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