have seen or felt that have caused you to worry.

Communicate your concerns. Explain that you think these things may indicate that there could be a problem that needs professional attention.

Ask your friend to explore these concerns with a counselor, doctor, nutritionist, or other health professional who is knowledgeable about eating issues. If you feel comfortable doing so, offer to help your friend make an appointment or accompany your friend on their first visit.

Avoid placing shame, blame, or guilt on your friend regarding their actions or attitudes.

Express your continued support. Remind your friend that you care and want them to be healthy and happy.

Treatment:
As mentioned earlier, eating disorders can be treated and healthy weight can be restored.

Seeking help and sharing one's difficulties with a supportive friend or family member, is often the first step to working one's way through the illness.

Eating disorders require a treatment plan involving medical care, counseling intervention and nutritional counseling.