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Crash,boom, bang

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DrArunKochar

Posted: Sep 26, 2007 at 0000 hrs IST

Chandigarh, September 25 In August this year, 22-year-old Luisel Ramos died due to heart attack, immediately after stepping off a catwalk fashion show in Uruguay. She reportedly had been managing to survive only on lettuce and soft drinks. Another supermodel from Brazil, Ana Carolina Reston, who worked for designer Giorgio Armani, died this week at the age of 23. She had been starving herself to look thin and was eating only tomatoes and apples at the end of her life. The recent spate of young deaths has shocked the fashion industry world over and the incriminating illness has been described as anorexia nervosa.

What is Anorexia Nervosa?

Anorexia nervosa is a type of eating disorder. People who have anorexia have an intense fear of gaining weight. They severely limit the amount of food they eat and can become dangerously thin. It usually starts as a dieting measure to lose weight. Gradually it becomes a fixation and the individual continues the endless routine of restrictive eating often to a point of starvation in order to be ultra thin. Simply speaking it is excessive dieting. Ninety five per cent of those affected by it are adolescent women, but males can develop the disorder as well. Heart, endocrine system, kidney and gastrointestinal systems are profoundly affected by anorexia nervosa. Over a period, they tend to develop electrolyte disorders and anemia, which could precipitate life-threatening abnormal heartbeats.

Anorexia and impaired heart function often go hand-in-hand. A recent study of 41 girls suffering from anorexia nervosa who were given a cardiac exercise stress test found that over half had significant cardiac impairment or cardiac abnormalities. These girls had no symptoms or other indications of heart problems. Three had potentially life-threatening electrocardiogram changes during the test along with irregular heartbeats.

Apart from the psychological factors, genetics also play an important role in the genesis of this disorder. But the greatest responsible factor is the role of mainstream media such as TV, magazines and movies. These glorify and promote the idea of being thin and help form a negative social attitude towards being overweight. An adolescent mind imbibes such insinuations and pursues the corrective measures of being seemingly over-weight to a position of self-annihilation.

Remedial measures

After these deaths, countries like Spain have legitimately prohibited lower than normal age corrected body mass index models to pursue a career in modeling. United States is also thinking of bringing a similar legislation soon. Nonetheless, this is not confined to fashion models alone and is more of a social problem. Concepts of crash courses in weight loss as well fad diets propagating assured weight loss over a short period are equally dangerous. An adolescent mind need to understand that to look good and proportionate is quite natural, but it should not assume self-extinction proportions.

Active psychological counseling from expert's as well forceful hospitalization may be needed and pursued in extreme cases. Patients of this disorder need extensive emotional support during the rehabilitation process. They may need to realize the concept of retaining their self-esteem not on becoming excessively thin but on developing fulfilling personal relationships and attaining reasonable academic and occupational goals.

The writer is an interventional consultant cardiologist working at Fortis Hospital, Mohali.

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