Izinhlobo Ezijwayelekile Zenkinga Yokudla (kanye Nezimpawu Zazo)

-Delile

• Ziyini izinkinga zokudla?
• Kubangelwa yini?
• 1. I-anorexia amanosa
• 2. IBulimia amanosa
• 3. Ukudla ngokweqile
• 4. IPica
• 5. Ukuphazamiseka kokuvuka
• 6. Ukugwema ukudla / ukuvimbela ukudla
• Ezinye izinkinga zokudla
• Okubalulekile

Yize igama elithi ukudla lisegameni, ukuphazamiseka kokudla kungaphezu kokudla. Yizimo eziyinkimbinkimbi zempilo yengqondo ezivame ukuthi zidinga ukungenelela kochwepheshe bezokwelapha nezengqondo ukuguqula inkambo yabo.

Lokhu kuphazamiseka kuchazwe kwi-American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, uhlelo lwesihlanu (DSM-5).

E-United States kuphela, abesifazane abalinganiselwa ezigidini ezingama-20 nabesilisa abayizigidi eziyi-10 bake baba nenkinga yokudla esikhathini esithile empilweni yabo (1).

Lo mbhalo uchaza izinhlobo ezi-6 ezivame kakhulu zokuphazamiseka kokudla nezimpawu zazo.

Ziyini izinkinga zokudla?

Izinkinga zokudla ziyizimo ezahlukahlukene ezingokwengqondo ezibangela ukuthi imikhuba yokudla engenampilo ikhule. Bangase baqale ngokukhathazeka ngokudla, isisindo somzimba, noma ukuma komzimba.

Ezimweni ezimbi kakhulu, ukuphazamiseka kokudla kungadala imiphumela emibi yezempilo futhi kungaholela ekufeni uma kungalashwa.

Labo abanenkinga yokudla bangaba nezimpawu ezahlukahlukene. Kodwa-ke, iningi lifaka ukuvinjelwa okunzima kokudla, imigqomo yokudla, noma izindlela zokuhlanza njengokuhlanza noma ukuvivinya umzimba ngokweqile.

Yize ukuphazamiseka kwemikhuba yokudla kungathinta abantu banoma yibuphi ubulili kunoma isiphi isigaba sempilo, kuvame ukubikwa kwabasakhulayo nakwabesifazane abasebasha. Eqinisweni, kuze kufike ku-13% wentsha engathola okungenani inkinga eyodwa yokudla eneminyaka engama-20 ().

Isifinyezo Ukuphazamiseka kokudla kuyizimo zempilo yengqondo ezimakwe ukukhathazeka ngokudla noma ukuma komzimba. Zingathinta noma ngubani kepha zivame kakhulu kwabesifazane abasebasha.

Kubangelwa yini?

Ochwepheshe bakholelwa ukuthi ukuphazamiseka kokudla kungabangelwa yizici ezahlukahlukene.

Enye yazo izakhi zofuzo. Izifundo ezingamawele nezokutholwa ezibandakanya amawele ahlukaniswa ngesikhathi sokuzalwa futhi zamukelwa yimindeni eyahlukene zinikeza ubufakazi bokuthi ukuphazamiseka kokudla kungaba yifa.

Lolu hlobo locwaningo selukhombisile ukuthi uma iwele elilodwa liba nenkinga yokudla, elinye linamathuba angama-50% okuthuthuka nalo, ngokwesilinganiso ().

Izici zobuntu zingenye imbangela. Ikakhulu, i-neuroticism, ukuphelela, nokungafisi kuyizici ezintathu zobuntu ezivame ukuxhunyaniswa nengozi ephezulu yokuthola ukuphazamiseka kokudla ().

Ezinye izimbangela ezingaba khona zibandakanya izingcindezi ezibonakalayo zokuba mncane, izintandokazi zamasiko zokuba mncane, nokuchayeka kwabezindaba abagqugquzela leyo mibono ().

Eqinisweni, ezinye izinkinga zokudla zibonakala zingekho kakhulu emasikweni angazange avezwe emibonweni yaseNtshonalanga yobuncane ().

Lokho kusho, izimiso ezamukelekayo ngokwesiko zokuthamba zikhona ezindaweni eziningi zomhlaba. Kodwa, kwamanye amazwe, bambalwa abantu abagcina benenkinga yokudla. Ngakho-ke, kungenzeka ukuthi zibangelwa ukuxubana kwezinto.

Muva nje, ochwepheshe baphakamise ukuthi umehluko ekwakhekeni kobuchopho kanye ne-biology nakho kungadlala indima ekuthuthukiseni ukuphazamiseka kokudla.

Ngokuyinhloko, amazinga wezithunywa zobuchopho i-serotonin ne-dopamine angaba yizici (5, 6).

Kodwa-ke, kudingeka izifundo eziningi ngaphambi kokuba kwenziwe iziphetho ezinamandla.

Isifinyezo Ukuphazamiseka kokudla kungabangelwa yizici eziningana. Lokhu kufaka phakathi ufuzo, i-biology yobuchopho, izici zobuntu, kanye nemibono yamasiko.

1. I-anorexia amanosa

I-anorexia nervosa cishe iyisifo sokudla esaziwa kakhulu.

Imvamisa ikhula ngesikhathi sobusha noma ebudaleni obusha futhi ijwayele ukuthinta abesifazane abaningi kunabesilisa ().

Abantu abane-anorexia ngokuvamile bazibheka njengabantu abakhuluphele, ngisho noma benesisindo esiyingozi ngokuyingozi. Bajwayele ukuqapha njalo isisindo sabo, bagweme ukudla izinhlobo ezithile zokudla, futhi babeke imingcele kuma-calories abo.

Izimpawu ezivamile ze-anorexia nervosa zifaka (8):

• ukuba nesisindo esincane kakhulu uma kuqhathaniswa nabantu abalingana nobude obufanayo
• amaphethini okudla anemikhawulo kakhulu
• ukwesaba okukhulu ukuthola isisindo noma isimilo esiphikelelayo ukugwema ukuthola isisindo, yize ukhuluphele
• ukuphishekela okungapheli kokuncipha nokungafuni ukugcina isisindo esinempilo
• ithonya elisindayo lesisindo somzimba noma isimo somzimba esibonwayo ekuzethembeni
• isithombe somzimba esonakele, kufaka phakathi ukuphika ukuthi ukhuluphele ngokweqile

Izimpawu zokucindezela ngokweqile nazo zihlala zikhona. Isibonelo, abantu abaningi abane-anorexia bavame ukuba matasa ngemicabango engapheli ngokudla, kanti abanye bangaqoqa ngokweqile izindlela zokupheka noma bakuthole ukudla.

Abantu abanjalo bangaba nobunzima bokudla esidlangalaleni futhi babonise isifiso esinamandla sokulawula imvelo yabo, banciphise amandla abo okuzenzakalelayo.

I-Anorexia ihlukaniswe ngokusemthethweni ngama-subtypes amabili - uhlobo olukhawulelayo nokudla ngokweqile nohlobo lokuhlanza (8).

Abantu abanohlobo olukhawulelayo banciphisa isisindo ngokudla kuphela, ngokuzila ukudla, noma ngokuvivinya umzimba ngokweqile.

Abantu abanohlobo lokuzitika ngotshwala nokuhlanza bangazitika ngokudla okuningi noma badle okuncane kakhulu. Kuzona zozimbili lezi zigameko, ngemuva kokudla, bayahlanza besebenzisa imisebenzi efana nokuhlanza, ukuphuza ama-laxatives noma i-diuretics, noma ukuzivocavoca ngokweqile.

I-anorexia ingalimaza kakhulu umzimba. Ngokuhamba kwesikhathi, abantu abaphila nayo bangathola ukuncipha kwamathambo abo, ukungabatholi abantwana, izinwele nezinzipho, kanye nokukhula koqweqwe lwezinwele ezinhle emzimbeni wabo wonke (9).

Ezimweni ezinzima, i-anorexia ingaholela ekuhlulekeni kwenhliziyo, ubuchopho, noma izitho eziningi nokufa.

Isifinyezo Abantu abane-anorexia nervosa banganciphisa ukudla kwabo noma bakunxephezele ngokuziphatha okuhlukahlukene kokuhlanza. Banokwesaba okukhulu kokuthola isisindo, noma ngabe bekhuluphele kakhulu.

2. IBulimia amanosa

IBulimia nervosa ngesinye isifo esidume ngokudla.

Njenge-anorexia, i-bulimia ivame ukukhula ngesikhathi sobusha nasebudaleni futhi ibonakala ingajwayelekile kakhulu kwabesilisa kunabesifazane ().

Abantu abane-bulimia bavame ukudla amanani amakhulu ngokungajwayelekile esikhathini esithile.

Isiqephu ngasinye sokudakwa ngokweqile siqhubeka kuze kube yilapho umuntu egcwala kabuhlungu. Ngesikhathi sokudakwa, umuntu uvame ukuzwa ukuthi akakwazi ukuyeka ukudla noma ukulawula ukuthi udla kangakanani.

Ama-Binges angenzeka nganoma yiluphi uhlobo lokudla kepha okuvame ukwenzeka ngokudla umuntu avame ukukugwema.

Abantu abane-bulimia bese bezama ukukhipha ukunxephezela amakhalori adliwe futhi banciphise ukungakhululeki kwamathumbu.

Ukuziphatha okuvamile kokuhlanza kufaka hlanza ngenkani, ukuzila ukudla, laxatives, isisu, i-enemas, nokuvivinya umzimba ngokweqile.

Izimpawu zingabonakala zifana kakhulu nokudla ngokweqile noma ukuhlanza ama-subtypes we-anorexia nervosa. Kodwa-ke, abantu abane-bulimia bavame ukugcina isisindo esijwayelekile, kunokuba babe nesisindo esincane.

Izimpawu ezivamile ze-bulimia nervosa zifaka (8):

• iziqephu eziphindaphindwayo zokudla ngokweqile ngomuzwa wokuntuleka kokulawula
• iziqephu eziphindaphindayo zokuziphatha okungafaneleki kokuhlanza ukuvimbela ukuzuza kwesisindo
• ukuzethemba ngokweqile kuthonywe ukwakheka komzimba nesisindo
• ukwesaba ukuthola isisindo, yize unesisindo esijwayelekile

Imiphumela emibi ye-bulimia ingabandakanya umphimbo ovuvukile nobuhlungu, izindlala ezivuvukile zamathe, uqweqwe lwamazinyo olugugile, ukubola kwamazinyo, i-acid reflux, ukucasuka kwamathumbu, ukomisa okukhulu kwamanzi nokuphazamiseka kwamahomoni (9).

Ezimweni ezinzima, i-bulimia nayo ingadala ukungalingani emazingeni ama-electrolyte, njenge-sodium, i-potassium ne-calcium. Lokhu kungadala isifo sohlangothi noma isifo senhliziyo.

Isifinyezo Abantu abane-bulimia nervosa badla inani elikhulu lokudla ngesikhathi esifushane, bese behlanza. Bayesaba ukukhuluphala yize besesisindweni esijwayelekile.

3. Ukudla ngokweqile

Inkinga yokudla ngokweqile kukholakala ukuthi ingesinye sezinkinga ezivame kakhulu zokudla, ikakhulukazi e-United States ().

Imvamisa iqala ngesikhathi sobusha kanye nokuba mdala, yize ingakhula ngokuhamba kwesikhathi.

Abantu abanalesi sifo banezimpawu ezifana nalezo ze-bulimia noma uhlobo lokudla oludakayo lwe-anorexia.

Isibonelo, badla ukudla okuningi ngokungavamile ngesikhathi esifushane futhi bazizwe bengenakho ukulawula ngesikhathi semigqomo.

Abantu abanenkinga yokudla ngokweqile abavimbeli ama-calories noma basebenzise izindlela zokuhlanza, njengokuhlanza noma ukuvivinya umzimba ngokweqile, ukukhokhela ama-binges abo.

Izimpawu ezijwayelekile zokuphazamiseka kokudla ngokweqile zifaka (8):

• ukudla inqwaba yokudla ngokushesha, ngasese kuze kube kugcwele ngokungakhululekile, yize ungazizwa ulambile
• ukuzwa ukuntuleka kokulawula ngesikhathi seziqephu zokudla ngokweqile
• imizwa yokucindezeleka, enjengamahloni, ukunengeka, noma ukuzizwa unecala, lapho ucabanga ngokuziphatha ngokweqile
• akukho ukusetshenziswa kokuziphatha kokuhlanza, njengokuvinjelwa kwekhalori, ukuhlanza, ukuzivocavoca ngokweqile, noma ukusebenzisa i-laxative noma i-diuretic, ukukhokhela ukubheja

Abantu abanenkinga yokudla ngokweqile bavame ukukhuluphala ngokweqile noma ukukhuluphala. Lokhu kungakhuphula ubungozi bezinkinga zezokwelapha ezixhunyaniswe nesisindo eseqile, njengesifo senhliziyo, isifo sohlangothi, nohlobo 2 sikashukela ().

Isifinyezo Abantu abanenkinga yokudla ngokweqile njalo futhi ngokungalawuleki badla inani elikhulu lokudla ngesikhathi esifushane. Ngokungafani nabantu abanezinye izinkinga zokudla, abazisusi.

4. IPica

I-Pica enye inkinga yokudla ebandakanya ukudla izinto ezingathathwa njengokudla.

Abantu abane-pica balangazelela izinto ezingezona zokudla, njengeqhwa, ukungcola, inhlabathi, ushoki, insipho, iphepha, izinwele, indwangu, uboya, amatshe, ilondolo yokuwasha, noma isitashi sommbila (8).

I-Pica ingenzeka kubantu abadala, kanye nezingane nentsha. Lokho kusho ukuthi, lesi sifo sivame ukubonwa ezinganeni, kwabesifazane abakhulelwe, nakubantu abakhubazeke ngengqondo ().

Abantu abane-pica bangaba sengozini eyengeziwe yobuthi, ukutheleleka, ukulimala emathunjini, nokuntuleka kokudla okunempilo. Ngokuya ngezinto ezifakiwe, i-pica ingaba yingozi.

Kodwa-ke, ukubhekwa njenge-pica, ukudla izinto ezingezona ukudla akumele kube yingxenye ejwayelekile yesiko noma inkolo yomuntu. Ngaphezu kwalokho, akumele kubhekwe njengokuziphatha okwamukelekayo kontanga yomuntu.

Isifinyezo Abantu abane-pica bavame ukuhalela nokudla izinto ezingezona zokudla. Lesi sifo singathinta ikakhulukazi izingane, abesifazane abakhulelwe, nabantu abakhubazeke ngengqondo.

5. Ukuphazamiseka kokuvuka

Isifo sokuqaqamba kwesinye isifo esanda kusaziwa sokudla.

Lichaza isimo lapho umuntu ephindisela khona ukudla abekade ekuhlafuna futhi akugwinya, akuhlafune kabusha, bese ekuphinda akugwinye noma akuphalaze ().

Lokhu kuvuma kwenzeka ngaphakathi kwemizuzu yokuqala engama-30 ngemuva kokudla. Ngokungafani nezimo zezokwelapha njenge-reflux, kungokuzithandela (14).

Lesi sifo singavela ngesikhathi sobuntwana, ebuntwaneni, noma ebudaleni. Ezinsaneni, ijwayele ukukhula phakathi kwezinyanga eziyi-3 kuya ku-12 ubudala futhi inyamalale yodwa. Izingane kanye nabantu abadala abanesimo ngokuvamile badinga ukwelashwa ukusixazulula.

Uma kungaxazululwa ezinganeni, isifo se-rumination singaholela ekunciphiseni isisindo kanye nokungondleki okukhulu okungabulala.

Abantu abadala abanalesi sifo banganciphisa inani lokudla abakudlayo, ikakhulukazi emphakathini. Lokhu kungaholela ekutheni banciphise isisindo futhi babe nesisindo esincane (8, 14).

Isifinyezo Isifo sokuqaqamba kwesibindi singathinta abantu kuzo zonke izigaba zokuphila. Abantu abanesimo ngokuvamile babuyisa ukudla abasanda kukugwinya. Bese kuthi bayayihlafuna futhi bayayigwinya noma bayikhafule.

6. Ukugwema ukudla / ukuvimbela ukudla

Isifo sokugwema ukudla / sokuvimbela ukudla (i-ARFID) igama elisha lesifo esidala.

Leli gama lingena esikhundleni salokho okwakwaziwa ngokuthi "ukuphazamiseka kokudla kusukela ebuntwaneni nasebusaneni," isifo esasivele sibekelwe izingane ezineminyaka engaphansi kwengu-7 ubudala.

Yize i-ARFID ivame ukukhula ngesikhathi sobuntwana noma ebuntwaneni, ingaqhubeka ibe mdala. Ngaphezu kwalokho, kuvame ngokufanayo kwabesilisa nabesifazane.

Abantu abanalesi sifo bahlangabezana nokuphazamiseka kokudla ngenxa yokuntula intshisekelo yokudla noma ukunganaki iphunga elithile, ukunambitheka, imibala, ukwakheka, noma amazinga okushisa.

Izimpawu ezivamile ze-ARFID zifaka (8):

• ukugwema noma ukuvinjelwa kokudla okuvimbela umuntu ekudleni ama-calories noma izakhi zomzimba ezanele
• imikhuba yokudla ephazamisa imisebenzi ejwayelekile yomphakathi, njengokudla nabanye
• ukwehlisa isisindo noma ukukhula kabi ngeminyaka nokuphakama
• ukushoda kwezakhi noma ukuncika kwizithasiselo noma ukondliwa kwamashubhu

Kubalulekile ukuqaphela ukuthi i-ARFID idlulela ngaphezu kokuziphatha okujwayelekile, njengokudla okukhethiwe ezinganeni ezincane noma ukudla okuphansi kokudla kubantu abadala asebekhulile.

Ngaphezu kwalokho, akubandakanyi ukugwema noma ukuvinjelwa kokudla ngenxa yokushoda kokutholakala noma imikhuba yenkolo noma yamasiko.

Isifinyezo I-ARFID yisifo sokudla esidala ukuthi abantu bangadli kahle. Lokhu kungenxa yokungabi nentshisekelo kokudla noma ukuphazamiseka okukhulu kokuthi ukudla okuthile kubukeka kanjani, kunuka kanjani, noma kunambitha kanjani.

Ezinye izinkinga zokudla

Ngaphezu kokuphazamiseka kokudla okuyisithupha ngenhla, kukhona ukuphazamiseka okungaziwa kangako noma okuncane kakhulu okukhona. Lokhu ngokuvamile kungaphansi kwesinye sezigaba ezintathu (8):

• Ukuphazamiseka kwesifo. Abantu abanenkinga yokuhlanza bavame ukusebenzisa izindlela zokuhlanza, njengokuhlanza, ama-laxatives, isisu, noma ukuzivocavoca ngokweqile, ukulawula isisindo noma ukuma kwabo. Kodwa-ke, abazidli ngokweqile.
• I-syndrome yokudla ebusuku. Abantu abanalesi sifo bavame ukudla ngokweqile, imvamisa ngemuva kokuvuka ebuthongweni.
• Okunye ukuphazamiseka kokudla noma kokudla okucacisiwe (OSFED). Yize kungatholakali ku-DSM-5, lokhu kufaka noma yiziphi ezinye izimo ezinezimpawu ezifana nalezo zesifo sokudla kodwa ezingalingani kunoma yiziphi izigaba ezingenhla.

Isifo esisodwa esingawela ngaphansi kwe-OSFED okwamanje yi-orthorexia. Yize kukhulunywa kakhulu ngakho kwabezindaba nakwizifundo zesayensi, i-orthorexia isazobonwa njengesifo esihlukile sokudla yi-DSM yamanje.

Abantu abane-orthorexia bavame ukugxila kakhulu ekudleni okunempilo, kuze kube sezingeni eliphazamisa impilo yabo yansuku zonke.

Isibonelo, umuntu othintekile angaqeda wonke amaqembu okudla, esaba ukuthi awanampilo. Lokhu kungaholela ekutheni ungondleki kahle, wehlise isisindo somzimba kanzima, ube nobunzima bokudla ngaphandle kwekhaya, nokucindezeleka ngokomzwelo.

Abantu abane-orthorexia kuyaqabukela bagxile ekwehliseni isisindo. Esikhundleni salokho, ukuzihlonipha kwabo, ubunikazi babo, noma ukwaneliseka kwabo kuncike ekutheni bayithobela kangakanani imithetho yabo yokuzibekela ukudla (15).

Isifinyezo Ukuphazamiseka kokugula nesifo sokudla ebusuku yizinkinga ezimbili ezingeziwe zokudla okwamanje ezingachazwanga kahle. Isigaba se-OSFED sifaka zonke izinkinga zokudla, njenge-orthorexia, ezingalingani kwesinye isigaba.

Okubalulekile

Izigaba ezingenhla zenzelwe ukuhlinzeka ukuqonda okungcono kwezinkinga zokudla ezivame kakhulu nokuqeda izinganekwane ngazo.

Izinkinga zokudla yizimo zempilo yengqondo ezivame ukudinga ukwelashwa. Futhi kungalimaza umzimba uma kushiywe kungalashwa.

Uma unenkinga yokudla noma wazi othile ongaba nayo, funa usizo kudokotela onakekela ukuphazamiseka kokudla.

Inothi lomhleli: Lesi siqephu sashicilelwa ekuqaleni ngoSepthemba 28, 2017. Usuku lwaso lokushicilelwa lwamanje lukhombisa ukubuyekeza, okubandakanya ukubuyekezwa kwezokwelapha nguTimothy J. Legg, PhD, PsyD.