Do not be thin-spired

Once upon a time, there was a beautiful little girl who lived next door to me. Her long, sleek hair was the envy of the neighbourhood. Her dimpled chin, almond-shaped eyes, were desired by all. As she grew up, her cheeks swiftly lost what they called was ‘baby fat’ and her hair lost the shine, which was promptly blamed on the hair products. It was only when they carried her away to the morgue, four days short of her 15^th birthday that they saw the culprit lurking. Anorexia is a Machiavellian villain.

The condition

Anorexia nervosa is an eating disorder characterised by intense fear of putting on weight, refusal to maintain a healthy body weight, and a distorted body image. With mainstream actors and actresses striving to attain the perfect body (read stick-thin), it is only natural that this idea percolates down to your pre-teens and teens. Much more prevalent in girls than boys, anorexia is of two types – the restricting anorexia, in which weight loss is achieved by restricting calories, and purging anorexia, in which when forced to have food, the affected person would attain the drastic results by vomiting or using laxatives or diuretics. Your girl prodigy might wish to explore the moon, fight for her country, etc. but would want to do all this while being thin and what she construes as beautiful.

Prevalence in India

Parents might think Indian children are not prone to eating disorders. From both the genders, a recent study has shown that the incidence of anorexia nervosa is 10-20 times higher in females. According to a research conducted by the Journal of Clinical and Diagnostic Research, in the age group of 15-19 years, 47% girls and 58% boys were thin, 56% girls and 30% boys are anaemic, which is some cases might lead to anorexia. Dr Ganesh Lokhande of Vedicure Vikroli hospital in Mumbai, says, “Teens tend to overlook the fact that they have an increased nutritional requirements, which demand a diet rich in vitamins, iodine, phosphorus and iron, and are highly prone to body dissatisfaction and depression.” Such statistics indicate that the youth in India have been struck by the thin bug and will do everything in their power to achieve their desire, he adds. Due to the diet consciousness in teens, the ‘health food’ sector is expected to grow at a Compound Annual Growth Rate of 20% in 2015.

The warning signs

There is no single test to determine whether your child is undergoing an eating disorder. The visible effects on the health are many, if parents pay attention. Has your 11-year-old been terming carbohydrates and fat as ‘bad food’ or dieting in spite of being thin? Did you come across a calorie-recording book in your teen’s room or have you been worried about her obsessive need to exercise and lose much more than she eats? This is exactly when you should feel the alarm bells going off in your head. Dr Dharini Krishnan, a Chennai-based dietician describes a 12-year-old who used to have half a cup of milk and then swim for two hours to burn it off. “Picking on food is the first sign parent should look out for,” advices Dr Krishnan. Teens generally fight foot and nail before accepting that they have a problem. An attempt to cover-up anorexia is lying or pretending to have eaten before, and avoiding having food in public places. In addition to this, you can also look out for signs such as thinning hair, shallow cheeks, and an introverted attempt to consider the mirror a foe in your child.

The reasons and the risks

With most pre-teens and teens embracing the philosophy of being thin, the fine line between being skinny and being anorexic is crossed swiftly and dangerously. There are no simple answers or causes of anorexia. The reasons might range from family environment and emotional difficulties to low self-esteem. Another reason is the faulty image propagated by the actresses and media, nowadays. Dr Krishnan says, “These images, though not realistic, latch on to the brains of these young gullible girls and force them to degrade their body.” 14-year-old Isha (name changed) got caught in the tentacles of anorexia due to low self-esteem, thanks to the frequent taunts of her friends for being on the chubby side. Sumathi Chandrashekharan, the clinical psychologist who helped the teen overcome the disorder, says: “Whenever Isha tried to talk to her mother about the taunts at school, she did not listen. The empathy or support was not there, neither was the acceptance or approval.” The risks associated with anorexia are many and varied – everything from anaemia to a compromised immune system to kidney failures and finally death.

Let your child get over it

If you see that your child is being picky about what she eats or is deliberately avoiding food, find out where the issue lies. “Most parent have a tendency to shout at their children or force-feed them the moment they realise that their children is not eating properly,” rues Dr Krishnan. The primary thing parent need to do is to bring the child to a doctor who can figure out what is wrong, she adds. Chandrashekharan says the action should be immediate and swift. “Parents have to understand that children might have problems outside home and if this is not discussed and resolved, can lead to their confidence and dignity being affected,” she says. The affected child might have to seek medical help if she is dangerously malnourished. Once she is out of danger, she needs to meet a nutritionist who will help her chart out plans to maintain health and nutrition. Counselling, that too not just one, but many (depending on how deeply the child has been affected by the disorder) have to be undergone by both the patient and the family. “Non-judgemental support and understanding is what the child needs now and craves for. If she finds that her family is always present as her support system, it will be easier for her to recover,” advices Dr Krishnan. Adding to this, Chandrashekharan says, “Empathise with your teen and let her know that what matters is the person that she is and not whether she is thin or fat.” One area that parents need to look out for is a relapse after the child recovers from a bout of anorexia. Talking about Isha, Chandrashekharan mentions how after the prescribed number of sessions, she or her parents never came back. “A follow-up must be done to ensure that the child does not fall into the trap again.”

If your child is diagnosed with anorexia, then be prepared for a long and difficult road ahead to recovery. But, fret not. The only thing the journey needs is support and encouragement from the family. Boost your child’s mind to understand that body images do not matter and help her discover herself positively.