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We often hear comments from friends and family about weight gain or loss, but what is often not covered in these conversations are disordered eating, and what it may look like if you are struggling with food.

Eating disorders are often unexamined and ignored in Ethiopian and Eritrean communities but is important to know that eating disorders can be treated.

What are Eating Disorders?

Eating disorders are behavioral conditions and are distinguished by a person experiencing a long-lasting disturbance in eating patterns, as well as thoughts and emotions that cause distress (Guarda, 2021). An eating disorder is an12 umbrella term that includes:

  • Anorexia Nervosa (AN)
  • Bulimia Nervosa (BN)
  • Orthorexia
  • Binge Eating Disorder (BED)
  • Avoidance Restrictive Food Intake Disorder (ARFID)
  • Pica
  • Rumination Disorder
  • Compulsive Exercise
  • Laxative Abuse

Historically, there has been a perception that eating disorders are issues affecting young white women of upper socioeconomic backgrounds in the West, though studies conducted in recent years show the existence and rise of eating disorders in Ethiopian and Eritrean communities back home and abroad (Shem-Tov et al., 2018).

Risk Factors

11In a scientific study by researchers at Gondar University on the disordered eating attitudes of teens aged 12-19 in Addis Ababa, they found that a significant number of adolescents were found to be at risk of developing disordered eating attitudes (Yirga et al., 2016).

One factor that could put our communities at risk is migration. Immigration, particularly from a non-Western nation to a Western nation, is a life event that can significantly increase the risk of psychological distress and mental disorders in individuals who have experienced extreme hardship and/or trauma (Shem-Tov et al., 2018).

Symptoms and What to Look Out For

Eating disorders can lead to a variety of risk factors that can affect physical, psychological, and social functions. If you are concerned that you have been experiencing some disordered eating patterns, here is what to look out for:

Anorexia Nervosa

  • Eating very little, sometimes to the point of extreme hunger
  • Being restrictive about the foods you will eat and/or becoming more restrictive over time
  • Over-exercising and spending increased time working out
  • The use of diet pills and/or laxatives
  • Denial of hunger
  • Significant weight loss that cannot be explained reasonably
  • Avoiding social occasions and mealtimes to avoid situations involving food

Bulimia Nervosa

A person who is experiencing bulimia nervosa eats, however, will follow with the act of purging (which is the act of vomiting to remove food out of the body so that the food has no effect on the body). Some symptoms include:

  • A cycle of uncontrollable binge-eating/over-eating followed by the act of purging
  • Making oneself vomit or overusing laxatives or diet pills
  • Excessive exercising and dieting
  • Extreme concern about body weight

Orthorexia

Orthorexia is an obsession with “healthy” eating, and those who experience this disorder are fixated on maintaining a healthy diet, which may actually lead to damaged health.

  • Obsessively checking nutrition labels and ingredients on food packaging
  • Unable to eat foods outside of what has been considered “healthy” or “pure”
  • Cutting out food groups from your diet (for example, cutting out all dairy, cutting out all sugars)
  • Showing signs of being distressed if “healthy” or “safe” foods are not accessible
  • Spending significant amounts of time per day thinking about what food may be provided at a future event

Binge Eating Disorder

  • Eating more quickly than you usually do
  • Eating until you are uncomfortably full
  • Eating large amounts of food even though you are not hungry
  • Feeling embarrassed by how much you eat, so opting to eat alone
  • Feelings of being depressed, guilty, and/or disgusted with yourself

ARFID

  • Avoidance or restricting food intake, making the person eat less than what is enough for their daily calories and nutrients
  • Eating habits that are interfering with your social life, such as sharing meals with others
  • Poor development or weight loss for your age or height
  • Nutrient deficiencies leading to dependence on either supplements or tube feeding

Pica

A person experiencing Pica will crave eating things that are not food, such as dirt, soil, chalk, pebbles, hair, or laundry detergent, and will regularly eat non-food items (Holm, 2019).

For the behavior to be diagnosed as Pica, the individual must be consuming non-food items for at least one month (Holm, 2019).

Rumination Disorder

This disorder is newly recognized and describes a condition where an individual regurgitates the food that they had already chewed and swallowed, re-chewing it, and then spitting it out or swallowing it. This process of regurgitating food usually happens between 30 minutes to 2 hours after eating (Vandergriendt, 2018).

Individuals experiencing rumination disorder often regurgitate their food after almost every meal, every day (Vandergriendt, 2018).

Compulsive Exercise

  • Engaging in exercise at inappropriate times and locations, that may interfere with other things one must do in their day-to-day lives
  • Exercising despite medical issues or injury
  • Feeling uncomfortable with resting
  • Exercising in secrete or hiding exercising from others
  • Using exercise as a way of purging or getting rid of calories

Laxative Abuse

Laxative abuse occurs when one tries to either lose weight or burn calories through frequent laxative use (National Eating Disorders Association, 2021).

It is often associated with body dysmorphia, anorexia nervosa, and/or bulimia nervosa. Approximately 56% of females who experience eating disorders engage in laxative abuse between the ages of 14 to 19 (Murray, 2020).

How To Get Help

So, what should you do if you recognize some of these behaviors?

Firstly, it’s important to remember that there is nothing to be ashamed of and that there are options for you to improve the issue. Eating disorders are quite common, with an estimated 1 million Canadians experiencing a form of eating disorders, so you are not alone. They can affect people of any background, ethnicity, sexual orientation, age, or socioeconomic background.

Eating disorders can be difficult to understand due to their complex nature. The first step you can take to find help with dealing with an eating disorder is to contact your family doctor, iIf you do not have a family doctor, visit a walk-in clinic. Your doctor will direct you to the right specialists and/or nutritional experts for your specific case.

Eating disorders can be treated, and although it may not be discussed often within Ethiopian or Eritrean communities, you are not alone. If you feel like you are experiencing symptoms, do not be afraid to reach out for help!

 

Resources

Find a Family Doctor or Nurse Practitioner, Ontario

Register for Health Care Connect and be matched with a Doctor in your area, click here

Mental Health Directory of Ethiopian and Eritrean Therapists and Psychiatrists in Canada. 

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References

Guarda, A. (2021). What are eating disorders? Home │ psychiatry.org. https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders

Holm, G. (2019, August 2). Everything you need to know about pica. Healthline. https://www.healthline.com/health/pica#outlook

Murray, K. (2020, September 18). Laxative abuse. Addiction Center. https://www.addictioncenter.com/drugs/laxative-abuse/

National Eating Disorders Association. (2018, February 21). Compulsive Exercisehttps://www.nationaleatingdisorders.org/learn/general-information/compulsive-exercise

National Initiative for Eating Disorders. (2020). Eating disorders in Canada. NIED. https://nied.ca/about-eating-disorders-in-canada/

National Eating Disorders Association. (2021). Laxative Abusehttps://www.nationaleatingdisorders.org/learn/general-information/laxative-abuse

National Eating Disorders Association. (2021). Orthorexiahttps://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/orthorexia

Petre, A. (2019, October 30). Learn about 6 common types of eating disorders and their symptoms. Healthline. https://www.healthline.com/nutrition/common-eating-disorders#anorexia

Shem-Tov, R. G., Zubery, E., Hecht, N. L., & Latzer, Y. (2018). Isr J Psychiatry. “A Full Stomach”: Culturally Sensitive Diagnosis of Eating Disorders among Ethiopian Adolescents in Israel, 55(2). https://cdn.doctorsonly.co.il/2018/10/06_A-Full-Stomach.pdf

Vandergriendt, C. (2018, September 18). Rumination disorder: Treatment in children vs. adults, and more. Healthline. https://www.healthline.com/health/rumination-disorder

Yirga, B., Assefa Gelaw, Y., Derso, T., & Wassie, M. M. (2016). Disordered eating attitude and associated factors among high school adolescents aged 12–19 years in Addis Ababa, Ethiopia: A cross-sectional study. BMC Research Notes, 9(1). https://doi.org/10.1186/s13104-016-2318-6

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