The eating disorders (ED) are more common in women (9 out of 10 cases occur in them) and their prevalence is higher in teenagersalthough more and more cases are affecting men and also older people. As warned by the president of the Spanish Federation of Associations to Help and Fight Anorexia and Bulimia (Feacab), Carmen Galindo, who has seen cases in women up to 60 years old, “This is not a whim of a girl who wants to be a model”.
This Friday and this Saturday, the Niño Jesús Children’s University Hospital in Madrid hosts the XII National Congress of TCA Associationsorganized by Feacab, in which, among other issues, disorders will be addressed underdiagnosed. Almost 40% of women who suffer from this disease state that they have not been diagnosed and 70% are not receiving any type of treatmentaccording to a study presented this Tuesday and carried out by the Ministry of Equality with 660 women between 18 and 30 years old who suffer or have suffered from an eating disorder. One day before the start of the congress, Galindo attends to 20 minutes to delve into this mental illness that requires “multidisciplinary treatment.”
Eating disorders mainly affect women, but also men and this percentage is increasing. Have you identified the why?Of all patients with eating disorders, only 1% were men. Now maybe a little more, but the majority are still women. In men, it increases slightly due to the proliferation of body worship in them as well, and this sometimes leads to the development of an eating disorder.
Why has it always affected women more?We have always been sold the idea that women have to be tall, blonde, young, thin… There are impossible sizes that not everyone can fit into. All this pressure, to which is now added that women have to have a good professional career, has not been exerted on men. We have to accept the body as we have it.
Is the cause always the non-acceptance of body image or are there other biological and personality factors?There are many genetic, biological, social factors… there are many. Whoever has that sum of factors, it can affect them. Personality can lead to the development of an eating disorder, which is a mental illness.
What are the keys to accepting our physique?We have to be happy with ourselves, accept ourselves as we are, with our virtues and our defects. Perfection does not exist, we cannot seek perfection in anything because it does not exist. We are as we are and that does not mean we are going to be better or worse than the person next to us. The problem of many patients who have an eating disorder is self-esteem: they do not value themselves, they do not love themselves… That is what mental illness gives them.
What measures would help social acceptance of a diversity of bodies, to break this stereotype that the thin woman is the most beautiful?In 2011, from the associations and the IMA foundation, which is a foundation dedicated to the study of image and self-esteem, we carried out the Not finding your size can make you sick. One of the basic guidelines is not to label anyone by the size they wear. A young girl who is 1.80 cannot dress the same as someone who is 1.60 and whose bone structure is different. That has already changed, in part, with some fashion stores. But they are still there hammering comments about the physical appearance of others, congratulations for losing weight, expressions like ‘bikini operation’ or slimming products. We have to continue working and thinking that each person is as they are and they have to accept themselves as they are. If we were all the same, it would be very boring.
Isn’t it appropriate to comment on other people’s bodies?No, better not. There are cases of 9 and 10 year old children who are rounder and then grow up. It is absurd to have said ‘how fat he is, what a gut he has’. And for girls, when they develop, their bodies change completely.
What age group do eating disorders affect most?They affect all ages. Girls and boys from 9 and 10 years old to 18-20, but then from 18 to 30-something there are many women and there are also men. Even at 40. This week, during the Congress of the Spanish Association for the Study of Eating Disorders, a case of a 70-year-old woman in the process of retirement was discussed and experiencing that situation caused her to develop a disorder. of food. This gives us an idea that this is not a whim of a girl who wants to be a model, this is a mental illness and you cannot control your head.
What are the youngest ages you see?Doctors tell us that the youngest cases are between eight and nine years old.
What signs should families watch out for?In these cases of small children, when they normally eat everything and, suddenly, they begin to reject certain foods, to say ‘I don’t feel like it’ or that something ‘feels bad’, or to worry about the coating on the croquettes… If they ate very well and suddenly start doing strange things with their food, let’s be on guard and consult with the pediatrician.
Could you give me an example of a good preventive action?Preventive action in schools is essential. We do workshops with specialists who never talk about illness to teenagers. They are talked about self-esteem, good consumer habits, and the false myths of advertising. In the end, what we do is enhance ‘I like who I am’. We work with examples of Photoshop retouching in magazines, seeing the real image and the published one, with images of albino models… That works, we have been doing it for many years. It is also important that teachers are trained and help Primary Care doctors so that they can refer quickly when necessary.
Many women, because they do sports, are healthy and, in theory, they eat healthy, it is hidden. However, then you give them a survey and they have textbook anorexia.”
How do they affect social networks?A lot. Because they have no control. Adolescents are formed, but only half-formed, and whatever a man or woman does influencer Those who follow can be influenced and cause great harm. The networks, especially during the pandemic, have caused cases to increase. It is also true that they can be used to help and can have a positive effect.
According to a recent study by the Ministry of Equality, 70% of women with eating disorders are not treated. Because?Many women, mainly older, eat anything in the office, such as a lettuce salad, because they say they are on a diet and do not believe they have an eating disorder. These are cases that also do a lot of exercise. Since they do sports, they are healthy and, in theory, they eat healthy, it is hidden. However, then you give them a survey and you get textbook anorexia.
One of the conference talks addresses underdiagnosed disorders. What are those?For example, binge eating disorder. There are many nonspecific eating disorders and of those, many in adults. We, as family members, wanted them to tell us precisely what to be alert about and how we can help these people to get treatment.
What does the treatment consist of?Treatment is always better when it is carried out by a multidisciplinary team that includes doctors, psychologists, nursing staff, which is essential, an occupational therapist and a physiotherapist, since there are times when patients need it due to inactivity or a lot of activity. That is the ideal.
And how long does it usually last?It depends on the patient. In a process in which everything goes well, three to five years. The one that is mild and has to go to the doctor every 15 days, then every month and then it ends. For those who need hospitalization, which is the one who needs all that interdisciplinary team, it can be ten years or it can be for life.
Currently they continue to die, that is not hidden, but the cure rate is now higher, although it depends on the patients.”
What is the cure percentage?There is more and more cure. Firstly, because they are caught more in time, there is more and more information and people are more alert, so they are treated earlier and cured more. When we started Feacab back in 1999, they told you about a 40-50% cure rate, a certain percentage that remained chronic, and a lower percentage that died. Currently they continue to die, that is not hidden, but the healing rate is now higher, although it all depends on the patients. But there are many who are cured and have forgotten it, they are mothers and are delighted with life.
And after the cure, what is it like to return to normal life?At the congress, Adaner Madrid will present a rehabilitation program for adolescents outside the medical field. We in Aragón do workshops, for example, we take them to the Aragonese Youth Institute to see all the workshops that are held, activities that help them to join normal life outside the hospital. We also organize relaxation sessions or any type of activity that ends up bringing them out of that shell in which they are stuck, in which they are thinking about their illness all the time.
Is it very hard to lead a normal life, to get out of that shell?It is very hard, very hard, to live with the disease. Because it’s a constant struggle in your head thinking ‘this I will do, this I won’t do’. Imagine that you have to spend all day thinking about constant decisions that you have to make at every moment. That one day, another day, another day… implies a lot of suffering. Freeing yourself from this suffering, from having your head somewhere other than ‘if I ate this, I will have to burn so much, if I have rested, I will have to do I don’t know what’, which generates a lot of anguish, anxiety. and suffering, helps them get out. If you find another activity for them that breaks with that (although for that they have to be in treatment and fairly well), it helps them see that there is life outside of the disease.
How to approach the topic with a person with ED who does not recognize it?It is very difficult, and in adults, more so. We have to work with them, so that they see that they really have a problem, that what is happening to them is not normal and affects the development of their daily life and that, by asking for help, they can improve and that anguish and fears can be overcome. go passing That involves a lot of work with a family therapist or a social worker with a clinical specialty to convince them that what they need is a specific treatment for that anxiety they have, that ‘lack of appetite’ or ‘stomach pain’ that changes them a lot. the character and they can’t stand it. Sometimes they have to spend a year working with them until they are convinced to go to a specific unit and, when they go, they say ‘I’m not going to come back’ because they are told what they don’t want to hear. And we must continue working so that they continue going and do not miss the treatment. It’s complicated.
