When things get to the level where the girl stands next to her mother and looks at the size of the bun she roasts and eats only the top layer because it has minimal calories, it's a huge red flag more than any academic or behavioral achievements I can appreciate. It seems that if everyone starts asking me about my weight , then what will happen to me, then I will try to keep losing weight. The easiest way to identify a eating disorder is to ask the person what you ate, how many calories you have eaten. number says but ever i feel lonely ever i miss someone i feel sad but i can't talk to anyone im feeling very low so come on now what to do now let's eat something when it starts to happen problems come while driving there is a speedometer in front it is rpm If I had a meter , I would know what is happening to me. Because of this, I don't see any indicators while eating. Mindful eating. Mindful eating should be stopped. Mindful hunger should also be stopped . 11 times the chances of getting 11 times a year I have to admit at least one girl to the ICU and do refeeding gradually and because if it's not done these people are going to die because cancer is so terrible if your kids are losing that much weight or If they are doing this kind of business you need to go to a doctor this is not a diet thing this is a disease level [music] hello hello i am omkar jadhav and you all are very welcome to the new episode of khushkhus very important very relevant and close to all of our lives Today we have come with such a topic, all the podcasts in Amuk Tamuk we are trying to do all the conversations to make our tomorrow better tomorrow in Khusfus and in Amuk Tamuk . Dr. Bhushan Shukla is a Child Psychiatrist, a Psychiatrist and works a lot with children and their parents. He has a lot of study on all these topics. He is with us today. Amita Gadre is a Clinical Nutritionist. If you are following Amuk Tumuk then you don't need to tell me different identity of Amit but both of them are favorite guest of Amuk Tamuk today in same format so welcome thank you both today topic is very important so now we were discussing about him basic then how big landscape it is I am actually feeling this right now, today we are going to talk about eating disorders, what exactly is eating disorders, how can it be looked at, today we are going to discuss all this, I think we can start from here, sir, why eating disorders are called, maybe by hearing this. It is only known that there is an eating disorder, but what exactly is an eating disorder? The most fundamental part of an eating disorder, without which we cannot call it an eating disorder, is the extreme sensitivity to the food that goes into our body in the form of calories and an extreme sensitivity towards it. Having a weird panic attack ok is feeling scared and so the calories going into the body again I'm not calling it food because people with eating disorders only see calorie numbers they don't see food ok at least try to do it consistently and if it ever gets out of hand Trying to get it back under control when it becomes the most important part of your life, your entire existence revolves around how do I eat less, how do I cut calories and lose weight. How to reduce When it becomes the core of your whole personality, we call it an eating disorder. Whatever it causes are changes in your behavior. They say OK OK and Amita are so common that is because if you look at eating disorders, maybe Now everyone who has become image conscious, everyone who sees different diets online because of instagram, everyone has followed a diet at least once in their life and kept an eye on their calories. It is possible to do it but how common is it to convert to a disorder it takes a long time to convert to a disorder but disordered eating is very common ie eating disorders and disordered eating are different types ok what is disordered eating what if i give up sugar today dili ok or i am now not going to eat wheat or i am non vegetarian but i give up salt completely or i will only eat boiled vegetables when you eat like this or detox diet cleanses or drink only juices etc or what you eat your Then after that extreme exercise is because that's also to reduce calories or to make him. These are all forms of disordered eating. Disorder eating, in my opinion, I see in almost everyone today is finding a person who understands their body and what they eat. We're eating to nourish us and it's for energy and not obsessing about it is something that very few people see today, which is that you want to focus on health but you don't want to be body focused or weight focused in today's world because we have messaging everywhere. That 's why eating disorder is very rampant, it is seen everywhere. Eating disorders are thankfully less common, 09% is common. Unfortunately, it is more common in women. Compared to men, this kind of messaging pressure is more on women than on girls. But you should take care that when you think that eating disorder is your focus, that I should stop eating dairy or dairy today to reduce my weight by 10 kg. So if it can ever escalate to an eating disorder, you're just a little bit because the lines are very blood like we were talking about before we start now that you have to take care of that and is there an age group that you get eating disorders? So classically eating disorders are the group that when Describe first started to be identified, it was a disease of young girls, young women , OK, but none of them were in their 20s, 25s, and now we It is seen that this age is decreasing and puberty is definitely starting from 12-13 years but in some children these difficulties are seen from seven and eight years as well . Don't we read that in cars and on the highway that there are some restrictions on how fast you should lose weight or what is safe and that is often broken if I'm correct I think a pound a week is 400 max. Around g is the maximum allowable healthy weight loss for people who are already significantly overweight yeah and that's also an important part of that is what we're seeing happening in young guys and girls especially girls like oh you already have a BMI of 20 and 21 yeah yeah yeah but you If you are trying to lose weight fast, you have to do it with extreme calorie restriction, literally, the boys and girls are eating less than 500 calories a day , literally. Because it has minimal calories, this is a huge red flag when things get to this level. Parents need to realize that the first thing you should do is ask your doctor if my child needs to lose weight. Another very important part is that Indian There are fundamental differences between the bodies of people and the bodies of Westerners, the bodies of Caucasians, which we are constantly looking at. That's why I say this again in the name of researchers, because these are not things in the air, but as Dr. Vaman Khadilkar, who is an endocrinologist in Pune, is close to them. About 20 years ago, after doing a huge research, they made different charts for weight and height of Indian children, earlier we were using western charts, so all our children seemed to be narcissists, but they made charts which are adopted by Indian Academy of Paediatrics, all over India we doctors. One part is that they use the chart which shows that their weight and height are very different from theirs and another very important research done by Dr. Chitraranjan Yagnik from his KM Hospital in Pune 20 years ago which is now world renowned. It has been published in the Lancet that Indians have more body fat than Caucasians. It is called The Fat, The Thin Fat Indian. This is the part discovered by this researcher. Before this, we had no idea that an Indian man and a Caucasian man of the same height and weight of the same age. There is a difference in their body fat. We have a lot of body fat. There are evolutionary reasons for it. Frequent droughts. We have grown up in it. We have evolved . There are different things. Yeah yeah and how the abundance of food that has come in the last 30-40 50 years has messed up the math of it all what are we doing how wrong and how dangerous is the way we think in the western way is a little brainstorming in every home. It is necessary, otherwise, it is not true. Yes, and it happens that on the one hand, it is a good thing that everyone is now quite fat aware to the extent that the times were fat phobic. How does it happen that you are afraid of being fat so you try to be thin by any means which is the problem you get all the issues ahead and where speaking of eating disorders is eating disorders why affect even disorder eating means now if I stop oil ghee on today's date If I do, my weight loss will be 100% because my caloric intake will be reduced by the same amount of calories, but at the same time I will start to develop vitamin deficiencies . Because our body needs fat, as sir said that in Indian population our fat distribution fat percentage is a bit higher, basically due to evolutionary reasons, but still we need fat, then we should remember that for our health, fat is whatever we need. Fatty foods are also necessary to eat in moderation of course but fearing it and then you mean especially when you grow up it is not healthy at all and it can damage your overall health a lot so I gave a small example. That if I stop the fat in the diet, when the eating disorders occur or the eating disorder is long-term when you do it long-term, because now today we see that people for 20 years, they have not eaten any oil, ghee, and we are like this, or any food. The group itself is left out and so these types of things are done to maintain body weight, so you can eventually suffer a lot more clinically speaking of eating disorders . Your intelligence can be reduced which means your learning capacity can be reduced It can affect your digestion You can get autoimmune disorders Autoimmune disorders can even get you Lupus or rheumatoid arthritis Today we have children with eating disorders at age 16 I have rheumatoid arthritis Arthritis is something that we associate with older people, senior patients, so it's not who we're talking about today, but we need to understand the seriousness of it. When we talk about babies, we have a very funny way of saying that a child is born as it is born Those children who are around everyone from the time they come, their only effort is to do whatever it takes to get the Cerellac baby who is famous as a healthy baby. And then these same children then it carries on till seven and eight years which they all feed in the same way until you go to second and third because what are children they are supposed to be chubby at this age and then how does it happen to girls especially when you are so This is how mothers, fathers in the house, people, parents, all those who feed like this, at a young age, when you have gained so much weight, then how is it that at the age of seven or eight years, they get their periods, when they get their periods, then suddenly, oh, how come their periods now, now lose their weight, then now you Don't eat then in this environment it leads them to disordered eating and eventually which can become eating disorders . Your entire nervous system yes your brain and all your nerves are 100% fat ok there's nothing else in it just fat ok so if you're going to remove fat from your body you're essentially mortgaging your brain in the name of a diet wow the second thing is every cell in the body is surrounded by cells What is the cover is a sandwich of protein and fat. Now if you have all these things, you need fat to maintain it and it needs good quality fat. Cholesterol plays a big role in it . Because of that , the only people who say we eat bad food are the people who eat koi and throw away the mangoes or the people who eat the peel and throw away the gar. Survive without Good Quality Fat Ho Simple is the first part and the second is how in the 1900s 40s-50s we don't use our own common sense much we tie it around our necks as if most things happened in the West and even if they are stones we have diamonds. If it spins as diamonds then for what ever region again the commercial reasons of the western countries are very warp then there is a big no fat program started there and everything starts to reduce fat but replace the fat for the taste of the food which is saty or its satisfaction value which is Food is good when you eat it and it has a big role of fat and protein if you are going to reduce fat so what is needed for that satisfaction so American industries started adding sugar to it ok and instead so fat was essentially replaced by sugar in diet always in everything. I mean you can't even imagine what has sugar in it, for example tomato ketchup has spoonfuls of sugar in it and we throw away the good stuff because of bad research and put in the bad stuff and everything starts to get sugary and that brings us. To the discussion that disordered eating is part of the journey from eating disorder to eating disorder that starts with the birth of the child, the mother declares that she is pregnant, that she has lost control of her own body, that everyone in the household takes control of her body and Now she starts deciding what to eat. All women say that the baby gained two and a half pounds during pregnancy and I gained 20 kg. This is the part of gaining 20 kg for a 2.5 kg child. I am not saying that pregnant women should do everything. What I'm trying to say here is that you need to be aware of that diet, sometimes gaining weight is not healthy, and after that, those poor women start trying to lose their own weight, and then start trying to increase the weight of their children. Constantly eating whatever they want, then giving them sweet food on that occasion , keeping the mobile phone in front of them, only putting things down their throats that will taste good to them. I am not saying to eat less because of these habits later on in life . It is very basic that you are withdrawing calories from it as you live, exercising, and depositing calories from food. This is a simple concept that adults need to keep in mind. The math is completely different for children. Children who are growing up, and the age of growth in children, when the exponential growth that begins in the tenth, eleventh, and twelfth years, does not continue . This should be a sign of appreciation. We're dealing with a very complex situation here. When leanness is overdone, I'm concerned as a doctor . Anorexia and eating disorders are said to be a disease , but allowing the body to grow as it pleases is also a problem . It's a complex part that we all have to deal with. Yeah, I think we have to talk about calories as well . We always say that our grandparents were eating junk food and nothing happened to them. Let's say that how much food was there in the house 100 years ago, there was no middle class or lower middle class at all. Ready to eat calories in the whole house were probably not more than four or 5000 calories. Your ladles were not full Grandma used to ladle once or twice a year and it would be finished within the next month or else it would be locked in grandma's ladle to get a ladle OK this one episode and Compare That With Our Homes I would urge the listeners to go and do an audit of your own home. How many calories are there in ready-to -eat situation in your house right now? Average house has more than 50000 calories ready right now . 2000 calories in a swipe delivered to your door in 15 minutes Ready to eat Yes because of it again and again that extreme thinness is a risk and on the one hand there is a risk of consuming that terrible caloric intake but somewhere in between and realizing that this balance is going to change with age. The rules that apply to a 60-year-old person in the house don't apply to a 40 - year-old person . You see and there is one rule from birth to death in the way that you have your own relationship with food that needs to change. There is a need to realize that and I think it's also because of social media that everyone is trying out different diets and now I'm gaining weight. I want to cut down I'm going to do keto for a few days then if it bothers me then I do something IF I do intermittent fasting no then I cut out sugar completely we keep experimenting and can't find the answer anywhere and then something towards that eating disorder Those things may not go away but it happens that now when a person does this kind of dieting or when you do something to lose weight whatever your means and methods might be , you get compliments from everyone around you. Yes, you look great, you have slimmed down, yes, you have lost weight, and I told you in an earlier episode that this happened to me too, when I stopped eating cans when I was in class seven. was or I gained weight I mean myself what we were talking about body image issues then when you don't like yourself you gain weight because the constant focus at home is on what you eat and then you puberty because eating disorders are in puberty that is when When the kids come around you look a lot more, one reason is that you realize that your body is different now that it's changing, so the kids then pay a lot of attention to how you look and then in that scenario when you start losing weight, I wasn't eating canned food. I started losing weight when I didn't eat daba and all the adults I met were complimenting me. Oh Amita, now I'm slim and I'm dark. It happened to me and then my face became pale. You have become bright. Yes, Pandu disease means you. So now when he was glorified, what did I feel as a child? Then what message did I get ? More than any academic or behavioral achievements, if I start getting compliments from everyone about my weight, then what will happen if I try to keep losing weight ? At the core of the discussion is the core of all the discussions that we are doing Swachh Bharat Abhiyaan or not littering on the roads, not littering, it is not just physical waste, what words we use when talking to people , are we creating waste around us, or a child if a little bit. Even if it looks like a ladder, why don't your parents feed you, why don't you feed this one, not your father ? When four people meet , the first thing they talk about is how thin you have become and how thin she has become . And we also have to see the stench it causes and the disease it causes because the things we keep saying change the other person's self-image . We need to live 25 to 30 years ago in middle class homes a big mirrored cupboard was a Godrej cupboard Godrej cupboard was a local brand available for those who couldn't afford Godrej Before that a small mirror of this size placed on a basin or in the house was just a tool to see the body by itself with lights. There were no lights, so we didn't know how we looked, so feedback was only what other people would say. Even Bajirao Peshwas and his Mastani did not have a mirror to see that others could see the leaves going down her neck. Mastani had no mirror. There were polished silver plates, and Italian mirrors were not of the highest quality . Not only that, but the body of the people we saw was a covered body, yes we who, let's talk about the big people, now let's talk about Amitabh Bachchan, the people who have seen the body of Amitabh Bachchan in his youth called Angry Young Man in the movie, that body is Hero today. Why will it be used as a body? Yes, not at all. Remember Amitabh's body, the one who put eight people to sleep in a fight. Yes, even recently, I remember Roy from Aashiqui. Yes, will that body be used as a hero's body today ? When I look at today's heroes, I don't even name them because I don't know why they are fake bodies, I don't even know whether they are real bodies or VFX, but this is constantly being shown a certain body and If this is not the body, then you The problem is that body dysmorphia is created that a woman's body has to be this particular display ha ha the difference between you look at a heroine today and a heroine 50 years ago is that your body is forced to change the body to sculpt you in a certain way is a continuous force . It happens to women It happens to men It happens to children It happens to everyone Even Chhota Bhima is now slowly getting cuts Now this deformity visual deformity which is caused so my body is not right so something has to change in it so grabbing one by one limb and behind it And it should look like this, then I should see those eight packs, then there shouldn't be any curves here, so I have more girth here, more roundness there, less roundness there, less straightness here and more curvature there. There is something strange about our food, our body, our life, and our self- image, and we all need to be aware of that . To see and where there are no available ones, we go to the movie theater paying money and see naked people who have very healthy bodies and they have no other business in life apart from maintaining their bodies. Your heroine doesn't have to work in a bank for eight hours. They are the ones who make the decisions and bring it to her every few hours and spoon it into her mouth.Other than that , she doesn't even allow any food to come near her . My relationship with my body, with my food, with my self-image, if I don't unravel it, if I don't unravel it, my whole life, whether I eat or not, where will it go, and then what will I do to remove it, and what will it look like if it is removed, and will it work if it looks like this? And if it looks like that, will it be possible if it has become the core of my life, then something has counted. Yes, it is very important to be aware of this. Children of every age, people, their parents and those who started with Bharat Swachh Bharat Abhiyaan, what are we talking about? Time is spent talking about food and body. Yes, when I first meet the other person, what do I look at, what do I say, what do I say, what do I give feedback? He is going to sit there giving off a foul smell and rotting . So there is a need for a National Nutrition Literacy Mission because when we as parents are feeding our children, I always tell the teenage children who come to my clinic to tell their parents first what your child is eating or not eating. Why don't you go and make it yourself? Yes, you made it for them. You have formed those habits and now the habit you have formed for eight years suddenly says now give up those habits. Now you eat vegetables. Now you eat salad. And you should note that the reason for today is the generation that is teenagers are very aware that they know that whatever you see in videos etc. is fake even though its images are very affecting but they generally know that they are It is not true but those are the images when you are at home when your parents or friends relatives and neighbors start saying that hey you have become fat or how much you are kidding hai kuch khata kyun nahin or hey sukh ud jayega hm or to dharti par Boz Hathi Aya all the terminology is so common that children hear it all the time . And think these are 10-12 year old kids who are thinking this You see that youtube is not true but yesterday when I went to meet that grandma and grandpa, they told me that there is a thick side and it can live a very deep impact on your child because of that and that responsibility is not on those children at all. - It's up to the father. Only the parents teach the children what to do. The parents show that if I'm not feeling well, let me sing and eat ice cream. Come on, are we in a bad mood today? Finishing off an ice cream then you're coping and this means we also know eating disorders or disordered eating in your environment and why I say both ED and disordered eating again and again because this can become the other. It's a spectrum that starts with full disorder eating and it can become an eating disorder, but it's a part of it, like when we talk about physiology that our body is a certain way or our fat distribution, but it's also about what's in our environment in our home. There is a big part in it and we see in clinical cases today that if the family members have a lot of research, it has been proven that if any of your primary relatives in the family, such as parents, siblings, have eating disorders, then you are also more likely to have an eating disorder. Chances increase 11 times 11 times 11 times 11 fold father and why is it good because if you look at it now like me then for example for example small I grown up I have always seen my mother unhappy about her body about her weight every time she looks in front of the mirror what If I say I am fat then I have learned that getting rid of this fatness is the purpose of my life I think again this is a very important issue especially for women that girls look up to their mothers we are still 25 in 20 years All children are aware that they are going to be like this in years to come and how they see these adults who are constantly unhappy with their bodies are constantly in front of the mirror talking to each other about their bodies about food and diet and being thin is a life goal if you are seven eight nine If you're a year old boy or girl and you've been hearing this for eight years and you're going to keep hearing it, what do you say to yourself , I don't want to get there because once I'm in that state, coming back from there is a hell of a lot of torture and death. I see how difficult it is for my parents because the moment these kids, especially girls, reach puberty, they start trying to get super skinny and that's when anorexia starts, where anorexia nervosa is a disease that has You are losing so much weight your bmi is now my bmi is around 24 ok that is your weight in kilograms divided by meter squared the part of your height should be around 21 to 23 above 19 if it goes below 21 a little worry If you go below 19 you have to worry terribly. If you go below 18 and a half, it means you have anorexia. Anorexia is such a terrible part of cancer. If your weight goes below a certain limit, actually your brain starts to change. And this is me. When working in an inpatient unit in the UK for Adolescent Anorexia, a small unit where we worked, one of our most popular exercises was to do this ultra-fine food diet for children who were not eating more than 400 and 500 calories a day, but who were 15-15 20 kg weight lost by themselves We used to put a big piece of paper on the floor and tell them to draw the outline of your body on this paper like we see in police thrillers or the dead person's chalk drawing We would make them draw their outline and then we would make them lie down on that outline and we would draw the actual outline, if the actual outline was so thin, the outline they drew would be so big around it that their brain itself would start to look as thick as the body. The bones are visible but the person thinks I'm fat, I'm ugly, and that visual They keep losing weight to reduce the fatness. Literally there are people who are so thin that they need the body of the spine and they say I'm fat. It means that your brain actually makes a difference . When I went to England in 2004 , I saw an anorexia in eight years from 2000 and 1996 to 2004. In India, when I was working in the Anorexia Unit in England, I used to say to myself, oh what a fool, I am a country of malnourishment . Coming as full question Malnutrition is the main disease of our country what am I learning here yes but you don't believe it since I came back in 2008 I am seeing continuous increase in this anorexia now I am seeing one anorexia in a month yes sir atleast one girl is admitted in ICU every year The refeeding has to be done gradually and because if you don't do it, these people are going to die, they are going to die, cancer is so terrible, so if your kids are losing weight like this or if they are doing this diet, you need to see a doctor. This is not a job. This disease has gone to the level. The father does not realize what these children are doing. Eating these papudres is an example. Yes , exercising to the maximum. They sit like they 're standing . It seems more that it is bulimia that you eat because you don't have control over eating but the moment you eat it you get a very guilty feeling and you go and eat everything and then you come back and this is a strange kind of thing that unfortunately started to appear very regularly. Something that has never been reported in men in the world's literature in the last 50 years is now starting to show up in men, which is what we do to ourselves constantly, which is what we see in other people's bodies, which we measure up to, and our own bodies in the big mirrors that we see. We are looking at our own images in cameras and thinking something about ourselves, we really need to think calmly that this garbage we are throwing everywhere and picking up and eating it and considering it as nutrition are wrong thoughts, wrong images. Talking about the symptoms, some of the symptoms in eating disorders, now let's talk about some basic things, firstly, what are the types of eating disorders and what are the symptoms, are there any visible changes or things that I notice that can be noted down? I think these things are disordered eating and when it goes here it converts into a disorder like sir said that if your child has lost weight very fast or how fast does it mean what speed does that fast means now if your child is losing five to seven kilos a month Losing weight suddenly or suddenly with in a month you start saying two sizes less which means if I used to wear size 32 jeans I suddenly started wearing size 28 because I gained weight within a month and apparently for some reason or another. If not, it can't be so fast now, but you should keep an eye on whether your children have started doing any different activities, or if they have done some classes like football or basketball . Why will they lose five kilos suddenly but not seven or eight kilos in a month? Second, their appetite is completely gone or they are afraid to eat or they don't eat in front of you but they will pretend to eat or then yes I eat I eat you go and then they They either throw away what they have or they start losing their hair too much ok and teenage girls who don't say I'm losing my hair keep an eye on how much it comes out of the comb or do you suddenly start to have clumps of hair that don't have your hair. Or teeth falling out Decay of the teeth because of impact even bulimia was also there. We will talk about bulimia separately because its associations are different . If you shut it down so much, then the body starts to reject it. Anorexia Sorry about the anorexia unit when you said how is it in hospitals the clinical protocol for it is that it's not like you 're anorexic in front of me and I suddenly have four hives and a lot of mass. If you have to feed them they will die, so there is something called refeeding syndrome which is to be avoided so you have to feed them slowly and its impact is on your intelligence, your study capacity, your sleep, so you can either be completely completely. Many types of sleeping or not sleeping Immunity very low Majority Anorexia Clinically when they start fever for no reason without any infection ok suddenly then fever then doctor says like you no age in then now we Let's do your blood work, then you can see all these parameters in it, if everything is impacted, even if fever starts for no reason, especially in children, I always say that you need to check hemoglobin. Children above 12 years of age, at least once a year, you should check hemoglobin. Check because the diet is helping you and you can keep an eye on whether or not something like that is going on between him and bulimia, which is like saying you've developed anorexia, a type of diet where you 're obsessed with losing weight, and bulimia is what it's all about. So if you 're after weight maintenance, ok so bulimia is not as correct me if I'm wrong but as obsessing over weight is not just about losing weight but keeping me as slim as I am and also about what I eat or what I eat. I am eating because I am comforting because food is comforting from childhood and we are programmed also that way that then we go to seek comfort in food then eat a lot and then because of eating a lot then will I gain weight now Giltney then you purge it out means induce There are a lot of people who say that you should go and do this and take laxatives or laxatives that will make you feel like two or three times or take diuretics because you lose weight when you are a shoe. There are types that is bulimia nervosa that on the one hand you eat terribly and then you gorge and purge and then you have to eat it and then you have to throw it out or somehow you have to remove it from your body because you feel bad about it. And you don't want weight to change the way you look and the emotional part, but there's a lot more about kids. A couple of parameters we can put into it is when is your growth spurt? Expected to reach the final stage of height growth then children are not expected to lose weight during that growth age Hmm Hmm so a fully grown child if you are losing weight then this is a clear red flag ok let's assume it 's a five foot boy or a five foot girl is and she weighs 85 kg and the doctor told her to lose weight but it's a different story with a regular normal child you may look a little chubby but not overweight and losing weight in the age of height gain is a dangerous part of any growth age child trying to lose weight If it's a girl, it 's very important that you talk to your pediatrician. This is the first part. The second thing that 's a big red flag is girls who have established periods and now have irregular or stopped periods because it's as simple as that. There is an intelligence in your body that when you reduce food intake, the body determines its own processes based on the level of nutrients in the body . No, he feels that there is a famine and there will be no food Because I have to use my fat stores, I have to break down my muscles and use that energy because I am not getting the energy I need for daily life in the form of I have to sell the family silver or cut up the land and have no money to eat. The first thing to shut down is going to be your reproduction. Because of that, when a girl who had regular periods starts, her periods are often irregular for the first year. Separately, someone who had started to have somewhat regular cycles and now has stopped and this pattern has been going on for more than three months, young girls come to the You're Looking at Something Very Serious clinic routinely as referrals from gynecologists or paediatricians 14 15 16 year olds have not had periods for years and parents have no idea and they think it's ok because they are irregular . Menstruation does not stop for any reason other than illness or pregnancy. If your daughter is not pregnant, then this is a symptom of some disease and she needs to be checked by a proper doctor. It is necessary to see if it is anorexia. Loss of height becomes permanent and ongoing period stops or becomes terribly regular It was coming every month It was coming every 45 days Now it comes every 2 months 2 and a half months It comes only 3 days instead of 5 I had to change 5 pads I have to change only one pad It used to take an extra large pad, but now it 's working on a medium or small pad, which means decreased menstrual flow. These are all very clear red flags. If you see something, something is wrong. This is anorexia . Let your doctor decide but the athlete can get these kids there and save their lives . If what we've already said is weight loss or irregular periods and plus the mouth feels like it's red or the tongue is constantly red, these are red flags because you often find that anorexia can be caused by nutritional deficiencies or Because of bulimia so much like vomiting, you don't have a throat . As a reference, there was a patient last month who was diagnosed with PCOS and then the gynecologist referred her for diet for PCOS and we did a full assessment, there was no insulin resistance, but still like periods. Gon, when we interview a girl without her parents because she's a teenager, we default to screening her for eating disorders, asking her questions like do you like to eat or what do you think about food, what about your body? Many of his screening tests are tools and tests, and if asked, then and then she has calluses here on her arm, not everyone gets it, but here she has these tight or scarred, it's called Russell's calluses. Nervous And Then She Got A Psychiatric Psychotherapy These people often end up at the dentist because after vomiting, the inner part of the tooth that you never see when you brush your teeth is damaged by the acid because you are expelling the acid from the stomach when you vomit. So they're like chalky teeth on the inside, so these are all the things that I think one thing is that we have again, we have hundreds of readers, our audience is middle class, upper middle class. Having a music system in their room that they're allowed to play too loud I think we have to look at everything from the parent's point of view, not the child's point of view . I don't know what my parents' attitude is Anna they are sitting down to feed me I'm not going to do this in front of them I'm going to close the door I'm going to play the music loud I'm going to the bathroom I'm going to do it in my bathroom I'm going to poop because of that, when I get up from the dinner plate, in the next fifteen minutes, in half an hour, when the child is looking for privacy, going to the toilet, something is wrong, yes, yes, I think this is the awareness that is needed. If you're not stuck, you'll see it. If I'm not aware of what's going on in my house, absolutely , it's not going to happen. Is she gaining weight or not? She was fine till the other day. Why is she standing like this? Why is she walking down like this? Why is she wearing a pedometer on her arm? I look fine, but why is she trying to lose weight? These are the thoughts. It is necessary for the parents to do this, the blind sided way of walking with their eyes closed and then hitting their head against the wall and suddenly waking up after hitting their head is not right. I want to ask one question about this . The focus is on what we are eating, how many calories we are taking in, whether we are exercising properly, because of it, it is becoming a culture to constantly monitor it. It is now becoming a culture to monitor it constantly, everyone has that watch on their hand, everyone knows their step count, then there are different apps that are different. People are sharing their step count on apps and it's become a routine, but maybe for parents or other people, it's not becoming part of their routine that it's becoming a disorder. The line of knowing is very blurred so how can he be looked at.Actually parents first need to understand that the basics of nutrition are taught in class 5 in fact CBSE and now it is taught in class 4 only . If so, you should do a little nutrition refresher and understand that not all calories are created equal . When we are not taking in calories, when we are doing extreme fasting or when we are cutting down on food, right, when we are talking about it, you should first understand your nutrition and what you are saying is that I am not saying that awareness has increased recently. Growing up in the house, parents, children, everyone has gained weight, all the physical activities, it means that everyone has put on a smart watch, but the parents are not looking to see if their goals are met or not. What is what I am getting from this food that I am eating? How this approach is going to help maintain health should be at home Parents should be themselves Parents should make physical activity or exercise a part of their lifestyle Not to burn calories or lose weight Your child will learn only when you start doing it yes or no exercise is a normal part of exercise everyone should do regardless of your body weight yes when you show it because kids learn more from what we show them than what we tell kids I have taken it that now I live in Pune, so there is a lack of things called public transport, so people have their own cars I have to take two wheeler four wheeler etc. I have made a rule for myself that wherever I go now I use google map and every place I want to go, when I come within 1 km of the place I want to go, I park my car at the first parking lot I see and the next one. Distance goes o even now my car is parked closer to Chandni Chowk than to Amuk Tamuk Studio haha but I have time discipline so I reach before time haha Most people reach there haha and then start looking for parking but automatically my 1 km walk It happens , so I have planted it across the main road, because of that, I am not doing it today to cross the middle four square, jam the traffic and contribute to the traffic there , but parents should also show the children that let's park here, let's walk, we are close. There is good parking . I climb the stairs, I don't take the lift , if I want to go to the corner to fetch the wares, what should I do ? If so, I walk 800 meters from the metro, then why should I use a rickshaw for that? The overall movement culture is different. Children need to see at home that we are doing this. Our parents are doing it. It is being promoted. No , that's the simple part, something kids need to see and again, the parameters of eating and drinking change with age, what's healthy for an eight year old may not be for a 15 year old, the 15 year old rule doesn't apply to the 30 year old, the 30 year old rule doesn't apply to the 60 year old. Horses 12% everyone cut calories and eat less calories is stupid as now you said where calories come from good calories and bad calories also need to be distinguished eating a handful of sugar maybe only 100 calories but they are more dangerous than eating a whole chicken Yes , this is the part of it that is the meaning of it . It is necessary to come into the food in the thoughts in the behavior and the speech . If I don't like something, the only reason I don't like it is because of the taste, so now I go to Amita and I also have some digestion issues, so when I look at things, I feel like, well, I don't like this thing because I don't like the taste or I don't like it. I want to eat it even though my body is suffering because I like the taste and I want to eat it so I never put this parameter that my body digests it . Then he would roll it in bread then again in chickpea flour and fry it in dirty oil and put mustard sauce on it and put cheese on it and put more cheese on it then put chaat masala on it then cut it into four pieces grate cheese on it and give it to you 90 % food reels are from this recipe what are we eating nutritionally what are we doing this what are we not bad calories this is dung this is the soil we are eating this is not food this is poison my home cooking i am not eating it Tomorrow I go to recycling and I come out and eat this and I go home and say I'm on a diet right now I'm not hungry hi what the heck this is crazy when I see people on the street if you don't have money then a sheep for two rupees is all you have for a day If it is available I can understand you standing there and eating it but a person who has enough money in his pocket is just for the taste when he is standing on the road with a plate and eating dung with a spoon, he is only paying EMI for a doctor like me to buy a bigger car . No Physicians Nutritionists Dieticians Cardiologists Vascular Surgeons We All Big Big Cars On Your Bhelpuri Money We are going to live in a big big house. Continue sir . What to do is go and eat something terribly calorie rich or drink alcohol haha cool something fun I always give this challenge to all my patients that come on the weekend now we will find something that you want to find non food non alcohol related fun It is for you and probably non-screen related non-screen now because it is associated with the screen then food comes with netflix but popcorn is shown to you so at least one time I will say that even if you are only going to watch the screen it will work but if it is associated then no father also find that That's fun because when you start looking at food as a joy as a comfort, 50% of the women who come to me today are doing stress eating emotional eating as adults and even speaking of bulimia or something like that . It's not changing what you're doing is you're doing it for keeping maintaining the weight yeah there's not much change in bulimia like that and so when I was reading up for this I found out now I knew about Lady Diana I know Lady Diana was a very famously bulimic patient that she had bulimia for many years but now Taylor Swift Ed Sheeran also has bulimia Taylor Swift four years ago her therapy is called she declared that I am out of an eating disorder and if they also mean like obviously when you are so When you're on the big screen or in front of so many people, you're under a lot of attention . It's natural for everyone to do that . Paying attention to what and like I said if I have seen my mother going to food that is to feel good then let's eat something if you have a habit then you are going to carry the same in your adulthood. Another thing to ask is that when we talk about eating disorders now, is it only related to undereating, if overeating means binge eating or emotional eating now that we mention it, are those also eating disorders? No but these things are common in people with eating disorder ok restriction is the real core of eating disorder in some diseases it can be bin eating or eating too much while sitting down and then feeling terrible about it the easiest solution to recognize which eating disorder is to ask the person What did you not eat? How many calories did you eat? A person with hitting disorder knows the number. He tells you the number. A normal person does not tell the number . She ate with this vegetable, so many calories of that vegetable, a normal person doesn't think about it. Haha, these thoughts come only to the level of eating disorder. A normal person just doesn't. Well, why eats four chickens every day? No, when numbers start popping into your head, you're headed for a disorder. Haha, when instead of food, you see numbers instead of food, something is wrong. Realize that brain chemicals are off. Okay, we're almost at the end now. So what's the solution if I see it ? My brother or sister around me or someone in my family or myself start to look at or eat in such a disordered way or I just start seeing calorie numbers and I start looking at 200 calories and this is what I should do. It's going to reach that level because it's the extreme end. OK 100 if a person is going to reach that level then I don't see any option but to seek medical help. Talking about what can be done for the 99 people who are absolutely not there because there are treatments for the disease. If you pay the EMI of my Mercedes by eating Bhelpuri, you give ten rupees to the Bhelpuri man No you are paying doctor mercedes EMI and keep in mind that this is a simple message in me I mean this may actually sound very old fashioned but now my hair in my beard has turned gray so people may write me as a boomer. They will also be ready to turn off, but there was a ritual with Anna that when taking mukhi grass, I am a person of the generation that says, "I am going to eat this food, why am I eating because I am really hungry, am I eating because it is time to eat, am I eating it?" I'm eating because I have nothing else to do when I'm watching NCIS or whatever, I'm having a bowl in my hand and I'm eating because I'm out with my friends and we're going out to eat so I'm already having dinner half an hour ago. Am I eating or if I am not eating why am I not eating I can see the numbers I am not I am full now so I don't want to eat or I ate two hours ago I don't need to eat now I am not old age Somewhere food conscious What is the need to come when driving there is a speedometer in front of the car, there is an rpm meter in front of it , there is a google map in front of me, I know what is going on, I do n't see any indicators when I am eating, because of this, I don't see any indicators. It is necessary to eat in state, if we keep awareness, in thoughts , in behavior , in feeling, then this can happen . A nutritionist, my disordered eating is that, look how it is today, right now, I have patients who come to me who either have hypothyroidism or have gained too much weight, so they have become hypothyroidism, so you start doing crash dieting, which is disordered eating, and then eating disordered. You got arthritis at 16 because of crash dieting and that 's what you do when you're trying to lose weight how do you lose weight or the first thing is as you say sir be conscious of your health from early childhood even That is, you should not let the weight gain so much, but if it has increased, in what way are you going to reduce it, whether it is mother or daughter, both of you need to keep an eye on it, because if not, eventually, even if it doesn't get rid of eating disorder , you will get some other disorder. If he is unfortunately given as a free gift, another thing to keep an eye on is the eating thing, which is often the case that I was at a point where tension or constant eating meant I had no idea what I was eating at home and no one was at home. If I want to watch TV, then I have four things in front of me before I decide what to watch first, and then what to choose from, and this is what to eat first, and then what to watch. I think it is very common among them who are overweight. When we eat something, we get happy hormones from it, even serotonin, dopamine. Why do we feel good ? Why do I feel good after eating something or eating ice cream? It's like you no releasing the serotonin of the dopamines in my in my brain so that's when it increases when when you start is you actually if I need therapy or actually I need to clear my mind but there's no person in front then now the mind If I can't break free, then I have to get out of it somewhere, then I look for happiness, then if I find that happiness in my ice cream, biryani, chips, then when we start going to that, that should actually be a red flag, as we say. Like if I eat whatever I eat once or twice let's eat today for fun you or panipuri eat today because I haven't eaten in a long time then it's a different thing but I ever feel lonely I ever miss someone I feel sad but I can't talk to anyone, I'm feeling very low So what do we do now, let's eat something. Problems come when it happens. As a clinician, I always tell people that if you feel like eating something, first ask yourself if you're really hungry. If you're not hungry. So go, water the plant, wash your clothes, get outside, get out of the house, open one, even if it's just a whirlwind, what triggers you at that time, I'm going to go eat something, and the associations that are now, I'm going to watch TV, today I'm bingeing netflix. If you are going to do it , I should do a diet, that is, a food binge . As for the reels of instagram, remember that bingeing is unhealthy, I am speaking of very old thoughts, what will everyone do, now the responsibility has fallen on me. There is something wrong with a single person sitting and eating. Living and eating by yourself is different, but what is normally expected to be eaten twice or thrice a day is expected to be eaten with people . What is your happiest childhood experience with food ? Can you eat? There is a difference between eating alone and eating with ten people. When other people are watching you eat, there is a natural break in your eating and what you are eating. What are we consuming? Am I really going to eat sitting four quarters? If my mother, wife, children, father, friends are in front, if the boss is in front, will I eat exactly like this and if I am not going to eat, then there is something wrong with it, I should not eat alone if possible. By the grace of God, you have a family, friends, if you have a drink, eat with that drink, that means you will automatically be fine. A closed door. There is something wrong with the life of a single man sitting in front of the TV. Even if the boss is in the office, call four people from the side. Can eat some food Be a little connected Be alone Disconnected I mean hyper connected to the internet or entertainment but disconnected from people If you are eating then there is a problem If you are taking pictures before eating I think there is not a problem There is something wrong that why am I eating this? You will say I am eating because I am really hungry . What exactly should I do? Send me a photo, but I don't ask you to send it to me or post it on social media. I'm not saying that I 'm a doctor, let me see what you're eating. Once again, I'm stuck in a circle, like a record. Keep it up, I think now as a final question, I mean, this is all, ultimately, I feel like our relationship with food with Anna is about food relationships because I think that's where it gets confused and then it goes to either binge eating or I mean my perspective of looking at food is all because of him. So let 's talk about how my relationship with food should be, and then we'll conclude today. Food is a necessity , so my relationship with Anna should first have gratitude. Without which literally tens of thousands of people were dying, this situation has not happened to me and anyone I know in the last 50 years. Now I need to be aware of what is going on because of the Red Revolution, and I need to be aware of what my age is, what is the age of those with me, and I have to change this rule. It is not a blanket rule . The most important thing is to realize that there is no one rule that applies to all. There is no one rule that applies to one person all the time. It is all a dynamic three dimensional chase . We should play like that and when we are eating, it is not a problem. If we get some pleasure from it, I like Puranpoli. If I eat Puranpoli for Ganpati, it is not a problem. But when pleasure becomes poison, I enjoy walking on the sky and water in the fair. It does not mean this. That I will continue to do the same thing all day long and the next one too Small pleasure becomes pleasure remains pleasure or joy remains joy If it is little or continuous how can we stay in a state of joy so continuous you should eat well like this is not necessary and should not happen so It's going to be a little bit sweet, a little bit sweet, yes. If you get it in the episode, thank you both, let me know how you felt about today's episode. If you have any other suggestions, please keep me posted. If you are watching on YouTube, please subscribe. Amita also has a channel. Amita also has a channel. Go and subscribe. Academy Parent Academy If you are listening on any other medium and listening on any other audio platform, please follow and subscribe. Thank you very much.