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Eating disorder- Bulimia Nervosa

A person with bulimia has not made a “lifestyle choice”, they are actually very unwell and need help.
The reasons for developing Bulimia will differ from person to person; known causes include genetic predisposition and a combination of environmental, social and cultural factors.
Bulimia is characterised by repeated episodes of binge eating followed by compensatory behaviour. In addition, people with bulimia place an excessive emphasis on body shape or weight in their self-evaluation. This can lead to the person’s sense of self-esteem and self-worth being wholly defined by the way they look.
A person with Bulimia can become lost in a dangerous cycle of eating out of control and attempts to compensate which can lead to feelings of shame, guilt and disgust. These behaviours can become more compulsive and uncontrollable over time, and lead to an obsession with food, thoughts about eating (or not eating), weight loss, dieting and body image.
These behaviours are often concealed and people with Bulimia can go to great lengths to keep their eating and exercise habits secret. As a result, Bulimia can often go undetected for a long period of time.
Many people with Bulimia experience weight fluctuations and do not lose weight; they can remain in the normal weight range, be slightly underweight, or may even gain weight.

What are the warning signs of Bulimia?

Having awareness about Bulimia and its warning signs and symptoms can make a marked difference to the severity and duration of the illness. Seeking help at the first warning sign is much more effective than waiting until the illness is in full swing. If you or someone you know is exhibiting some or a combination of these signs it is vital to seek help and support as soon as possible.

The warning signs of Bulimia can be physical, psychological and behavioral. It is possible for someone with Bulimia to display a combination of these symptoms.

Physical signs:

Frequent changes in weight (loss or gains)
Signs of damage due to vomiting including swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath
Feeling bloated, constipated or developing intolerances to food
Loss of or disturbance of menstrual periods in girls and women
Fainting or dizziness
Feeling tired and not sleeping well

Psychological Signs:

Preoccupation with eating, food, body shape and weight
Sensitivity to comments relating to food, weight, body shape or exercise
Low self-esteem and feelings of shame, self-loathing or guilt, particularly after eating
Having a distorted body image (e.g. seeing themselves as overweight even if they are in a healthy weight range for their age and height)
Obsession with food and need for control
Depression, anxiety or irritability
Extreme body dissatisfaction

Behavioral Signs

Evidence of binge eating (e.g. disappearance or hoarding of food)
Vomiting or using laxatives, enemas, appetite suppressants or diuretics
Eating in private and avoiding meals with other people
Anti-social behaviour, spending more and more time alone
Repetitive or obsessive behaviours relating to body shape and weight (e.g. weighing themselves repeatedly, looking in the mirror obsessively and pinching waist or wrists)
Secretive behaviour around food (e.g. saying they have eaten when they haven’t, hiding uneaten food in their rooms)
Compulsive or excessive exercising (e.g. exercising in bad weather, continuing to exercise when sick or injured, and experiencing distress if exercise is not possible)
Dieting behaviour (e.g. fasting, counting calories/kilojoules, avoiding food groups such as fats and carbohydrates)
Frequent trips to the bathroom during or shortly after meals which could be evidence of vomiting or laxative use
Erratic behaviour (e.g. spending large amounts of money on food)
Self harm, substance abuse or suicide attempts

What are the risks associated with Bulimia?

The risks associated with Bulimia are severe. People with Bulimia may experience:

Chronic sore throat, indigestion, heartburn and reflux
Inflammation and rupture of the esophagus and stomach from frequent vomiting
Stomach and intestinal ulcers
Chronic irregular bowel movements, constipation and/or diarrhea due to deliberate misuse of laxatives
Osteoporosis– a condition that leads to bones becoming fragile and easily fractured
Loss of or disturbance of menstrual periods in girls and women
Increased risk of infertility in men and women
Irregular or slow heart beat which can lead to an increased risk of heart failure

Treatment
What Is the Treatment for Bulimia?
The primary treatment for bulimia often combines psychotherapy,antidepressants, and nutritional counseling. It is helpful to find a psychologist or psychiatrist experienced in dealing with eating disorders. The same is true for nutritional counseling, whether the patient sees the family doctor or another health professional.
Clinics that specialize in eating disorders can often provide psychiatrists, psychotherapists, and nutritionists. All therapists involved should work in close cooperation with one another.
Therapies to be considered for the treatment of Bulimia Nervosa include:

Psychological Treatments
Evidence-based self-help programs
Cognitive behavioral therapy for Bulimia Nervosa
Interpersonal psychotherapy
Maudsley family-based treatment (for children and adolescents)
Dialectical behaviour therapy
Guided imagery
Crisis intervention
Stress management

Psychology and Food

- By Nidhi Jindal

Why do we get hungry at regular times during the day even we don’t even see or smell food?

The reason may be another hormone of interest to researchers called Grehlin. It is the powerful appetite stimulator. Under normal circumstances, grehlin levels rise before a meal and go down after we have eaten. When grehlin is injected into human volunteers, it makes them very hungry. This suggests that grehlin is a key part of the appetite control system. People with a rare condition called Prader-Willi syndrome have chromosomal abnormalities that create many problems, one of which is very high levels of grehlin. Sufferers are extremely obese and often die before 30 from obesity-related causes. Although this genetic disorder is very unusual, findings such as this highlight the role of genetics in the regulation of eating behavior and weight.
There are various family and social influences that leads to obesity in people. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. It does not only affect people physically but also psychologically. Whether it is a child or an adult or an old person, obesity is a problem that can occur at any stage and so it affects differently. Family attitudes to food are important because their consequences are likely to remain with us for a longer time. People who are obese have markedly more adipose cells than people of normal weight.
There are various family and social influences that leads to obesity in people. Family food habits, early developmental lifestyle of the child, parenting, early family relationships and harmony all contribute towards the growth and development of a child. It does not only affect people physically but also psychologically. Whether it is a child or an adult or an old person, obesity is a problem that can occur at any stage and so it affects differently. Family attitudes to food are important because their consequences are likely to remain with us for a longer time. People who are obese have markedly more adipose cells than people of normal weight.

STRESS AND ‘COMFORT FOOD’
We are all conditioned to eat in a number of situations including when watching television or going to movies or to parties. However, obese people are conditioned to many more cues that may lead to overeating. For example, anger, anxiety and boredom. The taste of food is pleasurable, it lessens anxiety and as a result if encourages more eating. When you are stressed or unhappy, what kind of food do you eat? Do you eat pieces of carrots or chocolates? Food that are high in fat or carbohydrates are the food that console us when we are feeling bad. Certainly many people who are obese experience pathological problems such as depression (Sadness or downswings in mood are normal reactions to life’s struggles, setbacks, and disappointments). Also, studies suggest that 26% of people who suffer from obesity also have mood disorders (Illness under mood disorders include: major depressive disorder, bipolar disorder (mania - euphoric, hyperactive, over inflated ego, unrealistic optimism). Anxiety, anger, boredom may lead to over eating. Eating in response to such feelings or cues is then reinforced because the taste of good food is pleasurable and because the individual’s emotional tension is reduced.

PSYCHOLOGICAL TREATMENT
Behavioral weight-loss programs are being strengthened by their increased emphasis on low fat intake and exercise, by more direct intervention on behavioral antecedents and consequences of eating, by the use of very low calorie diets (VLCDs) and by the adoption of a chronic disease model and the concomitant lengthening of treatment programs. With these approaches, initial weight losses of 10-20 kg can be achieved, and maintenance of weight losses of 5-10 kg can be expected. Treatments may also be strengthened by the identification of subgroups of the obese. Cognitive behavioral therapy (CBT) is an effective treatment for obesity. It addresses various problematic aspects of the condition - eating behaviour (including the emotions that underlie eating patterns), the level of involvement in physical activity, body image dissatisfaction and participation in social life.

Psychological interventions including psycho-education, stimulus control strategies (to counteract triggers for eating), self-monitoring, behaviour modification i.e. to reduce excessive eating and promote a pattern of regular eating behavior through reinforcements , token economy etc. and cognitive therapy work towards implementing lifestyle changes and addressing underlying psychological issues.

Eat Smart Tips to Dieters to follow at social event / gathering / people on the move

- By Priyanka Bankeraika

It’s easy for all of us to follow a diet at home or on work. But for some-one who is always on the move and more particularly, when at social gathering / events / parties, it becomes far more impossible to resist the tempting flavours & presentation of the delicacies on offer for you.

So here are some tips as to how you can enjoy the delicacies, don’t angry your hosts nor put much strain on your regular diet:

Don’t skip your meals if you are to go for event or party. You won’t be served food as soon as you reach there. There is a waiting period in which you socialise and relax. Have enough of liquids (non alcoholic & non carbonated) in this time and during your meals. This will give you a feeling of full-filling-ness, and hence would avoid over-eating. Don’t make yourself too hungry. If too hungry you will end up eating too much of calorie rich food un-sensibly.
Have light food and enough water before the event / party so that your tummy will respond as full and your intake of edibles will be lower.
Always take few moments to first access the delicacies on the offerings. Access the items that you want to have.
Always first opt for ample salads & soups (without cream).
Select the choicest edibles that you don’t have much often. This will curtail and filter your choice of selection from all the offerings.
If You like some edibles so much that it’s impossible to resist, have it but in limit. Don’t deprive yourself of that happiness.
Always take smallest portion of the deserts / sweets / high calorie food.
Eat slowly and munch properly, enjoy your food and satisfy your taste buds. This will start fulfilling your urge for the delicacy.
Avoid second servings and over-eating.
Avoid sitting near to the food serving area.
Leave for your home early to limit your intake of edibles and give a rest to your temptations.

By your smart planning & choice you will leave the event/party guilt-free and without much piling over the calories on your body and thoughts.

Obesity

- By Ms. Japnam Kaur under guidance of Ms. Kalyani Singh

OBESITY - the state of being grossly fat or overweight .An obese person has accumulated so much body fat that it might have a negative effect on their health. If a person's bodyweight is at least 20% higher than it should be, he or she is considered obese. If your Body Mass Index (BMI) is between 25 and 29.9 you are considered overweight. If your BMI is 30 or over you are considered obese.

It is important for patients to realize that a small drop in weight is a good start and a great achievement. Experts have found that obese people who lose weight slowly and constantly, say one or two pounds each week, are more successful in keeping their weight down when they have reached their target weight.

According to the experts, successful and permanent weight loss is best achieved as a result of increased physical activity, changing how and when you eat, and modifying your behavior. Some patients may be prescribed medication, while others might undergo weight-loss surgery.

Weight gain usually happens over time. Most people know when they've gained weight. Some of the signs of overweight or obesity include:

Clothes feeling tight and needing a larger size.
The scale showing that you've gained weight.
Having extra fat around the waist.
A higher than normal body mass index and waist circumference.

The balance between calorie intake and energy expenditure determines a person's weight. If a person eats more calories than he or she burns (metabolizes), the person gains weight (the body will store the excess energy as fat). If a person eats fewer calories than he or she metabolizes, he or she will lose weight. Therefore the most common causes of obesity are overeating and physical inactivity. Ultimately, body weight is the result of genetics, metabolism, environment, behavior, and culture.

Heredity (genetics) - A person is more likely to develop obesity if one or both parents are obese. Genetics also affect hormones involved in fat regulation. For example, one genetic cause of obesity is leptin deficiency. Leptin is a hormone produced in fat cells and also in the placenta. Leptin controls weight by signaling the brain to eat less when body fat stores are too high. If, for some reason, the body cannot produce enough leptin or leptin cannot signal the brain to eat less, this control is lost, and obesity occurs. The role of leptin replacement as a treatment for obesity is currently being explored.
Binge-eating (overeating) - Overeating leads to weight gain, especially if the diet is high in fat. Foods high in fat or sugar (for example, fast food, fried food, and sweets) have high energy density (foods that have a lot of calories in a small amount of food). Epidemiologic studies have shown that diets high in fat contribute to weight gain.
A carbohydrate rich diet - The role of carbohydrates in weight gain is not clear. Carbohydrates increase blood glucose levels, which in turn stimulate insulin release by the pancreas, and insulin promotes the growth of fat tissue and can cause weight gain. Some scientists believe that simple carbohydrates (sugars, fructose, desserts, soft drinks, beer, wine, etc.) contribute to weight gain because they are more rapidly absorbed into the bloodstream than complex carbohydrates (pasta, brown rice, grains, vegetables, raw fruits, etc.) and thus cause a more pronounced insulin release after meals than complex carbohydrates. This higher insulin release, contributes to weight gain.
Frequency of eating - The relationship between frequency of eating (how often you eat) and weight is somewhat controversial. There are many reports of overweight people eating less often than people with normal weight. Experts have observed that people who eat small meals four or five times daily, have lower cholesterol levels and lower and/or more stable blood sugar levels than people who eat less frequently (two or three large meals daily). One possible explanation is that small frequent meals produce stable insulin levels, whereas large meals cause large spikes of insulin after meals.
Slow metabolism - Women have less muscle than men. Muscle burns (metabolizes) more calories than other tissue (which includes fat). As a result, women have a slower metabolism than men, and hence, have a tendency to put on more weight than men, and weight loss is more difficult for women. As we age, we tend to lose muscle and our metabolism slows; therefore, we tend to gain weight as we get older particularly if we do not reduce our daily caloric intake.
Less physical activity - Sedentary people burn fewer calories than people who are active. Research has proven that physical activity is strongly correlated with weight gain in both sexes.
Medicinal side-effects - Medications associated with weight gain include certain antidepressants (medications used in treating depression), diabetes medications (medications used in lowering blood sugar such as insulin), and certain hormones such as oral contraceptives. Weight gain may also be seen with some high blood pressure medications. The reason for the weight gain with the medications differs for each medication. If this is a concern for you, you should discuss your medications with your physician rather than discontinuing the medication, as this could have serious effects.
Psychological factors - For some people, emotions influence eating habits. Many people eat excessively in response to emotions such as boredom, sadness, stress, or anger. While most overweight people have no more psychological disturbances than normal weight people, about 30% of the people who seek treatment for serious weight problems have difficulties with binge eating.
Obesity related diseases - such as hypothyroidism, insulin resistance, polycystic ovary syndrome, and Cushing’s syndrome are also contributors to obesity.

Following a healthy lifestyle can help you prevent overweight and obesity. Many lifestyle habits begin during childhood. Thus, parents and families should encourage their children to make healthy choices, such as following a healthy diet and being physically active.

Make following a healthy lifestyle a family goal. For example:

Follow a healthy eating plan. Make healthy food choices, keep your calorie needs and your family's calorie needs in mind, and focus on the balance of energy IN and energy OUT.
Focus on portion size. Watch the portion sizes in fast food and other restaurants. The portions served often are enough for two or three people. Children's portion sizes should be smaller than those for adults. Cutting back on portion size will help you balance energy IN and energy OUT.
Be active. Make personal and family time active. Find activities that everyone will enjoy. For example, go for a brisk walk, bike or rollerblade, or train together for a walk or run.
Reduce screen time. Limit the use of TVs, computers, DVDs, and videogames because they limit time for physical activity. Health experts recommend 2 hours or less a day of screen time that's not work- or homework-related.
Keep track of your weight, body mass index, and waist circumference. Also, keep track of your children's growth.

Hopefully after this article you are more aware of the effects of obesity. Many people do not realize how damaging obesity can be to the body and for your overall health. Obesity is something that is increasingly on the rise today and will continue to rise unless we do something about it like informing people of how bad it really is and encouraging people to live a health-enhancing lifestyle. A healthy diet and exercising two to three times a week is key to not becoming obese. Let's change the trend of obesity by living healthy lives and building towards a healthy India.

Carbonated Soft Drinks (Aerated Water) - Likely Contributing to Health Problems

- by Priyanka Bankeraika & Ms. Kalyani Singh

An unfortunate news for the lovers of bubbly beverages…We drink colas and aerated drinks enough to put our health at risk. The amount of soda you sip on to might not only boost your sugar intake and pack on pounds—it may also increase risk for various health related issues. Many studies add a new consideration to the list of links that have tied sugary carbonated beverages to obesity, metabolic syndrome, type 2 diabetes, cardiovascular diseases, dental caries, low nutrient levels and development of kidney stones.
"Sugar-sweetened" drinks include those that use high-fructose corn syrup as well as those which use sucrose.
Many soft drinks contain such ingredients that are themselves a source of concern: caffeine if consumed in excess may cause anxiety disorder and sleep apnea. According to University of Sheffield’s, Sodium benzoate, a well-known preservative has been investigated as a possible cause of DNA damage and hyperactivity.
Most soft drinks contain high concentration of simple carbohydrates namely the monosaccharides-glucose and fructose, and disaccharide-sucrose, and other simple sugars. Oral bacteria produce acid on fermenting carbohydrates which dissolves tooth enamel; thus, increasing risk of dental caries. The risk is the greater if the frequency of consumption is high.
A large number of soft drinks are also acidic with pH of 3.0 or even lower. Drinking acidic drinks over a long period of time and continuous sipping can also erode the tooth enamel.
A drinking straw is often advised by dentists so that the drink does not come into as much contact with the teeth. It is also suggested that brushing teeth right after drinking soft drinks should be avoided as this can result in additional erosion to the teeth due to the presence of acid. In a meta-analysis of 88 studies, drinking soda correlates with a decrease in milk consumption along with the vitamin D, vitamin B6, vitamin B12, calcium, protein and other micronutrients.
A study published in the Clinical Journal of the American Society of Nephrology in 2013 concluded that consumption of soft drinks was associated with a 23% higher risk of developing kidney stones.
A chemical called 4-methylimidazole (4-MeI) is a potential carcinogen found in some types of caramel color. The artificial ingredient is used to turn colas and other soft drinks brown.
Regular consumption of sugar-sweetened sodas might influence disease development, not only by straining the body’s metabolic control of sugars, but also through accelerated cellular aging of tissue. So all you lovers of bubbly beverages, beware of the risks you are putting your health into. Instead of the colas drink lemon water, lassi, aam panna, jaljeera, weak tea and fresh juice. Drink a lot of water and detoxify your body to stay healthy, fresh and young.

Balanced Diet

- By Ms. Kalyani Singh

Optimum nutrition remains an elusive goal because the demands of the body change from minute to minute based on physical activity, and because medical science does not have a definitive set of comprehensive nutritional requirements for every human genetic variations. The schedule for eating can be fairly flexible because the body is able to store nutrients for later use, but prolonged famines followed by episodes of gorging are not optimal. For the body to thrive, it is better if the nutrients are available in moderate amounts on regular schedules.

Balance diet is a mixed diet made of a combination of appropriate foodstuffs from food groups , which can provide all the nutrients in adequate amounts to fulfill the body needs. In addition, it provides additional amounts of some nutrients which are stored in the body and can melt the requirements of the body during short period of leanness. The factors affecting the nutritional requirements of an individual depends upon its age, sex, body size, physiological conditions, climate, physical activities which includes sedentary, moderate, heavy workers. Similarly for women who are pregnant or lactating requirements of their nutrition increases by double as they are providing nutrients to the infant as well. Indian Council of medical Research has designed recommended dietary allowance (RDA) for various age-groups according to their nutritional requirements that depend upon factors.

Lack of proper nutrition affects the health badly and is termed as Malnutrition, which can be defined as a pathological state resulting from a relative or absolute deficiency or excess of one or more of essential nutrients, which can manifest into over nutrition and under nutrition. Over-nutrition means the diet that provides excess of nutrients than their adequate amounts required by the body thus making the diet imbalanced. Diets and excessive calories and improper balance of proteins, fats and carbohydrates lead to Obesity and may eventually result in metabolic syndrome – a combination of medical disorders that occur together (Diabetes, cardio-vascular diseases, High blood pressure). Comparatively Under-nutrition is the diet that does not provide the nutrients required by the body in sufficient amounts to meet the requirements i.e. deficient in amount as well as quality. Inadequate diets can result in malnutrition and dietary deficiency diseases such as rickets, goitre, anaemia, scurvy, etc. Malnutrition is the primary cause of immune-deficiency worldwide, with infants, children, adolescents and elderly most affected.

Optimum nutrition seeks to balance dietary nutrients to avoid diseases caused by deficiencies or excesses. The food that you eat should have the proper proportion of nutrient for your current stage of life. Women of reproductive age for example, need more iron than post menopausal women. Optimum nutrition should provide the right quantities of protein, fat, carbohydrate, vitamins, minerals, fibre and pro-biotic bacteria to maintain a healthy body and to sustain the desired level of activity for best quality of life giving us a balanced food value.

The interaction between the nutrition and infection is synergistic, i.e malnutrition can make a person more susceptible to infection and infection also contributes to malnutrition which causes vicious cycle.

Having a healthy diet is sometimes easier said than done. It is tempting to turn to less healthy food choices because they might be easy to get or prepare, or they satisfy a craving. Between family and work or school, you are probably balancing a hundred things at once. Taking time to buy the ingredients for and cooking a healthy meal sometimes falls last on your list. But you should know that it isn't hard to make simple changes to improve your diet. And you can make sense of the mounds of nutrition information out there. A little learning and planning can help you find a diet to fit your lifestyle, and maybe you can have some fun in the process!

What is Fooducate ?

- By Ms. Japnam Kaur under guidance of Ms. Kalyani Singh

To educate is to make people aware about some grey areas of the science. "FOODUCATE" is to make a boon for mankind as from the ancient times we know how to cook, what to use, and how to experiment. But hardly anyone paid attention to how much to consume and what is right for you and your differently designed metabolism.

Hippocrates - One nutrient theory

According to Hippocrates everybody is the same no matter what they have been eating or where they have lived. He concluded that every food must contain one nutrient which makes us the way we are. This one nutrient myth continued for thousands of years. Hippocrates is also famous for having said, "Let thy food be thy medicine and thy medicine be thy food."

Health is a state of complete physical, mental and social well being, not merely the absence of disease infirmity. In general, the context in which an individual lives is of great importance for both, his health status and quality of life. It is well recognized that health is maintained and improved not only though the advancement and application of health science, but also through the efforts and intelligent lifestyle choices of the individual and society. One of the golden rules to attain good health is a good nutrition. NUTRITION - nutritional status of an individual can be judged from his physical well being and his behavior. Healthy look, being alert, eyes clear and sparkling, absence of dark circles below eyes, smooth and glossy hair, strong and straight bones, healthy teeth and gums, well developed and firm muscle, good muscular tone, and good posture and alert gait all are signs of good nutritional status. Nutritional science studies how the body breaks food down (catabolism) and repairs and creates cells and tissues (anabolism) – catabolism and anabolism = "METABOLISM".

Metabolism refers to biochemical processes that occur with any living organism, including humans, to maintain life. These biochemical processes effectively allow us to grow, reproduce, repair damage and respond to our environment. Nutrition is that branch which deals with nourishment to the body. It is a science of food nutrients and other substances and their action, interaction, and balance in relationship to health and diseases. It is the process by which the organism indigests, digests, absorbs, utilizes food and excretes waste / end products.

Nutrients are the building blocks of a balanced diet. Nutrients are chemical substances that are obtained from food when consumed in appropriate amounts which are required for energy, body building, regulatory functions, reproduction for healthy lifestyle and protection from diseases. These are divided into 2 categories MACRO (carbohydrates, proteins, fats) and MICRO (vitamins and minerals). Eating the right amount of nutrients on a proper schedule to achieve the best performance and the longest possible lifetime in good health is Optimum nutrition. Assuming that, external negative influences like accidents and infectious can be avoided.