Worried about being chubby, developed an eating disorder in her first year of high school,A female doctor who was hospitalized with a weight of 35kg speaks outWhat is important for weight management

Kana Yamamoto, M.D., Ph.D Physician, Medical Governance Research Institute

"A Little Iken(Medical Opinion) Notebook" is a column in which a female doctor explains events and news that may be of concern in everyday life from a medical and health perspective.

This time, Dr. Kana Yamamoto, an internist at Navitas Clinic of the Tetsui Association and an internist at the NPO Medical Governance Research Institute, will make Iken(Medical Opinion) regarding what I realized after being hospitalized for an eating disorder.

Have you ever thought, "I want to lose weight!" or "I don't want to be this fat..."?

I have had this thought many times in the past. About five years ago, I took GLP-1 receptor agonists [*1] and succeeded in losing weight. However, since I stopped taking the medicine, it has been very difficult to maintain the weight I had lost, and if I let my guard down for even a moment, my collarbone line disappears and my stomach becomes flabby.

It's true that "no one cares about my body," but I can't help but worry about my body shape. I can't help but think, "Even if I don't have a model-like body, I would like to be somewhat thin."

My personality of thinking this way has not changed since I was old enough to understand things. This personality, combined with the sensitive adolescence period when the body and mind are unstable, meant that I was unable to stop myself from restricting my diet rigorously, and I developed an eating disorder.

In my first year of high school, I started worrying about being chubby and weighed 35kg.

It all started when I was in first year in high school. I was quite chubby and began to notice the difference in my body shape between other people and myself. I couldn't help but worry about my shape, and I began to constantly compare my body shape with the people around me. "I have to get thinner!" I thought to myself, so I started a diet that involved restricting my food intake.

It was around that time that I started to think about university entrance exams and began to put more effort into studying than ever before. In order to lose weight and succeed in my university entrance exams, I decided to strictly restrict my food intake at three meals a day, not eat any snacks, and study hard until I went to bed when I got home.

Because of this stoic lifestyle, one day I started to get thinner and thinner day by day. My weight was also decreasing rapidly. I was so happy to see these visible changes in my body that I started restricting my food intake even more. Gradually, my cheeks started to sunken and my menstruation became irregular.

My strength was declining day by day, and I could barely carry my school bag or even climb stairs. Even though my weight was below 35kg, I still thought to myself, "I need to lose even more weight..."

By the advice of the homeroom teacher to a hospital

My homeroom teacher, unable to bear seeing me like that, strongly recommended that I (reluctantly) visit the psychiatry department of a university hospital near my parents' house. The doctor who examined me told me, "You are on the verge of starvation. If you continue like this you will die." and the doctor immediately admitted me to the psychiatric ward.

Yes, at some point, I had been suffering from an eating disorder. Of course, at the time, I had no idea that I had an eating disorder. As a result, the concerns of my friends, homeroom teacher, and parents never reached my heart.

I was immediately admitted to the hospital, and what awaited me was life in a psychiatric ward. Having no awareness of my illness, I couldn't contain my anger at being locked up in a locked ward. My doctor told me, "You can't be discharged unless you gain 10kg in weight," and I received a mountain of rice in a bowl and side dishes for every meal. At first, I couldn't accept my situation, barely ate anything for days.

Although I was able to leave the hospital after 4 months

After about two months, I realized that they really weren't going to let me leave the hospital, so from that day on I tried to limit my movement as much as possible to reduce my calorie consumption and focused hard on eating my meals. Thanks to that, I was able to leave the hospital in about four months, but I started to overeat and restrict my food intake, and I became very unstable and couldn't concentrate on studying. I managed to graduate from high school, but of course I failed the university entrance exam. I had to take the entrance exam again next year.

After a year of studying for entrance exams, I managed to get into university. Looking back now, I feel that the experience of a student taking gap year and studying towards my goal was a very good experience. However, when I think, "If only I hadn't restricted my food intake back then, if only I hadn't developed an eating disorder, I might have been able to get into the university I really wanted to go to..." I can't help but feel regretful.

Perhaps it's because I experienced firsthand that extreme actions are not appropriate. To this day, I have not had a relapse of my eating disorder. However, my character to be concerned about my body shape remains the same, so I have to be conscious of maintaining my weight.

The method I found to maintain my weight

There are three ways I currently maintain my weight. The first thing is food. By changing from my beloved a bread-based lifestyle to a rice-based one, the time it took me to feel hungry after a meal increased the number of times I snacked was significantly reduced. My unbalanced eating habits led me to develop zinc deficiency during the COVID-19 pandemic, but I’ve been blessed with a partner who has helped me add variety to my meals and made mealtimes more enjoyable.

The second thing is exercise. I spent my childhood focusing more on studying than exercise, so I didn't have the habit of exercising. So even though I joined the gym, I always gave up on my goals too easily and never lasted long. But now, I've been going to the gym for two and a half years. It's only an hour-long workout that combines light strength training with aerobic exercise, but since I realized that sweating helps me concentrate better, I've been attending almost every day.

The third thing is to stay away from social networking services (SNS) as much as possible. SNS is full of posts encouraging people to lose weight, such as "This is how you can lose weight." Even if it's not so direct, when I see many posts of thin, slender, beautiful people, I can't help but think, "I want to lose weight."

From a medical perspective, women who are clearly "too thin" are considered "beautiful" in today's society.

Diet information to overflow around us

In fact, it has been pointed out that excessive use of SNS may be associated with an increased risk of eating disorders [＊2]. For example, evidence has become clear that when young women use social media, the pictures they see typically promote thinness as the ideal form of beauty. It has also been found that some adolescent girls tend to take and post photos of themselves on SNS, hoping to prove that they are more attractive than their friends through the comments and praise they receive.

"Eating disorders don't just affect girls," says Mr. Stuart, an associate professor of psychiatry and behavioral sciences at the University of Southern California. According to Mr. Stuart, one in three people with eating disorders are men or boys, pointing out that the stereotype that eating disorders only affect girls is not true.

"Men also develop eating disorders because they feel pressured to conform to a particular socially acceptable masculine body type, whether that be a muscular hero or a petite computer nerd," said Mr. Blake, a professor of psychiatry at the University of Toronto. He points out that in addition to restricting calories, some people also resort to excessive training, excessive protein intake, and drastically restricting nutrients like fat and carbohydrates.

In recent years, there have been concerns about the impact that SNS posts encouraging excessive dieting and the like have on the younger generation, including minors. In response, LINE Yahoo! [※3] has reportedly begun to step up measures to crack down on posts that encourage eating disorders and the like in its "Open Chat" section, where users can chat anonymously. The company will begin displaying direct warning messages to users such as "Is that diet correct?" and may take measures such as deleting posts or suspending their use if they are found to be "posts that encourage overeating, anorexia, or eating disorders."

I tend to gain weight easily and am very self-conscious about my body shape, so when I casually browse SNS, my eye is drawn to photos of people with beautiful bodies or posts that say, "I lost weight by doing XX." However, by keeping my mobile phone out of reach (because I can't help but pick it up when I realize it) and turning off notifications (because when a notification sound comes on, I can't help but pick up my mobile phone to look), I've not only avoided posts that made me self-conscious about my body, but I've also stopped wasting time immersed in the world of SNS. Furthermore, by staying away from the world of SNS, I feel less envious or envious of people I don't know at all, and I feel a lot more at ease.

My experience of how excessive dieting ultimately led to an eating disorder is just one example. However, I can't help but feel that in today's society, which is filled with advertisements, promotions, programs, and SNS posts that encourage dieting, there are many factors that can lead to eating disorders. I hope that by seriously addressing this issue, we can create a world where we can reduce, even just one, the number of people who engage in excessive dieting and eating disorders

[Reference URL]

[※1]https://dot.asahi.com/articles/-/249250?page=1

[※2]https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2021.641919/full

[※3]https://www3.nhk.or.jp/news/html/20250412/k10014777171000.html

This article was originally published in Japanese in AERA dot. on Apr 16, 2024.