Diet mania: ‘Eating disorders are often preceded by a diet’

Dieting is at its peak in the first month of the year. New genera spring up every year. Most of them differ from each other, but they have one characteristic in common: for many people they can mean poison.

To put it bluntly, restrictive diets carry the risk of developing unhealthy and disordered eating habits. Gabriella Milos, president of the Swiss Eating Disorders Association (SGES), explains why dieting is often the start of a vicious cycle.

January is the month of renunciation. Many people start the new year with a diet. In addition, many people suffer from intolerance. Do we generally live in an eating disorder society here in the Global North?
Gabriella Milos: Tough question. In fact, we live in a difficult time when it comes to nutrition. No generation has ever had so much food available. When we walk into a grocery store these days, we see more food than any human being has ever seen in a lifetime. We are offered something to eat on every corner. Self-regulation is required. That is difficult for many people. At the same time, people are constantly pretending what is healthy and what is not. For many people these days, eating means not only pleasure, but also stress.

Do you have any advice on how self-regulation works?
The golden rule is: don’t skip meals.

Many diets are often seen as triggers for eating disorders. Can dieting actually lead to an eating problem?
Eating disorders are often preceded by diet. Diets completely ruin the feeling of hunger and satiety. This paves the way for an eating disorder such as bulimia or binge eating disorder. Because prolonged fasting can lead to cravings with binge eating. This in turn leads to frustration and despair. And like I said, food is available everywhere. This can quickly lead to a vicious circle.

Can a diet also bring about the opposite – namely that you are no longer hungry and eat less and less?
Yes, anorexia nervosa (anorexia nervosa) often starts with a diet. Those affected tried to lose weight with excessive exercise and controlled eating. Compliments and approval can encourage people to eat less and keep losing weight. If anorexia lasts for a long time, the feeling of hunger can also decrease, making it difficult to eat a regular, balanced diet again.

Can the different syndromes occur simultaneously or sequentially?
Yes, it is possible that people with anorexia also experience binge eating and/or vomiting. It is also possible for the symptoms of an eating disorder (restrictive eating, binge eating, vomiting) to change as the disorder progresses.

Are there groups of people who tend to end up in an eating disorder as a result of dieting?
Children and young people between the ages of 10 and 20 are particularly at risk. Eating disorders often start in this age group and mainly affect girls. However, the age limit is being pushed further and further down.

How is that possible
There are several reasons for this. Social media is especially influential. Today, children and young people compare themselves not only with their classmates, but with the whole world.

A make-believe world…
Precisely. In particular, unrealistic body staging, which is mainly communicated via social media, often carries the risk that young adults will not feel comfortable in their bodies. The confrontation with body images that are far removed from reality, however, starts before primary school. The dolls, the role models for children, with their large heads and bodies that are much too thin, can contribute to children developing a less realistic body image. Adults are also not good role models in this respect.

Why?
Adults are often dissatisfied with their appearance and compare themselves to other people on social media. This can chafe.

What happens to people who already have an eating disorder and are increasingly confronted with diets, intermittent fasting or juice cleanses?
Confronting such problems puts a lot of pressure on people prone to eating disorders. It must be disguised that people with eating disorders are caught in a merry-go-round of thoughts that revolve around eating or not eating. If these people then prescribe when they can eat something or when they must abstain from meals, the disease can worsen.

Does this have a different effect depending on the disease?
Yes. People with anorexia (anorexia) feel reassured by dieting. They convince themselves that it’s okay to eat less or almost nothing. For people with bulimia or binge eating disorder, dieting can lead to binge eating and/or vomiting. There’s a simple reason for this: Cravings often lead to uncontrollable binges, especially in people whose hunger and satiety levels are unstable.

Do you see an increase in therapy admissions in the diet month of January?
In short, more people request therapy in January than in December. But that probably has to do with the fact that you prefer not to start therapy until the new year. This despite the fact that December is tough for people with eating disorders.

Because the subject of food is in the foreground in this day and age?
Correct. But not alone. Especially young people have Christmas holidays. Regulated daily routines have disappeared. This can cause the eating rhythm to become unbalanced. There is also contact with family. You exchange compliments. Banal compliments like “Oh, you look great” can be misinterpreted. For example, someone with anorexia might interpret it like this: “I’ve gained weight, I’ve gained weight, everyone can see it.” Laymen are often not aware that all kinds of statements about the body and appearance evoke frustration and dissatisfaction. It must be said that the holidays are emotionally stressful for many: the fact that there is a lot of food lying around during these days does not make life easier for people with eating disorders.

Except during the holidays. Don’t the symptoms worsen earlier in the summer if you can’t hide under thick clothing?
That is very individual. The symptoms vary from person to person. There are underweight people who party and there are people who put on three sweaters because they feel so uncomfortable in their bodies. Perception can vary greatly. There are also people who simply do not accept certain parts of their body.

Do you always notice that you suffer from disturbed eating habits?
People who suffer from binge eating and/or bulimia usually notice that something is wrong with them. It is different with anorexia, which is usually diagnosed by people close to you. The following applies to all diseases: don’t look away! One has to handle the situation tactfully. Eating disorders are usually not phases that go away on their own. While confrontation can be uncomfortable for people with eating disorders, it can be a major trigger. The sooner you treat an eating disorder, the better.