Are you able to recognise an eating disorder in you or someone you know? Well, health experts say this is not as easy as one may think.

Most of the time, they say one can consider it as a normal habit or behaviour.

In most cases, experts say, it’s believed that people with eating disorders appear to be malnourished and skinny, however, this is a wrong perception as eating disorders go far beyond this notion.

This, experts say, is where people change their habits related to dietary requirements.

Dr Janvier Rusizana, a general practitioner at La Nouvelle Clinic in Remera, Kigali, notes that people think a person with an eating disorder is either skinny or carries a lot of weight.

"What people should understand is that eating disorders are different from eating habits,” he says.

According to him, this doesn’t reflect reality, and that an eating disorder can be tough to handle.

He says an eating disorder is eating habits that negatively affect a person’s physical or mental health.

What are the common types?

Anorexia nervosa disorder

Emmy Ntamanga, a nutritionist consultant in Kigali, says anorexia nervosa is the most common type of eating disorder, and it’s a very challenging issue worldwide and in Rwanda.

He says this is a situation where people choose to eat very little with the fear of gaining weight and as a result, they experience low body weight.

Private Kamanzi, a nutritionist and dietician at Amazon cabinet clinic in Remera, Kigali, says its most common in adolescent girls and women, and that it has, for the last couple of years, been more common in France, but currently, in our society, people have started developing this condition as well.

Here, he says, this particular group of people intentionally stop eating some foods, and instead concentrate on taking water mixed with lemon and ginger, or other concoctions believed to work as ‘slimming properties’ with the aim of losing or maintaining a certain weight.

He says the consequence is that they end up losing some essential nutrients that the body needs to carry out its functions well.

For instance, he mentions that for the case of young girls, in so doing, they may end up not getting enough iron.

"When these adolescent girls go into menstruation, they can end up developing anaemia, because this is a period where lots of blood is lost through menstruation,” he says.

The help needed, Ntamanga says, is through ongoing therapy and nutrition education, aimed at getting the patient back to a healthy weight.

This, he explains, can be done through family counselling and behavioural alteration. Adding that one needs to consume adequate calories, starting slowly, and increasing at a healthy stride as directed by nutritionist.

Bulimia nervosa disorder

This is another common eating disorder that, experts say, goes with depression.

According to Kamanzi, the condition happens when people eat a lot and then try to rid themselves of the food, by triggering vomiting.

The condition is also more common in girls than boys, and that in most cases, young girls do this, especially when they are dating.

The dangers, the nutritionist explains, are that as one continues to trigger the vomiting every now and then, it makes the gastric acid go up and damage the oesophagus and other digestive tract parts.

Since oesophagus is the part of the alimentary canal that connects the throat to stomach, the condition can as well lead to ulcers.

"If left untreated, some ulcers can lead to potentially life-threatening complications, including penetration, perforation, bleeding (haemorrhage),” he says.

Dr Rusizana adds that bleeding can also occur, which he says is a common complication of ulcers and may be exhibited by vomiting bright red blood and passing black or obviously bloody stools.

For the treatment, the medic says the situation requires a combination of nutritional counselling and psychotherapy, preferably cognitive behavioural therapy and medications.

Binge eating disorder

Binge eating disorder is when people eat a large amount of food in a short period of time.

It’s most common in adolescent boys, whereby people continue consuming food regardless of whether they are full or not.

In their mind, Rusizana says, it’s like having a psychological problem where one thinks they are not satisfied, however much they have eaten, and to some extent, some even end up forcing themselves to eat and finish food.

To tell if a person has this kind of disorder, he says, behavioural emotional signs and symptoms include, eating unusually large amounts of food in a specific amount of time, such as over a two-hour period and feeling that their eating behaviour is out of control.

Also, eating even when one is full or not hungry, is another sign indicating binge eating disorder.

When it comes to complications of binge eating, Rusizana he says it can lead to ulcers as well.

The most common consequences of this is gaining weight in an abnormal way, which in the end leads to diabetes, obesity, hypertension and different allergies.

According to Ntamanga, other risk factors include body dissatisfaction, weight stigma, fat-shaming and a desire to be thin.

Meanwhile, several studies have also shown a link between binge eating disorder and trauma, including post-traumatic stress disorder.

For the treatment, Ntamanga says it is managed by nutrition counselling which helps to restore normal eating arrangements and involves a nutritional balanced diet.

"Medication and psychotherapy aiming to change behaviour is also necessary as far as treatment is concerned,” he says.

Alternatively, Ntamanga says, restriction as part of treatment can entrench the eating disorder, especially when patients are using food to deal with their feelings and restricting food to compensate for the binge.