2024-02-05 13:58:08
by Anna Fregonara
The only way to get out of these pathologies is to get help to recover, little by little, the awareness of what is happening
It’s called the honeymoon: the moment in which those suffering from anorexia are satisfied with how they have controlled their diet for a few weeks because they are able to eat less, train constantly and lose weight.
Psychology
Those around notice it (Damn, how you’ve lost weight!) and the feeling of someone on a honeymoon is clear: I’ve found the solution: I feel strong, efficient and, above all, control depends only on my will. But eating disorders are never a question of willpower. The myth of the will that heals diseases is a simplistic and always painful concept for those suffering from an eating disorder, begins Stefano Erzegovesi, nutritionist and psychiatrist, expert in preventive nutrition and eating disorders, author of the new book One bite at a time (Mondadori) , in which he takes the reader by the hand to explain a way to help himself but not a way to cure himself independently.
Opposing forces
Eating disorders are the manifestation of opposing forces. On the one hand the desire to control oneself and what one eats, not realizing that the more one uses control, the more one is driven to use it; the result is being dominated by fixed and recurring thoughts about food, weight and the body, through a mechanism that self-feeds in a circular manner. On the other hand, the force of survival biology which, at any cost, wants to save the subject from extinction and, consequently, raises alert levels, in turn making the thought of food become even stronger. These forces fight each other and, depending on who wins, combine into anorexia nervosa and bulimia nervosa, which often intersect as two phases of the same disease, and into binge-eating disorder (Bed) in which one tries to stay on a diet, but eat without control. The solution to these problems must never start from a sense of guilt, because eating disorders are no one’s fault.
Because it is essential to get help
The problem is that the brain is functioning badly and the only way to get out of these pathologies, which always have a multifactorial origin, is to get help to recover, little by little, the awareness of what is happening. Just like what happens to the gambler who, in order to relive the thrill of the bet, becomes completely insensitive to the consequence of being left broke. The key is to counteract the obsession with food: you don’t need willpower but you need a lot of care, patience, love and a bit of “architecture” to reorganize your daily habits, starting from the plate you eat from, continues the ‘expert. Thanks to the teamwork of the doctor, the nutritionist, the psychologist and those close to us, we feel guided to understand, for example, that a minimum amount of good fats, which are scary because they are caloric like those of extra virgin olive oil or of dried fruit, are essential for keeping cell membranes in perfect shape, especially those of the most important cells in our life, namely the brain. Obviously, the approach changes depending on the disorder: if those suffering from anorexia have to limit fibre, for example by excess vegetables, in those suffering from obesity or Bed, fiber is fundamental.
Obsession takes away freedom
However, there remains a common element to be treated in all eating disorders: the trap of obsession which takes away the most important thing in life: the freedom to choose. When, during the course of treatment for anorexia, the obsession begins to loosen its grip, the daily search for freedom can help a lot: freedom to go out with a loved one and at the beginning have even just a freshly squeezed juice which, over time , it will become an ice cream. If you suffer from Bed, freedom will be equally important, because eating abundantly, solitarily, confusedly and hastily is not a way of being free, but of following the obsession of loss of control and emotional hunger. In both cases you will begin to appreciate the freedom to choose what to eat by listening to your internal needs.
Relatives and friends can do a lot
Parents, but also siblings, friends, grandparents, school teachers, coaches, spiritual fathers: the people closest to those suffering from an eating disorder have a fundamental role in weaving, with love and patience, a protection network. At the beginning you will argue with the kids and discuss through trial and error but, over time, you will learn to personalize the topics and techniques that can help them recognize and overcome a problem. For example, the blaming phrases “Realize how thin you are” or “Stop bingeing” should be avoided. it is more effective to shift the focus and opt for expressions like “Let’s do something about this feeling of cold that never leaves you” or “Let’s do something about these mood swings”. There is no need to raise the fear of negative consequences to motivate people to change habits. Another piece of advice is to use a tone that is as least judgmental as possible and express yourself in the first person (“I am observing that…”), because the “you” (“you don’t eat”) can sound accusatory.
I social media
I look at my wounds and say to myself: today it shouldn’t have gone like this, I shouldn’t have vomited, I shouldn’t have hit myself, I shouldn’t even cut myself and I shouldn’t have turned my sadness into anger. The book Social hunger (Il Pensiero Scientifico Editore) opens with this story from Camilla, 15 years old, by Laura Dalla Ragione, director of the Uoc Nutrition and eating disorders of the Local Health Authority 1 of Umbria, and Raffaela Vanzetta, director in Bolzano of a Center for the prevention of nutrition and eating disorders.
There are over three million adolescents in Italy who suffer from eating and nutrition disorders (Dan), with a 30% increase after the pandemic. These data are underestimated, because many patients do not receive treatment because they are not motivated for treatment and due to the lack of specialized structures in many regions, says Laura Dalla Ragione. Social media has had a big impact because the main topics discussed online are body image and nutrition. The photos posted, often unreal because they have been modified, become models to imitate, they become elements of frustration for young people who are looking for their own identity and affirmation.
Today, for Dans, a digital medical history is always taken to understand what online information the young person has been exposed to. The new challenge is understanding how to intervene in a world that is impossible without its digital dimension and in which, it must be recognized, social media can also be a resource, such as when they become a place of aggregation around a common cause. To learn to defend yourself in a critical way, I recommend including digital literacy, which also includes emotional literacy, as a school subject starting from middle school. Even before that, however, we need to literate the relevant educational figures: parents, teachers, sports coaches, doctors. The first step to combat risk factors is to avoid two positions: criminalizing social media and minimizing its impact, two mistakes that adults often make.
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February 5, 2024 (modified February 5, 2024 | 2:56 pm)
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