Anorexia and bulimia are not the only eating disorders. Moreover, people who suffer from these problems may not be "bone and skin" at all
First and foremost, it should be emphasised that eating disorders - whether anorexia nervosa or bulimia - are serious psychiatric illnesses requiring specialist treatment. Furthermore, there is no complete 'cure' for the problem, and most of those who have experienced some form of eating disorder (ED) carry the risk of relapse with them for the rest of their lives. Although women dominate the PPP population, this does not mean that men are immune to these disorders - the prevalence is approximately 10 times lower. Most patients in the Czech Republic are hospitalized with PPP in the 10-14 age group and also in the 15-19 age group. As experts point out, it is during adolescence that the disease can do the most damage to the human body, with as many as 10% of all patients eventually succumbing to it. The cause of death is not necessarily due to the damage that PPP causes (heart failure is common, for example), as those who suffer from PPP also face a twofold increased risk of suicide compared to an otherwise healthy population...
Women vs. men?
In the case of women, one of the widely cited reasons for PPP is the media pressure they are under - after all, a woman's body is supposed to be slim, and weight is a major issue for many teenage girls too (regardless of other body proportions). Boys and men, on the other hand, do not face such a "media massage" as much - and the classic triggers for the disease are, in addition to socio-cultural norms, problematic family relationships or related anxiety states. If some form of eating disorder is already present in the male population, it is often only when men reach what is known as premorbid obesity (a condition preceding grade 3 obesity). Libuše Stárková, M.D., CSc., who also focuses on the occurrence of mental bulimia in men, directly states that "while women who choose to diet feel fat, only half of the time men actually are." Anorexia thus manifests itself in a very radical dietary regime to maintain low weight, but it is not unusual for anorexia to develop into bulimia, i.e. binge eating that leads to deliberate vomiting of food (or even inducing diarrhoea, etc.).
"Since I was a kid, I stood out among the kids because of my fatness; my parents just indulged me, encouraged me to eat, told me that to be healthy and strong, I had to eat a lot. And so I ate. Even in elementary school, I was considered fat, and people laughed at me. When I sat down, my stomach rolled up so that it looked like there were three tires underneath me. But after I started high school, it started to escalate, and one day I was looking through photos and when I saw how I looked among my classmates in fifth grade - just like a giant barrel - I decided to do something about it," Roman, now 25, recalls how he started to develop anorexia nervosa. "Unfortunately, the way I was losing weight so quickly didn't turn out to be very good; I started cutting down on food so much that after a few months I collapsed and had to be rushed to hospital, where I was also diagnosed with anaemia. That was caused by my new regime. Of course, all the time I tried to pretend nothing was wrong. Because I was living on the intro, I managed to hide the fact that I was basically not eating well, and my parents therefore didn't suspect - I did lose a few kilos, but at the weight I was - over a hundred - it wasn't noticeable at all. But without food, the body refused to function. In the end, I was in the hospital for over two months and at first I denied there was anything wrong with me at all. I also tried not to eat food there, so I wouldn't get fat again, but they were used to the various practices of where to hide what," he adds, adding that when he was released from the hospital, he started going to therapy regularly and his parents also made an appointment with a nutritional therapist. "So, even though it took a lot of time from my point of view, in the end, I not only lost weight, but more importantly, I'm still fine today. In fact, as I tracked down all the information over time, I realised that I was really lucky that I caught everything early - even at the treatment I saw girls who were complete walking skeletons. And they've been there a few times. For me, I managed it quite calmly in the end, and today I exercise, do sports and follow a diet, but I would definitely never want to end up where I already was," he concludes.
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Male patients with anorexia nervosa, which Roman also suffered from, are found in 5-10% of all cases, while bulimia affects men slightly more often, in 10-15%. On the other hand, a large proportion (25-40%) of men also suffer from psychogenic binge eating, which is usually a reaction to stressful situations of various types. This can be, for example, sexual trauma, loss of a loved one, relationship problems, difficulties at school/work, etc. In practical terms, psychogenic overeating manifests itself in a jump in body weight, with which comes a feeling of low self-esteem, anxiety and often social isolation. Given that all types of eating disorders can build on each other and flow freely into one another, binge eating can eventually become bulimia (which is a 'solution' to weight gain due to binge eating).
An (un)healthy obsession
Although people classically associate eating disorders with diagnoses such as anorexia nervosa and bulimia nervosa, the fact is that in addition to the aforementioned binge eating, so-called bigorexia and orthorexia also fall into this category. While the former disorder mostly affects men - it is a psychological disorder where a person is literally obsessed with exercise and building muscle mass (and also with excessive steroid consumption) - the latter is the 'obsession of our time'. If one suffers from orthorexia, one is extremely focused on healthy eating. However, at least for the time being, neither of these disorders is as prevalent in the population as anorexia and bulimia. Regardless, though, it is clear that too much of anything is simply harmful. No matter how hard a person tries to lose weight, exercise extremely, or eat a healthy diet, it doesn't bring anything nice (let alone a nice body)...
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Treatment? A long run
Given that all types of eating disorders are psychological disorders, it is necessary to seek help primarily from psychiatry or specialised psychiatric centres that specialise in this area. The treatment itself often involves hospitalisation - where the primary focus is on restoring a standard diet, followed by psychotherapy and, not infrequently, family therapy - followed by long-term outpatient care. The latter should primarily help patients to change their thinking and outlook on their own bodies. Yet it has to be said that up to half of those who develop some form of PPP are treated repeatedly.
Also because eating disorders in particular are often downplayed as 'trying to lose weight', it is particularly important to emphasise that this is a serious so-called biologically influenced disease. Indeed, according to recent research, one of the causes could be the state of the gut microbiome, which affects the central nervous system and influences emotions, and it has already been shown that PPP patients perceive them differently from the healthy population. Last year, the world heard that anorexia nervosa could be genetic - a genetic mutation has been found in patients with the disease that causes the body to lose control over metabolic processes, so that the person can go hungry for longer. It is all this new research that offers hope not only for current patients, but also for those who have already had the disease but carry a lifelong threat of relapse.
