Today on Jornal da Noite
Cases of anorexia, bulimia and binge eating are increasing around the world. They mainly affect younger people and, in particular, girls. In the Great Report “No Fio da Balança” we met those who suffer from eating disorders, we sought to understand the influence of social networks and what answers exist to stop these diseases.
For more than 20 years, Catarina Alves Costa has sought to escape obsessive thoughts about weight and food. Catarina recognized early on her desire to take refuge in food to find comfort.
“Eating everything from cookies to frozen pizzas and drinking three liters of milk with four boxes of cereal in a row and not being satisfied. You start to lose track. Then comes the anguish, comes the guilt.”
According to the endocrinologist Isabel do Carmo, “all the conditions are created for binge eating, due to the fact that there are very appealing foods that are relatively cheap. These foods can trigger eating behavior disorder, which has a mental illness pattern.”
In Portugal, more than 10 thousand cases of eating disorders are diagnosed through Health Centers. THE highest number on record. The most serious situations, which require hospitalization, are mainly due to anorexia nervosa.
At 1.64 meters tall, Ana Sofia Fernandes weighed 32 kilos. She was admitted to the Elysio de Moura residence, located at the Valongo Center of the São João Local Health Unit. It is the only residential response that exists in the National Health Service (SNS) for people with eating disorders. THE Minimum admission age is 18 years old.
The path that Ana Sofia had to take until she once again saw a future took more than two years. The mother, who followed her daughter’s illness closely, remembers the suffering she also went through.
Anorexia is the psychiatric illness with the highest mortality rate: one in 10 patients ends up dying.
“It’s very distressing and destructive of functioning for a family that doesn’t know what they want to do, because as their children lose weight, they can oscillate between wanting to force them to eat, which doesn’t achieve anything. Having big arguments at mealtime because of the food, nothing works either, or they give up and give up because they are afraid of doing something that is wrong”, explains the psychiatrist Dulce Bouça.
While in anorexia, people restrict what they eat to the extreme, in compulsive eating they alternate periods of restriction with the consumption of large quantities of food in a very short time..
Already Bulimia also involves binge eating, but to avoid gaining weight, patients then resort to compensatory strategies, such as vomiting or using delaxatives..
Bulimia is the expression of the eating disorder that Vanessa Revez has been facing for seven years.
“The fear of gaining weight is as great as in anorexia. Social media also influenced me a lot. I only lived for the gym, for food. It’s very exhausting, it’s very distressing… .While with drugs, if we were addicted we never go back, with food, if we have an eating behavior problem, to cure ourselves we have to eat regularly.”
Endocrinologist Isabel do Carmo explains that “addiction to alcohol, drugs and sweets is exactly the same mechanism: the release of dopamine. If the person does not have access to said sweets, there may be a hangover.”
A dopamine is a neurotransmitter in the central nervous system associated with the sensation of pleasure. When sugar is consumed in excess, high levels of dopamine are released and the number of receptors on neurons decreases and it becomes necessary to consume more and more sugar to obtain the same feeling of pleasure. When this happens, behaviors become compulsive.
In Portugal, eight out of every 100 girls suffer from some type of eating disorder. Four times more than boys.
According to a recent study by a satisfaction with physical appearance decreases among young people who spend more than three hours a day on social media. These platforms are full of bodies that look perfect. There is no shortage of applications for counting food calories, dieting or following training plans with promises of miraculous results.
O Physical appearance is one of the factors that young people say is one of the most important factors in feeling happy and is also the one in which they are least satisfied. More than half of young people say, in fact, that they are dissatisfied with their own image.
The physical aspect is still the reason why more young people say they have felt discriminated against, more than by gender, age, ethnicity or sexual orientation.
In the child psychiatry inpatient unit at Hospital Dona Estefânia, in Lisbon, the response capacity is at its limit: “We have 16 beds and currently we have half of the beds, that is, eight beds with cases of eating behavior pathologies”, he states. Sandra Pires, pedopsychiatrist at this hospital unit.
The director of the National Program for Mental Health, Miguel Xavier, recognizes that the area of child and adolescent psychiatry is struggling with a huge lack of human resources, especially pediatric psychiatrists.
“Very few [pedopsiquiatras] per year, much less than was desirable in terms of specialty and, in fact, teams are very scarce. Fundamentally south of the Tagus, therefore, Alentejo and Algarve, the situation is very complicated.”
Tired of the slow pace of the National Health Service (SNS), a group of experts applied for financial support and created, in 2023, the in Lisbon, a pioneering alternative: a day hospital for the treatment of eating disorders. Receives patients from adolescence.
“The idea of the day hospital is exactly to take people away from the permanent time they spend thinking about food and controlling food”, says psychiatrist Dulce Bouça, who coordinates this project.
Those who suffer from eating disorders often also have to face ignorance and prejudice regarding these diseases. This is the case of “Tiago” – his fictitious name – who suffered from anorexia for more than 10 years.
“I couldn’t tell anyone that I had anorexia. My parents still don’t know that I had anorexia. They were aware that I wasn’t well, because I was very thin, but they didn’t understand what was happening. Hiding comes mainly from this, from a suffering that is alone and from realizing that the world around us will not understand. And it’s not easy to find people who have gone through the same situation, especially a man.”
Psychiatrist Dulce Bouça says that patients often let the illness drag on, and warns: “There needs to be time, but there must be a rush, because otherwise the illnesses become chronic. When the first signs that a teenager or child feels bad about their body or that they are starting to restrict themselves begin to appear, they will not immediately look for weight loss diets. Talk to your family doctor, and if things get worse, then consult a specialist.”
On the professionals’ side, he emphasizes that there must be “consultations that have psychological, nutritional and medical intervention working in conjunction, and that there is also a response for parents. This is the key to treating these diseases“.
Journalist: Catarina Marques catarinamarques@sic.impresa.pt
Image: Romeu Carvalho; João Fontes
Image Editing: Rui Félix
Graphics: Marta Coelho; Rui Aranha; Tome Alves
Editorial Production: Diana Matias
Audio post-production: Octaviano Rodrigues
Coordination: Miriam Alves
Director: Marta Brito dos Reis; Ricardo Costa
