Could modern diet culture disguise serious distress signals in certain individuals

Healthcare experts help lift the veil on eating disorders

Wednesday, April 7 2021

Could the diet culture so prevalent in our society be normalising certain issues that could potentially be harmful, leading us to misread warning signals that someone is in serious distress and need of help? Two healthcare experts share insights into eating disorders.

It’s about self-worth
According to Marlene van den Berg, occupational therapist practising at Akeso Montrose Manor psychiatric hospital in Cape Town, diet culture and body image are closely interconnected with self-worth. This is is a core issue in eating disorders such as Anorexia Nervosa and Bulimia Nervosa, serious mental health conditions that can have devastating effects on the emotional and physical health and well-being of those affected. 

“Anorexia is a condition in which the sufferers have a distorted belief that they are grossly overweight and they therefore starve themselves, often to the point where their weight loss becomes so severe that it is life-threatening. This can result in symptoms such as dry skin, loss of bone density, severe constipation and depression, amongst others, as the body begins to starve,” says Van den Berg.

“Bulimia, on the other hand, involves repeated ‘binge’ episodes during which the sufferers cannot control their urge to eat excessively, followed by compensatory behaviours, like vomiting, to purge themselves in an attempt to lose or control their intake of food. Individuals who suffer from Bulimia may also make use of unhealthy methods of weight control, including the use of laxatives, excessive exercising and restricting between binges. Sufferers seldom lose as much weight as those with anorexia and they hide their binges, so family members are often unaware of the condition in their loved ones. Symptoms can include chronically inflamed sore throat, swollen glands leading to puffy cheeks, worn tooth enamel from stomach acid and dehydration,” she notes.

Binge eating disorder is a third common eating disorder in which sufferers also have repeated ‘binge’ episodes where they experience a loss of control over their eating, but they do not use compensatory behaviours, such as purging, afterwards. They often struggle with intense feelings of guilt and experience a complete loss of control during the period of binging. 

Van den Berg advises concerned family and friends to be on the lookout for the red flags of eating disorders such as skipping meals regularly, highly specific food rituals, over-or under-eating and over-exercising. “This can be difficult to separate from the many popular fitness regimes that individuals subscribe to. However, eating disorders are strongly tied to ‘rules’ in the mind of the sufferer. For example, ‘I can eat that slice of toast because I am going to run 10km’. Or, ‘If I do not run 10km I cannot eat anything at all’,” she notes.

“This type of imbalanced view is very different from a healthy weight management and exercise plan. An eating disorder is not a lifestyle illness; it is the result of an underlying emotional issue. Persons who have reached extreme stages of eating disorders usually require specialised inpatient care at a treatment facility for the best chance of recovery,” she explains.

Caught between a rock and a hard place
“People suffering from eating disorders are very much caught between a rock and a hard place. On the one hand, they exist in a society where body stereotypes dictate that men should be muscled, and women should be slim. On the other hand, there are stigmas around people with severe weight issues and the subject of eating disorders is not an easy one to broach. For these persons it can seem difficult to find a safe space in which to address the emotional issues connected to their body image,” notes Van den Berg. 

Natascha Stallkamp, a registered clinical psychologist practising at Akeso Montrose Manor, says that despite the disabling effects of an eating disorder, there is light at the end of the tunnel. “Individuals suffering from an eating disorder or a potential eating disorder can be helped early on in the process if they seek professional help as soon as possible. In fact, the earlier these types of conditions are addressed, the higher the chances are of a sustainable recovery and a healthy, fulfilled life.”

Check in with yourself
Stallkamp explains that while disordered eating affects people of both sexes and all ages, there is a higher prevalence of young women among the treatment-seeking population and the onset of this illness is often in the teen/adolescent years. 

She further asserts that while sufferers are often unaware they are developing an eating disorder they themselves can be the first to pick up warning signs that something is not right. “It is important to check in with yourself if you feel like your eating habits might be problematic. Consider whether you are able to function normally or if your functioning is impaired by your weight loss. 

“People often wonder if they actually have an eating disorder or if they might be developing one. Ask yourself if your eating habits and concerns around weight have begun to affect your ability to do normal things that you used to do,” she suggests.

Van den Berg adds that if the sufferer is not addressing the issue it is often the ‘gate-keepers’ in that person’s life who can assist with early detection. “Naturally, parents are often the very first to notice a problem. Beyond that, there are the teachers, guidance counsellors, true friends or extended family members, like an uncle or an aunt. These individuals are more removed from the situation but also have the sufferer’s best interest at heart and can be on the lookout for any unusual behaviour that could be a cause for concern,” says Van den Berg. 

According to Stallkamp, those who are concerned but unsure how to raise the subject without hurting the individual in question could begin by considering their tone and language use. “If you speak calmly and with compassion, using phrases like ‘I’m concerned about your health, I’ll support you through this, let’s get help together’ you are more likely to get a positive response than if you speak with panic and say things such as ‘It’s scary how thin you are, you look bad, you need to stop this!’, which may push that person away,” she explains. 

Advice for parents and guardians
“Parents are often paralysed by fear when they see their child slipping into the grip of an eating disorder. It is important to remember that there is help available and it’s ok to ask for professional advice on how to broach your concerns in a supportive way. Sometimes, there is so much talk around food that one stops talking about the eating issues: It’s not about ‘what’; it’s about ‘why’. A change in behaviour is not enough; we need to address the issue underlying the problem in the first place,” notes Van den Berg.

For parents wishing to know what causes eating disorders and how they might help in preventing them, Stallkamp suggests that there are multiple factors involved and a parent is not always able to control every element, e.g. influences from peers or the media. “It is, however, important to keep in mind that children learn a lot from their environment. Try to model a healthy relationship with food by eating three balanced meals per day, ideally together as a family, and teaching them that it’s ok to eat in moderation. Children also hear how you speak about your own body, so be aware of criticising yourself as this is likely to affect your child’s body image negatively. If you notice that your or your child’s eating behaviours are getting out of hand, you should seek help to reduce the negative impact on your child’s self-esteem,” she advises. 

When it comes to addressing the underlying emotional issues with a mental health professional, Stallkamp explains that a number of different contributing factors will be explored, including family history, traumatic events, life influences and other possible triggers. “It can be difficult to open up about past emotional experiences but that is why it is done in a professional environment where you are gently guided through the process in a supportive, therapeutic space. As with any mental disorder, there is no quick-fix. Therapy will require a lot of work, but the sooner you address the issue, the more likely it is that you will find a healthy path and plan for recovery,” concludes Stallkamp.

For information about eating disorder treatment or accessing mental health services or if you are in an emotional crisis, Akeso is here to help. Contact or visit In the event of a psychological crisis, emergency support can be reached at 0861 435 787, 24 hours a day.
Out-patient psychologist and occupational therapist consultations can be booked via and psychiatrist consultations through Netcare appointmed™, online at or by calling 0861 555 565. The COPE Therapy website also contains many useful blog posts on various issues and tips relating to mental health.


About the Akeso Group
Akeso is a group of private in-patient mental health facilities and is part of the Netcare Group. Akeso provides individual, integrated and family-oriented treatment in specialised in-patient treatment facilities, for a range of psychiatric, psychological and substance use conditions. Please visit, or email for further information. In the event of a psychological crisis, please call 0861 435 787 for assistance.

For more information on this media release, contact MNA at the contact details listed below.

Issued by:            MNA on behalf of Akeso Montrose Manor
Contact:    Martina Nicholson, Meggan Saville, Estene Lotriet-Vorster and Clementine Forsthofer 
Telephone:    (011) 469 3016
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