When food is the enemy

Henriette Lamprecht - Eating disorders are not common in all cultures. An obsession with being skinny is more prevalent in cultures where food is abundant, says clinical psychologist dr. Anina du Toit of Let’s Talk Psychologists in Windhoek. Citing Causes of eating disorders Janelt Polivy and C Peter Herman Annual Review of Psychology, 2002; 53 Du Toit explains in cultures where food is scarce, the ideal body shape is being more rotund, suggesting ideals tend to lean towards what’s difficult to achieve. “A culture of abundance valuing slimness may be a background cause, but whether a person takes this valuation to a pathological extreme depends on additional factors,” says Du Toit.In the past, it was believed the idealisation of a svelte figure was concentrated in the upper SES strata (?) of the culture of abundance. However, culture became increasingly homogenised with media images of a slender ideal now permeating every corner of society. The media is often blamed for the increased incidence of eating disorders because it broadcasts images of slim physiques. As with the culture of abundance, idealised media images are at best a background cause of eating disorders. The idealisation of a slender figure in cultures of abundance is more intense in females than males, explains Du Toit. “Societal disparagement of being overweight and the glorification of being underweight contributes to young women expressing dissatisfaction with their weight and shape.”The more intense this dissatisfaction, the more likely one is to undertake attempts to lose weight. Peer pressure is often also cited as a contributor to eating disorders, as is family influences. “Friends and family often praise anorexic patients’ slenderness and envy the self-control and discipline required to achieve this. This reinforcement doesn’t cause the disorder, but helps to perpetuate it.”Case reports and studies of family interaction show families with a prevalence of eating disorders to be enmeshed in, intrusive and hostile to and negating of the patient’s emotional needs. Adolescents who perceive family communication, parental care and expectations as low, and those who report sexual or physical abuse are at increased risk for developing eating disorders. “Mothers of girls with eating disorders may well have an influence on their daughters’ pathology in that they may have an eating disorder themselves or pressurise their daughters to conform to social expectations regarding slimness.”Personal experiences that have been most frequently linked to the development of eating disorders include abuse, trauma and bullying. Stress and negative mood are commonly reported as precursors of eating disorders as is low self-esteem, obsessive thoughts, inaccurate judgement and rigid thinking.Anorexia is characterised by the persistent restriction of energy intake, the intense fear of gaining weight and disturbed body image. Signs of hair loss, the absence of menstruation for longer than three months, soft, fine hair on the face and body, yellowing of the skin, constipation, abdominal pain, cold intolerance, lethargy and excess energy may also be evident. A body mass index (BMI) of between 17 and 15 kg/m2 would indicate mild to extreme anorexia.When seriously underweight, many individuals with anorexia show signs of depressed mood, social withdrawal, irritability, insomnia and diminished libido. Suicide risk is also elevated in individuals with anorexia.Obsessive-compulsive characteristics, both related and unrelated to food, are often evident. “Most individuals with anorexia nervosa are preoccupied with thoughts of food. Some collect recipes or hoard food.”Other features sometimes associated with anorexia include concerns about eating in public, feelings of inferiority, a strong desire to control one’s environment, fixed thinking, limited social spontaneity and overly restrained emotional expression. Living with someone who suffers from anorexia can have a devastating effect on family members, says Du Toit. Siblings can become resentful about what they perceive to be a deliberate insistence on losing weight while parents often engage in self and mutual blame. Accompanied by the anger, blaming and resentment is the fear the loved one may die. “Family and friends often feel at a loss as they watch their loved one suffer from anorexia. The confusion and hopelessness that arise from being unable to help a loved one are enough to break even the strongest of relationships.”Hospitalisation may be required for medical complications, severe psychiatric issues and severe malnutrition. Specialised eating disorder programs may offer more intensive treatment over longer periods of time. Should you know someone who may suffer from anorexia, engage the person in a conversation while remaining calm, compassionate and loving, Du Toit says. Then seek the treatment of a reliable professional. Family and friends can plan to eat healthy meals together.“Shopping together may allow you to introduce new foods. Keep conversations neutral, no talking about food and weight. Engage in activities like watching a movie – no exercising. Acknowledge and voice the loved one’s value as an individual.”anina@letstalkpsych.biz

When food is the enemy

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Namibian Sun 2025-05-15

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When food is the enemy

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Namibian Sun 2025-05-15

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