Why are eating disorders so hard to treat? - Anees Bahji

Prevodilac: Nada Nikolajevic Lektor: Milenka Okuka

Globally, about 10% of people

U celom svetu, oko 10% ljudi

will experience an eating disorder during their lifetime.

doživi poremećaj u ishrani u nekom periodu svog života.

And yet, eating disorders are profoundly misunderstood.

Uprkos tome, postoji duboko nerazumevanje poremećaja u ishrani.

Misconceptions about everything from symptoms to treatment,

Zbog zabluda vezanih za sve, od simptoma do lečenja,

make it difficult to navigate an eating disorder

teško je nositi se sa poremećajem u ishrani

or support someone you love as they do so.

ili podržati drage osobe u njihovoj borbi.

So let’s walk through what is— and isn’t— true about eating disorders.

Zato, hajde da razjasnimo šta jeste – a šta nije – tačno u vezi sa njima.

First, what is an eating disorder?

Prvo, šta su poremećaji u ishrani?

Eating disorders are a range of psychiatric conditions

Poremećaji u ishrani predstavljaju dijapazon psihijatrijskih bolesti

characterized by these main patterns of behavior:

koje odlikuju sledeći glavni obrasci ponašanja:

restricting food intake, bingeing, or rapidly consuming large amounts of food,

ograničenje unosa hrane, prejedanje ili brz unos velikih količina hrane,

and purging or eliminating calories

kao i pražnjenje i eliminacija kalorija

through vomiting, laxatives, excessive exercise, and other harmful means.

pomoću povraćanja, laksativa, preteranog vežbanja i na druge štetne načine.

An eating disorder can involve any one or any combination of these behaviors.

Poremećaj u ishrani može da obuhvati jedan ili kombinaciju ovih tipova ponašanja.

For example, people living with anorexia

Na primer, ljudi koji imaju anoreksiju

usually restrict the amount of food they eat,

obično ograničavaju količinu hrane koju jedu,

while bulimia nervosa is an eating disorder

dok je bulimia nervosa poremećaj u ishrani

characterized by recurrent binges and purges.

koji karakterišu naizmenična prejedanja i pražnjenja.

Importantly, these behaviors determine whether someone has an eating disorder.

Ovi tipovi ponašanja su važni jer pokazuju da li neko ima poremećaj u ishrani.

You can’t tell whether someone has an eating disorder

Ne može se reći da li osoba ima poremećaj u ishrani

from their weight alone.

samo na osnovu njene težine.

People who weigh what medical professionals might consider

Osobe čija težina po medicinskim merilima

a healthy range can have eating disorders,

spada u zdravu, mogu imati poremećaje u ishrani,

including severe ones that damage their long-term health in invisible ways,

uključujući i teške oblike koji vidljivo i trajno narušavaju njihovo zdravlje,

including osteoporosis, anemia, heart damage, and kidney damage.

izazivajući osteoporozu, anemiju, oštećenja na srcu i bubrezima.

Just as we can’t tell whether someone has an eating disorder

Kao što ne možemo reći da li osoba ima poremećaj u ishrani

based on their weight alone,

samo na osnovu njene težine,

we can’t get rid of these disorders simply by eating differently.

ne možemo ni da izlečimo ove poremećaje jednostavnom promenom ishrane.

That’s because eating disorders are, at their core, psychiatric illnesses.

Razlog je to što su poremećaji u ishrani, u svojoj srži, psihijatrijske bolesti.

From what we understand,

Ono što znamo je

they involve a disruption to someone’s self-perception.

da oni uključuju poremećaj u pacijentovom doživljaju sebe.

Most people who experience them are severely critical of themselves

Većina obolelih od poremećaja u ishrani je preterano kritična prema sebi

and report many self-perceived flaws.

i uočava na sebi brojne nedostatke.

They may use eating to try to regain some control

Hrana im može služiti za vraćanje kontrole

over an internal sense of chaos.

nad osećanjem unutrašnjeg haosa.

We still don’t know exactly what causes eating disorders.

Još uvek ne znamo šta tačno izaziva poremećaje u ishrani.

There likely isn’t a single cause, but a combination

Najverovatnije ne postoji jedan uzrok, već se radi o kombinaciji

of genetic and environmental risk factors that contribute.

genetskih i sredinskih faktora rizika koji doprinose nastanku bolesti.

Sometimes, other mental illnesses— like depression or anxiety—

Ponekad, druge mentalne bolesti – poput depresije ili anksioznosti –

can cause symptoms of eating disorders.

mogu da izazovu simptome poremećaja u ishrani.

In addition, certain psychological factors,

Pored toga, određeni psihološki faktori,

such as perfectionism and body image dissatisfaction,

kao što su perfekcionizam i nezadovoljstvo izgledom tela

are risk factors for eating disorders.

predstavljaju faktore rizika.

Several social factors contribute, too,

Doprinose i neki društveni faktori,

including internalized weight stigma, exposure to bullying,

kao što su internalizovana stigma težine, izloženost maltretiranju,

racial and ethnic assimilation, and limited social networks.

rasnoj i etničkoj asimilaciji, i ograničena društvena umreženost.

Although there is a common misconception that only women

Iako je uobičajena zabluda da samo žene

experience eating disorders,

pate od poremećaja u ishrani,

people of all genders can be affected.

oni se mogu javiti kod ljudi svih rodova.

As these disorders intimately affect the development

Pošto ovi poremećaji duboko utiču na razvoj

of one’s identity and self-esteem,

identiteta i samopoštovanja,

people are particularly vulnerable to developing them during adolescence.

adolescencija je period posebne ranjivosti usled koje se oni mogu pojaviti.

Although these are among the most challenging

Iako spadaju u psihijatrijske poremećaje koji su najzahtevniji za lečenje,

psychiatric disorders to treat,

effective therapies and interventions exist,

delotvorne terapije i intervencije postoje

and many people who receive treatment make a full recovery.

i mnogi ljudi koji su na lečenju izleče se u potpunosti.

Treatment has a higher chance of success the earlier it starts

Šanse da lečenje uspe su veće ako ono počne što pre

after someone develops disordered eating behaviors.

nakon pojave simptoma poremećaja u ishrani.

But unfortunately, less than half of people with an eating disorder

Ali nažalost, manje od polovine obolelih od poremećaja u ishrani

will seek and receive treatment.

zatraži i dobije pomoć.

Because of the complex effects of eating disorders

Zbog složenih posledica koje ovi poremećaji imaju

on both the body and the mind,

kako na telo tako i na um,

treatment usually includes a combination of nutritional counseling and monitoring,

lečenje obično obuhvata kombinaciju savetovanja i nadzora nutricioniste,

psychotherapy, and in some cases, medications.

psihoterapije i, u nekim slučajevima, lekova.

Evidence-based psychotherapies exist as treatments for most eating disorders,

Psihoterapija je dokazan vid lečenja većine poremećaja u ishrani,

including cognitive-behavioral therapy and family-based therapy.

uključujući kognitivno-bihejvioralnu i porodičnu terapiju.

These are talk-therapies that help people gain the skills

Ovo su terapije razgovorom koje ljudima pomažu da steknu

to deal with underlying psychological problems

veštine nošenja sa skrivenim psihološkim problemima

that drive eating disorder symptoms.

koji upravljaju poremećajima u ishrani.

Because not all patients will respond to these treatments,

Pošto ne reaguju svi pacijenti na ove vrste lečenja,

researchers are also investigating treatments outside of psychotherapy,

naučnici istražuju i lečenja mimo psihoterapije,

such as transcranial magnetic stimulation.

poput transkranijalne magnetne stimulacije.

Proper treatment can reduce the chances of dying from a severe eating disorder.

Adekvatno lečenje može umanjiti šanse da se umre od teških poremećaja u ishrani.

Eating disorders can provoke a powerful sense of powerlessness,

Poremećaji u ishrani mogu da izazovu snažno osećanje nemoći,

but education for individuals, families, and communities

ali edukacija pojedinaca, porodica i zajednica

helps erode the stigma and improve access to treatment.

pomaže da se izbriše stigma i da se poboljša pristup lečenju.