Identifying Signs: Body Image & Eating Disorders

0:00 [Music] 0:07 thank you 0:14 hi Dr Seema Segal how are you today I'm 0:18 very well rupali thank you for having me 0:21 so we were just talking before this call 0:24 about a very important topic and it's 0:26 been going on in the news a lot about 0:29 body image of a young person and even 0:33 like an older person so let's talk a 0:35 little bit about anorexia and the some 0:38 of the cultural implications and how 0:40 social media is aiding to it so tell me 0:44 all the secrecy that's being you know 0:46 people don't talk about it right being 0:48 thin is is a cool way to look right now 0:52 so tell me some of the signs and what 0:54 are the things to watch out for 0:56 sure 0:58 um you know you're absolutely right 0:59 rupali 1:00 um it is you know anorexia has been 1:03 around for a long time and you know if 1:05 you look at it historically right I 1:07 think there are early cases all the way 1:09 back to the Hellenistic era and then the 1:12 Victorian sort of image of you know 1:14 being very thin and that being looked on 1:17 uh positively by you know your family 1:20 and Society where you know you lived and 1:22 did business and unfortunately because 1:25 it is shrouded in so much uh secrecy 1:28 because unlike other mental health 1:30 issues 1:31 anorexia has not just the stigma from 1:34 society as such but there is a lot of 1:38 self-stigmatization the patients you 1:41 know themselves feels really terrible 1:44 about themselves their self-image their 1:47 sense of worthlessness and guilt and 1:50 they speak even less about it and so it 1:53 gets you know very little visibility 1:54 there is very little awareness 1:57 um you know about this disorder and if 2:01 you look at the definition it basically 2:03 encompasses three big aspects one is you 2:06 know restriction what we call 2:08 restriction of energy not necessarily 2:10 restriction of food because food is just 2:13 fuel for the body and so there is when 2:16 there is restriction of energy for the 2:18 body that is what you know causes the 2:20 downstream effects on the body itself 2:22 this is coupled with an intense fear of 2:26 gaining weight and along with that can 2:29 be associated with a disturbance in how 2:32 your body and shape is perceived and you 2:35 know there are 2:37 um many factors that come together you 2:40 know there are there's a lot of thought 2:42 in the field that it is actually a 2:46 developmental disorder which which 2:48 presents in a biological psychological 2:52 and social landscape so if you think 2:55 about it the highest incidence of where 2:57 it appears the most is between ages of 2:59 about 10 and 20. now you know 3:02 developmentally all of us have what we 3:05 call developmental tasks every child has 3:08 to navigate certain milestones in their 3:10 development in order to 3:13 um you know be sort of confident and 3:15 have a good sense of themselves so 3:18 during this period you know the major 3:20 developmental tasks if you think about 3:22 it are puberty 3:24 autonomy they're trying to become 3:26 autonomous and have a say in you know 3:29 what's happening to them and their body 3:30 and the choices they make and their 3:33 sense of identity 3:34 so you know with these three things 3:36 being sort of the primary goals there's 3:39 a lot of things that can come along and 3:42 disrupt this 3:44 now the disruption can be you know some 3:47 traumatic event in fact they say about 3:49 75 percent of people have experienced 3:52 some trauma at the onset of you know the 3:56 eating disorder taking off and the 3:58 trauma could be you know it doesn't have 4:01 to be something really big it could be 4:04 um just you know a different parenting 4:07 style than what the child needs it could 4:09 be some dysfunction in the family for an 4:12 athlete it could be you know suddenly 4:14 not being able to participate in their 4:16 you know favored athletic activity or a 4:19 gymnast hurting themselves and that 4:22 being taken away from them you know 4:24 something that disrupts their sense of 4:26 self or you have you know parenting 4:29 where it's an over controlling parenting 4:32 style where again the child is not able 4:34 to express uh their own sense of what 4:37 they want and need and then you know we 4:40 can't forget the cultural component of 4:42 what food means in different cultures 4:44 yeah now where for a lot of parents food 4:48 is how they show love and parenting to 4:51 the child and when the child is not 4:53 allowed to have a say or decide or 4:56 create for themselves their own 4:58 relationship with food it starts to sort 5:01 of you know go a different way 5:03 another thing that you know is important 5:05 to watch for is the type of 5:08 characteristics of the child themselves 5:11 you know the personality style so we 5:13 often see the children who are affected 5:16 by this tend to be more perfectionistic 5:18 they tend to be more anxious they tend 5:21 to be they tend to have OCD traits not 5:24 the full disorder but just traits 5:26 obsessive traits 5:28 um they tend to be what we call harm 5:31 aversive they like they don't like 5:33 taking risks so when you have a child 5:36 that is like this and then there is 5:39 superimposition of other factors in the 5:42 family you know the society and social 5:45 media also saying okay you know the 5:48 child feels for whatever reason the 5:51 trauma that has you know the child has 5:53 seen could be the death of a loved one 5:55 sometimes you know a death of a parent 5:57 precipitates it 5:59 or from something in the school of 6:01 friendships right absolutely you know 6:03 where you're bullied where you are not 6:06 uh you're not seen for who you are but 6:09 just the body in which you live and in 6:12 which you do business yeah so you know 6:14 for different reasons the child begins 6:16 to feel unsafe in their own body yeah to 6:19 try to distance themselves from their 6:21 body they find a way to express very 6:25 difficult complex emotions and food 6:27 becomes the easiest handiest most 6:30 available tool that gets weaponized yeah 6:34 and you know so they start to use the 6:36 food as a way of control as a way of 6:40 actually to their mind it makes total 6:43 logical sense that they withhold and 6:46 they you know use it as a way to express 6:48 these emotions and before you know it uh 6:52 it's getting it's getting to a point 6:54 where it starts to get dangerous and so 6:56 the important thing to remember is it is 6:58 a deadly disease with a very high 7:02 mortality and the patient is not your 7:05 enemy so the family and the patient have 7:08 to work together against the eating 7:10 disorder which is the enemy and it takes 7:13 a while to make that leap yeah so I 7:16 think that's a really good point that 7:17 you made right it's the family and the 7:19 loved one and the the support that you 7:21 have around what are the signs uh like 7:24 you know these kind of things happen in 7:26 a lot of isolation too right people do 7:28 it when they're living alone or so what 7:30 are the things that people can watch out 7:31 to help their loved one right and you 7:34 know that is really important because 7:35 awareness is everything so you know your 7:39 child right you know your child you know 7:41 their behavior you know what how they 7:43 normally eat what they normally do so if 7:46 you notice a sudden change in their 7:49 behavior in terms of their eating less 7:52 they're becoming more picky about what 7:54 they eat they don't want to eat in 7:56 public they want to eat in the secrecy 7:58 in isolation of their room they refuse 8:00 to go out for dinner 8:02 um you know in gatherings in restaurants 8:04 they are beginning to have these 8:07 patterns of eating where they must eat 8:09 this first or that verse you know that 8:11 rigidity is coming in they start to wear 8:14 loose clothes they start to have an as 8:17 the you know the weight loss and ask the 8:19 energy depletes from the body 8:22 different organ systems will begin to 8:25 manifest signs of that depletion so 8:28 there can be medical issues you know the 8:30 heart rate goes down they start to get 8:31 dizzy their you know brain isn't getting 8:34 enough uh fuel so you're starting you 8:37 know your concentration Focus your moods 8:39 are more irritable you're angry 8:42 there is a level of almost delusional 8:45 idea of your own starvation and that's 8:49 what makes it scary because they are not 8:52 able to there is such a disconnection 8:54 between who they feel they are as their 8:58 self and the body in which that self is 9:01 living so a lot of people say that you 9:03 know some describe the recovery from 9:05 anorexia as really connecting with this 9:09 lost identity 9:10 and so the signs you look for you know 9:12 other physical signs you have sort of 9:15 the you know other 9:17 um medical signs could be hair falling 9:19 out men situation that stops because you 9:22 know as different systems are shutting 9:25 down you start to see the manifestations 9:27 wow 9:29 and it's also like tied like you said a 9:32 lot to self-esteem 9:34 Etc right and so what are some of the 9:36 resources 9:37 um you know I think it's mostly for the 9:40 caregiver or a loved one to seek out to 9:43 so would you share some of that at the 9:45 end of the video definitely so we'll put 9:48 resources there are lots of you know 9:50 National agencies that uh have wonderful 9:53 resource pages and you know kovid has 9:56 been talk about trauma talk about that 9:59 perfect storm where 10:01 um you know for the anxious uh person 10:04 who loves the routine who loves 10:06 predictability came covered where uh 10:09 everything went out the window you know 10:11 there was no Surety about anything you 10:15 were anyway isolating you weren't going 10:16 out to get food you were trying to sort 10:18 of you know stick with what was at home 10:20 so the incidence of uh you know Eating 10:23 Disorders went up tremendously during 10:25 coven because of its uncertainty the 10:28 isolation unpredictability and ambiguity 10:30 that it brought and the other important 10:32 thing to remember that is not spoken 10:34 about is anorexia in men you know we 10:38 talk about it as just anorexia in women 10:41 and if you look at you know Fitness 10:43 magazines if you look at Fitness 10:45 magazines that are directed towards 10:47 young men or boys they talk about you 10:50 know having a muscular body in the body 10:52 shape whereas if you look at the women 10:55 it's all about diet and fungus and then 10:59 you know there are social constructs 11:01 like inspiration and you know words like 11:04 that that are sort of bandied about and 11:06 you know the the sort of 11:08 um you know social media and the 11:10 modeling of all these really really 11:13 wrong constructs that you are how you 11:15 look you are not what's inside you are 11:18 just how you look and the more thin you 11:21 can be the better it speaks for your 11:23 sense of discipline and control over you 11:25 know all aspects of your life so to just 11:28 you know word of caution that if you're 11:31 feeling that disconnected with aspects 11:34 of yourself sometimes we say you know 11:36 cultivate a good hobby put yourself out 11:39 there in a uh in a situation that you're 11:42 giving back to somebody to feel good 11:45 about yourself and really talking about 11:49 it I think the more we talk the easier 11:51 it gets to talk yeah 11:54 wow that is really educational thank you 11:56 so much Dr SEMA we will put the 11:59 resources and I think I love the thing 12:01 get a hobby right like where does it get 12:03 a life or mostly it is absolutely find 12:06 something that you love that you know uh 12:09 that talks to you that sings to you and 12:12 uh and treating yourself with kindness 12:15 and compassion that it's a very very 12:17 hard you know uh illness to go through 12:21 and nobody should go through this alone 12:23 that there are resources there are 12:25 people you can talk to there is help 12:27 that can be had and to reach out for 12:29 those 12:31 before we end this let me ask you if a 12:34 person realizes that they are in this 12:36 you know this trend 12:37 what is like should they be talking to 12:40 their psychiatrists the doctors like 12:42 what is the first line that they should 12:43 reach out to the first line I always say 12:46 is if you have a primary care doctor 12:48 talk to them if you have a parent that 12:51 you trust uh you know just like the uh 12:54 two stories that you had uploaded one of 12:56 them mentioned that her parents really 12:58 were the resource that sent her to 12:59 treatment that you know had her reclaim 13:02 her life so if you have a uh caregiver 13:05 that you trust that's often the first 13:08 you know place to go or your primary 13:10 care physician is a good starting point 13:13 because it is it does involve the entire 13:16 you know the whole family this is not a 13:18 journey that can be undertaken alone and 13:21 there is education to be done for the 13:23 family as well not just the patient but 13:26 the whole system in which the patient 13:28 lives 13:29 has to sort of mold and grow and learn 13:33 together so the family has to have 13:36 buy-in 13:37 great thank you so much Dr SEMA Segel 13:40 appreciate your time today you're 13:42 welcome thanks 13:58 foreign