Thursday, December 31, 2020

Corona Daily 227: Parents Look Out


This week, the UK’s Royal College of Pediatrics and Child Health (RCPCH) warned eating disorders were on the rise among children and adolescents. This was based on a survey of forty pediatricians and child specialists in England. The number of their patients have tripled or quadrupled this year. Waiting lists are long and beds for patients in severe shortage. Children with eating disorders are appearing in advanced stages of illness. They have missed interaction with friends, teachers and doctors, any of whom may have noticed and pointed out the visible change earlier.

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The three key eating disorders are binge eating (eating too fast, too much, eating when not hungry), anorexia (fear of gaining weight, starving oneself to remain slim) and bulimia (binge eating followed by vomiting it out – some professional ballerinas are victims of bulimia).

Social media has aggravated the crisis by glorifying thinness and fitness. Forgetting that genetics also contribute to the size and shape of our bodies, many young girls fall victim to body comparison. Young boys, on the other hand, may get obsessed with a muscle-oriented body image or a six-pack abdomen. Modern teenagers know ratios like BMI (body mass index), and have weighing machines and apps to monitor them.

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Pandemic and lockdowns have made matters worse. Eating disorders are now considered a crisis in child mental health. Children are isolated with school closures, exams are postponed, sport activities cancelled, physical exercise is curtailed and replaced by increased screen time and social media. There was also an extensive media coverage further focusing on BMI and how overweight people are vulnerable to Covid-19.

UK pediatricians have identified two patient profiles in the pandemic time. One is the high achieving, ambitious, truly driven young girls. They had meticulously planned their future which is now in danger or shattered. The second type is those with personality disorders and problems with controlling their emotions.

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What symptoms should parents look out for?  (a) Child eating very fast (b) cutting food into small pieces (c) going to the bathroom or shower immediately after meals (d) hiding how much was eaten (e) significant weight loss or gain (f) avoiding meals with others (g) sudden change in diet (h) obsessive exercise (i) refusing to eat food previously enjoyed (j) use of negative comments about their bodies or other people’s bodies (k) wearing larger clothing (l) avoiding social situations (m) excessive fear of going out (n) skipping meals. (o) calorie counter apps on phones.

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Studies in the UK, USA and Netherlands suggest this crisis is widespread.  

In the USA, 9% of population (29 million) suffers from eating disorders. NEDA (National Eating Disorders Association) reported that in November, 72% more people were seeking help through online chats, as compared to previous years.

In Canada, some Olympic and Paralympic athletes became new victims of eating disorders. They had a set exercise and diet routine. With the Olympics postponed, and rigourous training halted, athletes are left confused, their diets disrupted.

Since September, there is a noticeable eating disorder spike among children in North America and Europe. To combat this crisis, school reopening should be a priority.

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This discussion is also relevant for adults. Our set routines, commute to the office and back, prime of the day spent in the office keep us away from food. Diet management is one of the lesser-known benefits of office-going.  Locked up at home, we need to be super-disciplined to manage diet, exercise and sleep. A bowl of chips can be quietly finished next to a business Zoom call. Fears about the virus and financial worries can cause retributive eating and drinking.

During new year parties, some people celebrate by binge-eating after midnight. What a way to start a New Year. If the curfew regulations can reduce indiscriminate eating while entering the new year, it will set a good tone for orderly eating in 2021.

Ravi 

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