© Hashim Badani
Wellness
It might be the season to celebrate, but it’s a complicated time for those who have disordered relationships with food, and their loved ones
Sure December is a time of twinkling lights, tinsel and cake. But from the point of view of someone with or recovering from an eating disorder, the situation can be different. A small and safe gathering of friends and/or family, primarily centred around a heaving table of food could be difficult to navigate and is probably not the joyous celebration it is for everyone else.
Social media has promoted our obsession with appearance, giving a platform to further narratives of the anti-feminist male gaze. Filters, tummy teas, waist trainers are the 21st-century versions of the corset to maintain the distorted view most of us have of our bodies. There are more people with a complicated relationship with food (usually a by-product of other underlying issues) than we think there are. According to a study of school children in India, 26.06 per cent of participants were likely to suffer from eating disorders “due to their abnormal eating attitudes”. Still, large-scale studies and research into eating disorders here are still rare, with conversations about it still on the down-low.
Conversations in pop culture, and through some celebrities have helped bring awareness to the prevalence of eating disorders. In season four of The Crown, Princess Diana's struggle with bulimia is discussed in detail. “I wanted you to see her experiencing it because she was so candid about her struggles with the media, which I think was incredibly ahead of her time," shared Emma Corrin, the actress who played Princess Diana on the show. Back in 2016, actor Richa Chaddha spoke about her struggles with it, suggesting that eating disorders were the “best-kept secret of the film industry."
It is important to identify an eating disorder to be able to talk about it. “It’s an umbrella term for anyone who has severe disturbances in patterns of eating,” explains psychologist and counselling psychologist Tanya Percy Vasunia. “They are obsessed with body weight and structure, with their appearance. And it’s more common than we acknowledge, leading to anxiety and depression.” Anorexia, bulimia and binge eating are the better known in this disorder. “A person with anorexia has a propensity to miss meals, go on an extremely restrictive diet, unhealthy diet, obsesses with thinness, weight, food, and has irregular eating patterns or/and rituals. In the form of bingeing, or overeating, bulimia introduces itself, accompanied by purging, either by induced/forceful vomiting or by laxatives,” elaborates psychologist and psychotherapist Shwetambara Sabharwal. Through the festive season, which brings a particular emphasis on food, this relationship gets even more strained.
Psychotherapy is a cornerstone to treat this concern. “The following evidence-based therapies would be offered alone or in combinations: Family-based therapy, cognitive behavioural therapy and interpersonal therapy," says Sabharwal. Psychotherapy also needs to work with medical markers—this is a multi-prong approach to healing. A patient’s medical progress needs to be monitored by experts as well as family or loved ones. Recognising, acknowledging, diagnosing, and seeking treatment is a complicated process and one that also needs a healthy support structure of professionals, family and friends. To help navigate this as someone who suffers from an eating disorder, as well as someone who is supporting such a person, here are a few guidelines as suggested by the psychologists we spoke to.
You must make yourself a priority. This means seeking help at the right time. “Timely intervention and therapy is key to arresting the progressions of the disease,” says Sabharwal. This also extends to caregivers, people around the one suffering who are building a supportive structure for them. It’s a demanding and emotionally draining process that can be taxing.
Sabharwal suggests the following plan for both caregiver/host and patient: “Try to make a meal plan that is mutually agreeable. Plus, agree that portion sizes, calories or the fat content of the meal will not be addressed by either of you. You can devise a sign or code that your buddy can remind you with to try and shift focus or switch to a calming breathing exercise. During mealtimes, try not to dwell too much on the food. Attempt to converse around light-hearted topics that are not related.”
The festive season also extends to shopping for new outfits—also a triggering activity for people with an eating disorder. It’s so enmeshed around physical appearance, that it’s not surprising that stores with different sizing policies can not only be misleading but also detrimental or challenging patients suffering from an eating disorder. Understand that these are not natural sizes. Size is fluid, as should your approach be. Different sizes will have different sizing policies, and within those, there will be different styles that will fit differently regardless of what size is stamped on the label.
If as a patient you find yourself at the receiving end of difficult questions or comments, take a deep breath and ‘reclaim your power’. So much about eating disorders is about control, says Vasunia, so having a way to deal with awkward or uncomfortable conversations around food on the dinner table is key. “Depending on your equation with who you're with, you can have a rational comeback to a question by preparing responses ahead of time. You can say that you're uncomfortable talking about food or weight if you feel able to, or you can stay silent because that is a response too," she confirmed.
This is a difficult journey and one of the best ways to make it easier is by gathering around you people who love you and who you trust. “Choose friends that support you and lift you up instead of trample on your goals. If your friends are supportive, they will automatically have no trouble respecting your wishes and boundaries. A little assertiveness never hurt anyone. If you have friends who force, ridicule or impose—be assertive and state your expectations. At the same time requesting support and cooperation works,” says Sabharwal.
Decide what health looks like to you—physically and mentally. They are inseparable. Understand that the visual representation of the world does not take into account actual human experience. It can be a struggle to survive within it, and with eating disorders getting more and more common every day, it’s a struggle that needs more attention. “We need to encourage difficult conversations,” says Vasunia. “In India, more or less anything under the realm of mental health is often misunderstood, neglected, feared, denied or brushed under the carpet,” says Sabharwal. “However, times are changing," she says, explaining that when adolescents or children with eating disorders are treated by a pro early, they are able to learn how to evaluate their thoughts about their weight, shape and self-image, work on reducing triggers and regulate emotions.
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