Eating disorders are not just a maladaptive relationship with food or body; they are Bipsychosocial disorders where you deal with biological causes, psychological aspects, and social factors. 
Dealing with our bodies or food could be a manifestation of how we see, think, and view ourselves. It could also be our internal and/or our external interaction with our world and with other people.

Accordingly, we need to learn more about the different types of hunger and how they are related to our personalities, our environment, our self-worth, self-esteem, and how we cope with day-to-day life.

The following guide will discuss every type, its signs, and how to cope properly. 
This guide could help if you &ndash; or anyone you know &ndash; are suffering with their eating pattern:

1-The Malnourishment Hunger: 
It is a physical hunger that you could experience if you are practicing any sort of restriction or if you don&#39;t eat specific food comparable to what your body needs. 
Speaking of restriction &ndash; it can be: 
-Physical restriction/Eating restraint: eating a small amount of food comparable to what your body needs. 
-Mental restriction/Food Avoidance: Feeling guilty over eating a specific food or labeling food as &quot;healthy&quot; and &quot;unhealthy&quot;. 
- Time restriction: Eating at a specific time, (for example preventing yourself from eating after 7 p.m.). 
-Social restriction: Avoidance of any gatherings that could hold the possibility of experiencing food, especially your fear food.

Signs: 
Avoidance of specific foods or food groups (No carb, no fat, no meat or poultry, no dairy, and/or no sweet). 
Protein deficient or vitamin deficient. 
Having a malnourished/starved brain. (Severe Anxiety &ndash; Irrational thinking &ndash; Altered body image) 
Fear of gaining weight. 
Fear of eating too much.

What to do: 
&nbsp;If you are &ndash; without any medical, ethical, or religious reasons &ndash; preventing yourself from eating specific food or don&#39;t eat what your body really needs, you have to allow yourself to eat these food even if it means experiencing shame and/or guilt. 
You can slowly, and with others&#39; help, incorporate this food into your daily meals. With time your body will get used to them and your feelings of shame or guilt gradually vanish.

2- Mental Hunger: 
Mental hunger or brain hunger is a critical &ndash; and normal phase &ndash; during recovery from an eating disorder, disordered eating, or any dietary restriction. It simply means &quot;thinking about food&quot;, &quot;thinking about anything that leads to food&quot;, or &quot;thinking about your fear food&quot;. 
Eating disorders or any restriction put our bodies in an &quot;energy deficit&quot;. We suffer from malnutrition and a lot of physical and psychological stress. 
During this phase, our digestive system becomes slower because our minds are convinced that food is scarce and movement is inevitable.

Because our digestive system is smart, it sends a message to our brain that it needs more energy/food to achieve optimal function. 
Our brain interprets that message into thoughts about food to push us to eat more and to make sure that food is available again.

Signs: 
Thinking about food: 
Thinking about food can happen even if you just finished your meal. You may dwell on what to eat the next meal, build a sandwich in your head, or imagine that you are eating one of your fear foods. 
You may also experience those thoughts in your dreams. 
 
Questioning your hunger: 
If you keep asking yourself whether you are hungry or not, you are certainly hungry and you are experiencing mental hunger. 
The problem is that eating disorder &ndash; and for a very long time &ndash; has taught you not to trust your hunger cues, and also made your brain build a direct correlation between hunger and the reward system.

Obsessing with cooking books, food pictures, or binging on cooking shows: 
Those who are suffering from eating disorders or food restrictions are constantly searching for permission to eat. 
But because our minds feel that food is unavailable/scarce, we would seek a replacement for it. 
&nbsp;Cooking books, cooking shows, and food pictures are typical alternatives to real food. They are like an embodiment of what we need.

Thinking about exercise: 
Excessive or obsessing with exercise is an obvious sign of a potential eating disorder, and it plays two leading roles: 
Firstly: it is a method to earn food. 
Secondly: it is a great way to burn off food. 
So, thinking about exercise is a thought about food, permission to eat food, or a choice to purge food.

Wanting to be busy all the time: 
Feeling of control is a subtle possible reason for developing an eating disorder. We want to be safe, perfect and empowered and cope with the fear of uncertainty. 
We keep ourselves busy by planning meals and/or movements to feel that we control everything around us.

It is also said &ndash; and from a Darwinian/evolutionary perspective &ndash; when the pre-agrarian humans experienced a decrease in food resources (Famine, Starvation or restriction), they seek a better environment (Migration). And to migrate (An act of movement), they saved their energy by shutting down their hunger cues as an adaptive mechanism to that starvation.

According to Shan Guisinger, those who are suffering from eating disorders or food restrictions are obsessed with filling their days with duties, excessive movement, or responsibilities to deny their hunger and also ignore the need for food which is known as Adapted to Flee Famine.

Cooking for others and never sharing them: 
Obsessing with cooking food for others is a manifestation of a desire to eat this food. 
Eating disorders make us create strict rules towards what we SHOULD and SHOULDN&#39;T eat which in turn leads to what is known as &quot;safe food and fear food&quot;. 
When we choose to cook our fear food and never eat it, it means that our minds are thinking about this food.

What to do: 
Stop questioning your feelings: 
You know that eating disorders are slimy and manipulative. When you begin to question your hunger, it means that YOU ARE HUNGRY. Trust your body and send a message to your brain that food is available and gaining weight is normal.

Eat what you crave: 
Stop labeling food, and stop overanalyzing your choices. All food is good and nutritious. 
&nbsp;Labeling food is an example of intrusive thoughts and can shrink your perspective. What you crave is what you need. Eating food is meant to be an enjoyable experience, so stop listening to diet culture&#39;s messages, break this vicious cycle, and eat what you want.

Normalize Guilt: 
After a prolonged period of living in your comfort zone where you only follow ED&#39;s rules, it is normal to feel guilty over breaking these rules. In fact guilt here is a sign of healing. 
Validate your emotions, and treat yourself with compassion. You are not alone &ndash; guilt can be a useful feeling to begin to take responsibility for your recovery. 
As time passes your body will rehabilitate, and your mind will learn that it is normal to eat what you want and that food is not a threat.

Get rid of the busyness mood: 
when you find yourself obsessing with filling your day with duties and responsibilities, ask yourself: 
&quot;Am I really busy? Or is it just a way or a distraction to avoid food?&quot; 
Be honest and remember that although self-knowledge is hard, it helps you recognize your needs and respond to them. 
There is no shame in wanting to eat more, and there is no shame in seeking rest and enjoying a meal.

3- The Pre-Menstrual hunger: 
It happens when woman feels that her bodies needs more food before her period.

Signs: 
Extreme Hunger. 
Having an appetite for more carbs or sweets. 
Feeling guilty after eating. 
 
What to do: 
Women should know that this is a normal phase, and she has to accept and respect it. It is also important to tell her that it is okay to eat more heavily before the period and that her body will handle it.

4- The Shift Worker hunger: 
It happens when we experience irregular work-hours that disrupt our natural cycle. You can consider it as an accidental restriction.

Signs: 
Skipping meals, especially breakfast. 
Malnourishment.

What to do: 
We have to schedule our meals, respect and respond to our hunger cues, eat frequently during the day, never skip breakfast and, more importantly, change our job if it becomes a burden on our bodies.

The following types of hunger will discuss the psychosocial factors that could affect our relationship with food; we will discover how anger, frustrations, happiness, and perfectionism could lead to an unhealthy relationship with food and body. 
But before we dig in, we need to emphasize that using food as a comfort tool is normal so you don&#39;t have to feel guilty over it, and, more importantly, restricting your intake is not the answer. 
&nbsp;But at the same time, we need to learn more about how to feel our emotions so eating becomes an enjoyable experience, not a tool to fix us.

5- Anxiety Hunger: 
It happens when you use food to calm your nerves. You can be unsatisfied with your intake and claim to be hungry all the time even though you actually eat sufficient meals. 
On the other hand, you can restrict your intake because you can&#39;t cope with anxiety or you think that you don&#39;t deserve a good meal.

Signs: 
Feeling hungry all the time. 
Experiencing frustration, confusion, and losing abilities to solve problems. 
Talking about what you &quot;want&quot; not what you &quot;need&quot;. 
Embracing perfectionism. 
Lack of entitlement. 
Experiencing stress and anxiety whether it is real or self-induced. 
Negative self-talk. 
Hardly making a decision. 
Not accepting making mistakes.

What to do: 
Since this hunger is a manifestation of suppressed emotions and underlying psychological factors, we need to learn how to regulate our emotions, practice mindful eating, learn to take care of ourselves, dig deeper to identify our needs, and stop depending on food as a crutch to solve our unresolved problems or our denied needs.

In addition to that we need to let go of the idea of comparing ourselves to others, put realistic standards for ourselves, learn new problem-solving mechanisms, cultivate our self-worth, set boundaries with our minds and with others around us, and try to be more assertive by expressing our wants and needs clearly and in a way that reflects respect to others.

6- Boredom Hunger: 
It happens when someone can&#39;t think of what else to do except food.

Signs: 
Symptoms of Alexithymia. 
The feeling of emptiness.

What to do: 
Identifying the underlying unresolved issues and how to feel emotions, validate and express them. 
Working more on cultivating self-worth and needs.

&nbsp;

7- Celebratory Hunger: 
It happens when food is used as a mechanism to enjoy an occasion.

Signs: 
The feeling of over-exciting in restaurants. 
Obsessing with &quot;wants&quot; Not &quot;Needs&quot;. 
Lack of self-esteem. 
Using food to reach small joy.

What to do: 
Here we seek small joy from food and although this joy can be satisfied for a short time, we are not intrinsically happy. 
We need to learn how to enhance our self-worth, prioritize our needs and focus on celebrate building healthy relationships with others.

8- Anger / rebellious Hunger: 
It happens when we seek instant gratification by using food when we feel angry. Or when we feel that we are prevented from doing what we want.

Signs: 
Embracing passive- aggressive communication: 
When someone expresses their frustration or anger and avoids responsibilities. 
Approaching life from the victim position. 
&nbsp;

What to do: 
We need to know why we are feeling angry and with whom. We also need to consider if our anger is real or dysfunctional. 
We also need to identify whom we are rebellious against, embrace more mature mechanisms to express our needs, and learn how to take responsibilities.

 
9- Loneliness Hunger: 
It happens when we use food as a comfort response to a devastating event we experience. We can also our restrict intake when we go through painful emotions.

Signs: 
Losing the ability to respond to a painful experience. 
Treating food as a method to escape uncomfortable emotions.

What to do: 
Since we are using food as a tool to deal with something heavy in our minds and souls. We need to identify and understand the subtle reasons behind our feeling of loneliness. We should ask for help when we find it hard to deal with grief after losing someone we love or after losing a relationship.&nbsp; 
We have to learn how to express our emotions and embrace helpful mechanisms to reach well-being.

10- The Giver Hunger: 
This person is used to getting a small amount of food and denying his/her hunger. 
Their hunger is a manifestation of their unheard needs.

Signs: 
Treating Food or feeding as an indulgence. 
Dedicating themselves to others&#39; needs and denying their own. 
Never say &quot;No&quot;. 
They are emotionally drained. 
Seeking approval from others.

What to do: 
Givers are happy (on the surface), but (underneath) they are suffering from resentment. 
They need to learn how to set boundaries, normalize saying &quot;No&quot;, stop pleasing others, identify their needs and assertively express them.

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Healing your relationship with food is hard and needs a lot of work and dedication. You have to remember that recovery is possible and it is an ongoing process. When you build a peaceful relationship with your body and your food, you are building a coherent relationship with yourself. Don&#39;t hesitate to ask for help, your mental health deserves your love and care. 
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دليلك لفهم الجوع

Your Guide to Understand Hunger

إذا كنت تتعافى من اضطراب الأكل، فمن الشائع جدًا أن تشعر بالخوف من بعض الأطعمة التي كنت تحرم نفسك منها قبل أن تبدأ في التعافي، لأنك اعتقدت أنها سيئة أو يمكنها أن تؤذيك. وهذا الخوف يؤدي إلى الشعور بالندم، والخزي، والقلق. مواجهة هذه الأطعمة التي تخشى قد تكون مرهقة للغاية، لكن العمل على كسر هذا الخوف سيجعلك تبدأ بالشعور بالأمان، وهذا هو الهدف من كل ذلك، الشعور بالأمان عند الأكل. 

فيما يلي بعض الطرق التي يمكن أن تساعدك على كسر هذا الخوف من الطعام:

صنف الطعام الذى يخيفك إلى &quot;طعام مخيف للغاية، طعام خوفك منه متوسط ، طعام مخيف قليلا 

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* أيضًا إذا كنت تأكل نوعًا معينًا من الطعام بكميات معينة وتخشى تناول كميات اكبر، فيمكنك إضافة فى فئة من الفئات العام بالكمية التى تخشاها

اختر أحد أطعمة الخوف التي كتبتها

يمكنك الاختيار مباشرة من الورقة، او جعل أحد أصدقائك أو أحد أفراد أسرتك باختيارها لك أو يمكنك جعلها أكثر إثارة وحماس عن طريق إضافة الاطعمة التى تخيفك في برطمان، واختيار ورقة واحدة بشكل عشوائي وتحدي الطعام الذي اقترعته. ولكن الأهم من ذلك هو تحدي اي اكلة مخيفة، لأن مرة واحدة لن تكسر خوفك منها تمامًا. الاستمرارية هي المفتاح.

اجعل شخص يجلس معك بينما تتحدى الطعام الذي يخيفك&nbsp;

هذا الشخص يمكن ان يكون فرد من العائلة، صديق أو اي شخص تشعر معه بالأمان. أطلب منه أن يشاركك خلال تحديك. يمكنك اختيار تحدي الطعام بمفردك، ولكن من الأفضل الحصول على الدعم. من المهم ان تكون في بيئة آمنة ومريحة ومؤهلة لتساعدك في تحدي مخاوفك.&nbsp;

امزجه مع أحد أطعمتك الآمنة

الغذاء الآمن: هو أي نوع من الأطعمة لا تخشى تناوله. يمكنك وضع الأطعمة التي تخيفك مع أخرى تشعرك بالآمان في برطمان واحد. 

شتت نفسك

إذا كنت خائفًا جدًا، قم بإلهاء نفسك (شاهد مقطع فيديو، أو فيلمًا، أو استمع إلى أغنية، أو تحدث إلى صديق، وما إلى ذلك ...)

اكتب مشاعرك وأفكار&nbsp;

خاصة قبل تناول طعام مخيف وبعده، ستجعلك كتابة أفكارك أكثر وعياً بما تشعر به ومعرفة ما إن كانت تلك هي أفكارك أم تتعلق باضطراب الأكل لديك.

لا تقسو على نفسك:

تحدى نفسك ولكن في نفس الوقت، لا تقسو على نفسك، إذا كنت لا تشعر أنك جاهز أو أنه سيؤثر بالسلب. من الجيد اتخاذ خطوات صغيرة ولا تقلق هذه الخطوات الصغيرة ستؤدي إلى خطوات أكبر في المستقبل.

استمر (التكرار مهم)

كرر كل التحديات مرة أخرى. تحدي نفسك كثيرا حتى يتحول الطعام الذى يخيفك إلى طعام طبيعي وآمن، لا يثير أي من مخاوفك.

من المحتمل أن تكون مواجهة مخاوفك من الأكلات مزعجة، خاصة في البداية، ولكن مع الممارسة سوف يصبح أسهل. اعترف وامنح نفسك الفضل في اتخاذ هذه الخطوة الشجاعة نحو التعافي. استمر، فأنت في طريقك لاستعادة نفسك.

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If you are in recovery from an eating disorder, it is very common to have a fear of certain foods that you were depriving yourself of before starting to recover because you thought they were bad or could harm you. This fear leads to feelings of regret, shame, anxiety and terror. Facing those foods that you fear can be intensely stressful, but working to break this fear will make you start to feel safe. 

Here are some ways that can help you break your fear of food:

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1-categorize your fear food into &quot;Extreme fear food, medium fear food, slightly fear food&quot;

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*Also if you eat a specific type of food with a specific portion &amp; you&rsquo;re afraid to eat more, you can add a bigger portion in one of these categories

2- Choose one of the fear foods that you wrote

You can choose directly from the paper, let one of your friends or a family member choose it for you or you can make it even more interesting by adding your fear foods in a jar and pick randomly one paper, challenge the food that you picked.

3- Combine it with one of your safe foods

Safe food: Is any type of food that you&rsquo;re not afraid of eating It. You can mix it in one jar and choose with no fear.

4-Distract yourself

If you&#39;re too scared, distract yourself (watch a video, or movie, listen to a song, talk to a friend, etc....)

5- Write down your feelings and thoughts&nbsp;

Especially before and after consuming the fear food, writing your thoughts will make you more aware of how you feel and if this thought is yours or your eating disorder!

6- have someone sit with you while you challenge your fear food&nbsp;

You can choose to challenge a fear food on your own but it can be more comfy to get meal support. Choose someone close you trust and ask him or her to join while you are preparing the challenge. It is significant to be in a peaceful, comfortable and empowered environment that helps you challenge your fears.&nbsp;

7-Do not be so hard on yourself:

Challenge yourself but at the same time, don&#39;t go too hard on yourself, if it&#39;s not going to make you feel comfortable. It&rsquo;s totally fine to take little steps and don&rsquo;t worry these little steps will lead to bigger steps in the future

8-Repeat 

Repeat all the challenges again. Challenging yourself more often makes fear foods, safe foods. Repetition is the key.

Finally, Practice self-compassion.&nbsp;Make sure that every step you take in this process is a step towards recovery, and you will never regret it at the end, working with your therapist is a golden step, overcoming your fear of food and building a healthy relationship with food is always the goal. 

Facing your food fears can be upsetting, especially in the beginning, but with practice, it will get easier. Acknowledge and give yourself credit for taking this brave steps. Keel going, you are on your way to regaining yourself back.&nbsp;

كيف تتحدى الأطعمة التي تخيفك؟

How to challenge your fear foods?

يمكن أن تكون جراحات السمنة مهمة في حياة البعض، لكن من المهم أيضا فهم المخاطر المحتملة والأثر الذي يمكن أن يكون له تأثير خطير على الصحة النفسية. سوف نتناول في هذه المقالة الارتباط بين جراحة السمنة واضطرابات الأكل، أنواع أضرابات الأكل التي يمكن أن تظهر، والعوامل النفسية التي تسهم في تطورها، وتحديد الأعراض، وإدارتها وعلاجها، وأهمية دعم الصحة النفسية، وتصحيح المفاهيم.

في بداية الأمر علينا أن نفهم، ما هي جراحة السمنة، فتلك الجراحة عبارة عن إجراءً يغير الجهاز الهضمي للمساعدة في فقدان الوزن. وعادة ما يتم تقديمها كحل لأولئك الذين لديهم مؤشر كتلة الجسم 40 أو أعلى أو مؤشر كتلة الجسم 35 أو أعلى مع مشاكل صحية ذات صلة. في حين تُعد اضطرابات الأكل مرضًا نفسيًّا خطيرًا يؤثر على علاقة الفرد بالطعام وجسده. ويجب التذكير بأن اضطرابات الأكل يمكن أن تحدث لأفراد من أي حجم، شكل، أو وزن. وفي حين يمكن أن تحسن جراحة السمنة الصحة الجسدية، فإنها يمكن أيضًا أن تثير أو تزيد من حدة اضطرابات الأكل لدى بعض الأفراد، وكذلك تؤدي إلى تفاقم مشاكل أخرى مثل الاكتئاب والقلق المرضي.

الرابط بين جراحة السمنة واضطرابات الأكل. 

تشير الأبحاث إلى أن الأفراد الذين يخضعون لجراحة السمنة يتعرضون لمخاطر أكبر في التعرض للاضطرابات نفسية على رأسها الاكتئاب اضطرابات الطعام. وفي الواقع، تشير الدراسات إلى أن ما يقارب 30% من الذين يخضعون لجراحة السمنة يتعرضون للاضطرابات الأكل والاكتئاب والقلق خلال خمس سنوات من إجراء العملية. هذه نسبة كبيرة وتؤكد على أهمية فهم المخاطر المحتملة وتقديم دعم صحي نفسي كافٍ.&nbsp; فإن التغير الكبير والمفاجئ في نمط التغذية وفقدان الوزن يمكن أن يؤدي إلى بدء حدوث اضطرابات الأكل. بالإضافة إلى ذلك، يمكن أن تؤدي ضغوط المحافظة على فقدان الوزن إلى دائرة مفرغة من التقييد أو التفريغ مثل القئ، والذي يمكن أن يؤدي إلى أسلوب أكل غير المنتظم.

ويضاف إلى ذلك العلاقة الاعتمادية لدى البعض على الأكل، وبالتالي عند إجراء العملية يصبح هناك فراغ عاطفي كبير بسبب غياب الدور السلبي الذي كان يلعبه الطعام، ولذلك تثير العملية خلالا عاطفيا كبيرا يسبب المزيد من الآلم النفسي.

يمكن أن تتخيل أن العملية هي تغير غير محسوب ومفاجئ في نمط الحياة وليس الأكل وحده، فعدم استعدادنا له يمكن أن يفاقم لدينا الكثير من المشكلات النفسية خاصة إذا كانت موجودة في الأصل. فقبل إجراء العملية عليك أن تتسأل ما الذي أوصلك لتلك النقطة وهذه العلاقة المؤذية مع الطعام.

العوامل النفسية المؤثرة بعد جراحة تصغير المعدة:

هناك عدة عوامل نفسية يمكن أن تساهم في تطوير اضطرابات الأكل بعد جراحة تصغير المعدة، وتشمل:

<ul>
	<li>صورة الجسم: صورة الجسم عامل مهم في تطوير اضطرابات الأكل. بعد جراحة تصغير المعدة، قد يواجه بعض الأفراد مشكلات في التصور عن جسدهم، حيث يرون أن جسدهم أكبر مما هو عليه في الحقيقة. </li>
	<li>الصدمات: يمكن أيضًا أن تساهم الصدمات في تطوير اضطرابات الأكل. فالأفراد الذين يتعرضون لصدمات قد يستخدمون الطعام كوسيلة للتغلب على مشاعرهم. وبالتالي قد تعييد العمليات فتح آلام تلك الصدمات الصعبة.</li>
	<li>&nbsp;حالات صحية نفسية: يمكن أيضًا أن تساهم حالات صحية نفسية مثل الاكتئاب والقلق في تطوير اضطرابات الأكل. بعد جراحة تصغير المعدة، قد يواجه بعض الأفراد صعوبة في التكيف مع التغييرات التي طرأت على جسدهم ويستخدمون الطعام كوسيلة للتغلب على ذلك.</li>
</ul>

ولذلك من المهم أن نركز على تلك العلامات بعد إجراء العملية لأنها قد تعني الاحتياج إلى طلب المساعدة ومنها أكثرها شيوعا:

<ul>
	<li>التفكير المهووس حول الطعام والوزن وصورة الجسم.</li>
	<li>اللجوء إلى سلوكيات تقييدية مثل التوقف عن الأكل أو التخلص منها عن طريق القيئ</li>
	<li>تجنب المواقف الاجتماعية التي تتضمن الطعام. </li>
	<li>التعبير عن مشاعر الذنب والخزي أو الانزعاج بعد تناول الطعام.</li>
	<li>فقدان أو زيادة سريعة في الوزن.</li>
	<li>القلق أو الاكتئاب.</li>
</ul>

استراتيجيات لإدارة العواقب النفسية بعد جراحة تصغير المعدة:

يتضمن العلاج الفعال لاضطرابات الأكل بعد جراحة تصغير المعدة نهجًا متعدد التخصصات. ويمكن أن يشمل ذلك: 

<ul>
	<li>المشورة الغذائية: يمكن أن تساعد المشورة الغذائية الأفراد على إقامة عادات غذائية صحية وتعلم التعرف على وإدارة المؤثرات التي قد تدفعنا لاضطرابات الطعام.</li>
	<li>العلاج النفسي: يمكن أن يساعد العلاج النفسي الأفراد على مواجهة العوامل النفسية التي تسهم في اضطرابهم في الأكل والتعامل مع المشاعر والأفكار بصورة أكثر مرونة</li>
	<li>الأدوية: في بعض الحالات، قد يتم وصف دواء للمساعدة في إدارة أعراض مثل القلق والاكتئاب</li>
	<li>مجموعات دعم: يمكن أن توفر مجموعات الدعم بيئة آمنة وداعمة للأفراد لمشاركة تجاربهم وتلقي الدعم من الآخرين الذين مروا بتجارب مماثلة.</li>
</ul>

أهمية الدعم النفسي

من الضروري أن يقدم المتخصصون في الصحة النفسية تقييما ودعمًا نفسيًا للمرضى قبل وبعد جراحة تصغير المعدة. يمكن أن يساعد هذا في تحديد عوامل الخطر المحتملة وتوفير الموارد لإدارة وعلاج أي مخاوف صحية نفسية. كما قد يساعد المريض في معرفة ما قد يوجهه وكذلك اتخاذ القرار الصحيح سواء بإجراء العملية أو عدم اجراءها، بالإضافة إلى ذلك، يجب على المتخصصين في الرعاية الصحية تقديم التثقيف حول المخاطر المحتملة والأثر على الصحة النفسية، التي يمكن أن تؤثر بها جراحة تصغير المعدة.

ويوجد الكثير من المفاهيم الخاطئة والشائعة حول جراحة السمنة واضطرابات الأكل ومنها&nbsp; الاعتقاد بأن جراحة السمنة هي علاج للسمنة، فعلى الرغم من أن جراحة السمنة يمكن أن تساعد الأفراد على فقدان الوزن، إلا أنها ليست علاجًا للسمنة. ومن المهم إقامة عادات صحية قبل وبعد الجراحة للحفاظ على فقدان الوزن ومن الأخطاء الشائعة أيضا أن اضطرابات الأكل تؤثر فقط على الأفراد ذوي الوزن المنخفض. ولكن في الحقيقة يمكن للاضطرابات الأكل أن تؤثر على أفراد من أي حجم، شكل، أو وزن . وأخيرا أن جراحة السمنة هي حلاً سريعًا لفقدان الوزن. ولكن في الحقيقة تتطلب جراحة السمنة تغييرات كبيرة في نمط الحياة والالتزام.

أخيرًا، من المهم أن يلجأ المرضى المقدمون على العمليات الجراحية للمتخصصين في الصحة النفسية لتأكد من عدم وجود مخاطر على الصحة النفسية، وكذلك تجنب أي أضرار نفسية قد تحدث بعد العملية. فقد يلجأ البعض للعمليات اعتقادا بأنها حل سحريا لحياته، وهو أمر عار من الصحة وتصور باطل قد يكون له تداعيات سلبية أكثر.

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While Bariatric surgeries can be significant for many, it is important to understand the potential risks and impact they can have on mental health. In this article, we will explore the link between bariatric surgery and eating disorders, the types of eating disorders that can arise, psychological factors contributing to their development, identifying symptoms, managing and treating them, the importance of mental health support, and addressing misconceptions.

Bariatric surgery is a procedure that alters the digestive system to help individuals lose weight. It is typically reserved for those who have a BMI of 40 or higher or a BMI of 35 or higher with related health problems. An eating disorder is a serious mental illness that affects an individual&#39;s relationship with their food and their body. Eating disorders can occur in individuals of any size, shape, or weight. While bariatric surgery can improve physical health in some aspects, it is worth noting that it can also trigger or worsen eating disorders in some individuals.

The Link Between Bariatric Surgery and Eating Disorders

Research suggests that individuals who undergo bariatric surgery are at a higher risk of developing eating disorders. In fact, studies show that nearly 30% of those who undergo bariatric surgery develop an eating disorder within five years of the procedure. This is a significant number and highlights the importance of understanding the potential risks and providing adequate mental health support.

The drastic change in eating patterns and weight loss can trigger the onset of eating disorders. Additionally, the pressure to maintain weight loss can lead to a restrictive or binge-purge cycle, which can be a slippery slope towards an eating disorder.

There are several types of eating disorders that can arise after bariatric surgery. The most common types include:

1. Binge Eating Disorder (BED)

BED is characterized by recurrent episodes of binge eating, where an individual consumes an excessive amount of food in a short period of time. This can lead to feelings of guilt, shame, and disgust. After bariatric surgery, some individuals may turn to binge eating as a coping mechanism, especially if they have used food as a way of coping with stress or with their emotions pre-surgery. Whereas people who have undergone bariatric surgery may not be able to consume an excessive amount of food in a discreet amount of time, they might still lose control over eating (which is the main characteristic of binge eating). It is also common for people who have undergone bariatric surgery to turn to grazing, which is the repetitive consumption of small amounts of food in an unplanned manner and usually not in response to hunger. When done with loss of control it can be considered a form of disordered eating.

2. Anorexia Nervosa

Anorexia Nervosa is characterized by restrictive eating, an intense fear of gaining weight, and a distorted body image. After bariatric surgery, some individuals may become preoccupied with maintaining their weight loss and develop an unhealthy obsession with food and weight.

3. Bulimia Nervosa

Bulimia Nervosa is characterized by recurrent episodes of binge eating followed by purging behaviors such as vomiting or using laxatives. After bariatric surgery, some individuals may feel pressure to maintain their weight loss and turn to purging as a way to control their weight.

Psychological Factors:

There are several psychological factors that can contribute to the development of eating disorders after bariatric surgery. These include:

1. Body Image

Body image is a significant factor in the development of eating disorders. After bariatric surgery, some individuals may struggle with a distorted body image, where they perceive their body larger than it is.

2. Trauma

Trauma can also contribute to the development of eating disorders. Individuals who have experienced trauma may turn to food as a way to cope with their emotions.

3. Mental Health Conditions

Mental health conditions such as depression and anxiety can also contribute to the development of eating disorders. After bariatric surgery, some individuals may struggle with the changes in their body and turn to food as a way to cope.

It is important for mental health professionals to be able to identify symptoms of eating disorders in post-bariatric surgery patients. Some common signs and symptoms include:

1. Obsessive thoughts about food, weight, and body image

2. Engaging in restrictive and/or purging behaviors

3. Avoiding social situations that involve food

4. Expressing feelings of guilt, shame, or disgust after eating

5. Rapid weight loss or gain

6. Preoccupation with weight and body image

7. Anxiety or depression

Strategies for Managing and Treating Eating Disorders After Bariatric Surgery

Effective treatment for eating disorders after bariatric surgery involves a multidisciplinary approach. This may include:

1. Nutritional Counseling

Nutritional counseling can help individuals establish healthy eating habits and learn to identify and manage triggers.

2. Therapy

Therapy can help individuals address underlying psychological factors contributing to their eating disorder.

3. Medication

In some cases, medication may be prescribed to help manage symptoms such as anxiety and depression.

4. Support Groups

Support groups can provide a safe and supportive environment for individuals to share their experiences and receive support from others who have gone through similar experiences.

Importance of Mental Health Support Before and After Bariatric Surgery

It is crucial for mental health professionals to provide mental health support to patients before and after bariatric surgery. This can help identify potential risk factors and provide resources to manage and treat any mental health concerns that arise. Additionally, mental health professionals should provide education about the potential risks and impact on mental health that bariatric surgery can have. This can help patients make informed decisions about their healthcare.

Finally, there are several common misconceptions about bariatric surgeries and eating disorders. These include:

1. Bariatric surgery is a cure for obesity.

While bariatric surgery can help individuals lose weight, it is not a cure for obesity. It is important to establish healthy habits before and after surgery to maintain weight loss.

2. Eating disorders only affect individuals who are underweight.

Eating disorders can affect individuals of any size, shape, or weight.

3. Bariatric surgery is a quick fix for weight loss.

Bariatric surgery requires significant lifestyle changes and commitment to maintain weight loss.

It is important for individuals to seek professional help for any mental health concerns after bariatric surgery. This can include speaking with a therapist, joining a support group, or seeking medication management. By addressing misconceptions and providing education, we can help individuals make informed decisions about their healthcare and improve their overall well-being.

ما هي المخاطر النفسية من جراحات السمنة

Bariatric Surgery: Understanding the Impact on Mental Health

Can you name your emotions when looking in the mirror? Is it a pleasant or unpleasant experience? Does the size or shape of your body affect how valuable you are as a person?

In his monograph &quot;The Image and Appearance of the Human Body,&quot; written in 1935, German author Paul Schilder defined body image as &quot;the picture of our own body that we form in our minds.&quot;

Schilder regarded body image as a psychological phenomenon before it was reexamined in 1988 as a perceptual and attitudinal phenomenon by Peter David Slade, who defined it as: 
&quot;The picture we have in our minds of the size, shape, and form of our bodies; and to our feelings concerning these characteristics, our constituent body parts&quot;.

Body Image &ndash; Feelings and thoughts 
According to the former and the latter descriptions, we can define body image as: 
&quot;How we see, feel, and think about our bodies and how we behave according to these views, feelings, and thoughts.&quot;

As Mental Health Foundation - UK suggests, Body Image is linked to a number of factors, including: 
1- Self-Perception: How we view our bodies and how accurate this view is. 
2- Satisfaction: how satisfied we are with both our bodies and our appearance. 
3- The environment: How we see our bodies in relation to our surroundings. 
4- Others&#39; views: To what extent do others&#39; opinions impact how we feel about our bodies and ourselves?

A Healthy Body Image: What is it? 
Being satisfied with our bodies is key to having a healthy body image. It is the capacity to respect our bodies, accept their abilities, and value them as much as we value our characters.

What is a Negative Body Image? 
A negative body image usually means body dissatisfaction. It can also mean having concerns about our bodies that manifest as concerns about our weight, shape, or size of certain body parts.

When Body Image Concerns Become a Problem 
Having concerns about our bodies is not a mental health problem in itself. However, if we experience persistent negative thoughts about our bodies that affect our day-to-day lives, and prompt us to choose maladaptive mechanisms, it can indicate a mental health problem. 
&nbsp;We might go through: 
1- Psychological distress. 
2- Poor quality of life. 
3- Symptoms of depression and isolation. 
4- Unhealthy eating behaviours.

Where Do the Issues with Body Image Originate? 
We are unique, and how we process and cope with our difficulties has a big impact on how we perceive our bodies. 
There are many factors that can affect how we see our bodies, including: 
1- Our relationship with our bodies. How we talk to and feel about our bodies. 
2- Our relationship with our families and friends. 
3- How our families and friends talk about bodies and appearance. 
4- Exposure to the so-called idealized bodies through media and social media. 
5- The social pressure to look a certain way in order to fit the group. 
 
Is there a Relationship between our Value and our Body Image? 

Our thoughts and behaviors about our bodies can easily affect our well-being and quality of life, and vice versa. 
Some people believe that their values depend on how they look. We can observe it when people adopt unhealthy eating behaviours, engage in excessive exercise, skip meals, take steroids, and avoid social gatherings because they don&rsquo;t look a certain way. &nbsp;

How Can Body Image Dissatisfaction Lead to Shame? 
Body shame is a feeling related to what is called &quot;internalization of the ideal&quot;, which means valuing, praising, glorifying an &quot;ideal&quot; body and considering it as an undisputed fact. 
Body shame occurs when we think that we can&#39;t reach the ideal body, or that we don&#39;t fit in or that we don&#39;t belong.

What are the ramifications of experiencing body image concerns? 
Persistently experiencing body image concerns can put the individual at higher risk of developing Body Dysmorphic Disorder and Eating Disorders. Examples of eating disorders are Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder.

To what extent does body image affect children young people? 
According to several studies, body image is ranked as the third- biggest challenge for young people after unemployment and academic failure. 
Additionally, it has been claimed that kids under the age of six struggle with body image issues.

How do peers and families influence one&#39;s body image? 
Our relationships with our peers and families have a huge effect on how we see and think about our bodies. 
Feeling of pessimism, shame, and loneliness can be cultivated by exposure to the so-called idealized bodies and critical comments.

According to Mind over Mirror &ndash; Parent Guide, talking negatively or critically about bodies (from parents) is more detrimental than displaying extreme weight-loss behaviors.

What are the elements that influence children and young people&#39;s perceptions of their bodies? 

1-Puberty Phase: 
A critical phase for both boys and girls who mature later or earlier than their peers. 
This phase includes body changes in height, weight, and shape. 
It is also the phase when young people go through comparisons and/or bullying.

2- Culture: 
Moving to new places and dealing with new cultures and values affect how young people view their bodies. 
 
3- Physical health conditions and disabilities: 
Chronic illness or life-long injury can change the way young people think about their bodies.

4- Neurodiversity and learning disabilities: 
Learning disabilities impact a person&#39;s capacity to: 
understand or use spoken language, calculate, move with coordination, and pay attention. 
These disabilities are life-long condition and need special schooling. 
When it comes to difficulties with motor skills, people with Autism Spectrum Disorder (ASDs) find it challenging to be completely aware, in control, and connected to their bodies.

5- Life changes and transition periods: 
This can include age-related ceremonies, birthdays, school graduation, changing schools, divorce, or experiencing trauma.

6- Technology: 
In addition to built-in features like camera filters on TikTok and Instagram, Mental Health Foundation- UK claims that using image-editing technology apps that are free and not age-restricted (color filters, teeth whitening, body shape, skin tone, height, and muscularity) can have a negative impact on body image and self-esteem.

How can you tell if your child/adolescent is having issues with their body image? 
Although having thoughts about the body is not in and of itself a mental health issue, we should proceed with caution when our behavior changes significantly. 
And here are other indicators that, if persistent, may point to a problem:

1- Notable changes in mood and interpersonal interactions. 
2- Showing frequent worries about how we look. 
3- A desire to conceal: feeling under pressure to hide certain body parts. (Beyond the usual behavior or cultural norms) 
4- Withdrawal: the inability to participate in activities where the body would be on display, such as swimming or physical education classes (Beyond the usual behavior or cultural norms). 
5- Body shaming/self-bashing: labeling or making fun of our bodies or expressing rigid thinking patterns about what is a &quot;good&quot; vs. &quot;bad&quot; body type. Or what is known as &quot;Black and white thinking&quot;. 
6- Self-Objectification: Treating our bodies as an object that needs to be fixed. 
7- Social Comparison: Engaging in talks about how others&#39; bodies are good and beautiful compared to our bodies and vice versa. 
8- Body checking: Spending a lot of time in front of mirrors. 
9- Negative self-talk and describing weight gain as a failure. 
10- Rigid Mentality: Insisting on having to look a certain way.

Men and Body Image

Mental health issues are feminized; therefore men might find it hard to make their voices heard. 
Men&#39;s perceptions of their bodies and how they relate to them are significantly influenced by low self-esteem, childhood trauma, sexual trauma, stereotypical beliefs, and unfounded notions about the mental health of men. 
 
Excessive exposure to unrealistic standards leads men &ndash; especially young adults &ndash; to develop problems with eating and exercise. 
According to a study by Anglia Ruskin University, masculinity emphasizes the value of toughness, self-reliance and pursuit of status which lead men to place greater value on the importance of being muscular. 
In addition to that, the terms of &quot;Muscle dysmorphia&quot;, &quot;Reverse Anorexia&quot; or &quot;Bigorexia&quot; are used to describe the obsession of having a bigger, more muscular body. 
Men who focus on gaining muscles and using steroids to accomplish unrealistic goals may develop anxiety, isolation, depression, and suicidal thoughts.&nbsp;

How to build a positive body image?

Body image dissatisfaction is a learned experience, so we can &ndash; by embracing cognitive reframing &ndash; unlearn this experience. 
Here is what we can do:

1-Practice Self-compassion: 
According to a study, treating our bodies with love and warmth enhances well-being. 
Expressive, non-judgmental writing that uses self-compassion towards our bodies will help us feel less isolated which in turn lessens self-criticism, symptoms of anxiety, and improves body-esteem.

2-Challenge limiting beliefs: 
Put an end to self-doubt and don&#39;t let your fears dictate what you want to do.

3- Practice positive self-talk: 
Language is important; therefore, we need to learn how to speak to ourselves in a way that reflects love, care, and gratitude.

4- Understand the limits of weighing yourself:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
Stop seeing weight as a measure of your health. Instead, concentrate on enhancing your physical and mental wellness by engaging in self-care activities.&nbsp;

5- Journaling: 
Write a list of 5 to 10 things you love about yourself that say nothing about how you look.

6- Pay attention to advertisements: 
Advertisements are made to sell us on the idea that we must change our appearance to be loved and appreciated. So, pay attention to these messages and keep in mind that they use filtered photographs that are not representative of reality.

7- Build your own values: 
Write about your intrinsic values and incorporate them into your daily activities.

8- Consider those you love and admire: 
Ask yourself: &quot;Do I love them because of their appearance or because of their personalities?&quot;

9- Observe your surrounding: 
Surround yourself with people that share your values.

10- Organize your social media feed: 
Unfollow any accounts that might make you feel ashamed of your body or your appearance.

11- Create a cozy wardrobe: 
Wear clothes that are comfortable and that express your personality.

12- Set boundaries: 
Learn to communicate assertively with others and let those around you know that you don&#39;t like/ appreciate comments on your physical appearance, whether they are positive or negative.

13- Avoid body bashing: 
Listen mindfully to the language you use when talking about your body.

14- Don&#39;t feel ashamed of your eating habits: 
Your body doesn&#39;t define you. Give yourself permission to eat whatever you want, exercise for pleasure rather than punishment, take time to rest, and remember that there is no shame in eating more than those around you.

15- Challenge your intrusive thoughts: 
Observe your unhelpful thoughts. Do you believe in ideas like: &quot;Losing weight will make me happy&quot;, &quot;I am fat&quot;, &quot;I have a big belly&quot;, &quot;I should work out every day to fix my body flaws&quot;, or &quot;I am ugly and I need cosmetic surgery&quot;?

16-Regulate your emotions: 
Body image concerns can be a result of childhood trauma or bullying or unspoken emotions. Learn to acknowledge and validate what you feel without judgment.

17- Perfectionism destroys happiness: 
There is no such thing as called &quot;perfect body&quot;. Our bodies are created to be fluid and changed. Accepting this truth will make you build a calm relationship with your body. 
Your worth as a human being is much more important than how you look. Learn to respect and accept your body. Learn to accept and respect others&#39; bodies. Ask for help. Beware of diet culture, social media posts, or comparisons that suggest you need to change your body to be accepted and loved. You are beautiful the way you are.

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دليلك لمواجهة صورة الجسم السلبية؟

Countering negative Body Image: How to be positive

إن الجميع معرض لمشكلات نفسية متعلقة بطريقة الأكل، ولذلك اصبح من المهم الحذر من تلك العلامات والتأكد من البعد عنها لضمان صحة نفسية أفضل، إليكم البعض منها:

<ul>
	<li>الانشغال بالطعام والتفكير فيه طوال الوقت.</li>
	<li>الاهتمام والقلق حيال الوزن وقياسات الجسد و الملابس (قياس الوزن باستمرارية، الاحتفاظ بالملابس القديمة التي لم تعد مناسبة ومحاولة ارتدائها، شراء الملابس ذات المقاسات غير المناسبة على أمل فقدان الوزن).</li>
	<li>ارتداء الملابس الواسعة والداكنة لإخفاء الجسد</li>
	<li>عدم الارتياح حيال الأكل أمام الناس</li>
	<li>عدم الارتياح والإصابة بالقلق حول الأكل من الخارج</li>
	<li>صعوبة اتخاذ قرارات ماذا تأكل وماذا تشتري للأكل</li>
	<li>قطع أطعمة معينة أو مجموعات غذائية كاملة من النظام الغذائي</li>
	<li>تفويت الوجبات&nbsp; والصيام لساعات مطولة</li>
	<li>تفويت وتأجيل التجمعات خوفًا من الأكل فيها</li>
	<li>الانعزال</li>
	<li>تجربة كل الأنظمة الغذائية الجديدة لفقدان الوزن حتى لو كانت مؤذية لصحة.</li>
	<li>التغيرات الحادة في الوزن (فقدان أو زيادة)</li>
	<li>تغير صورة الجسد بصورة متطرفة</li>
	<li>التمارين المكثفة والشعور بالذنب عند عدم القدرة على القيام بها أو تأجيلها</li>
	<li>صعوبة التركيز على المهام اليومية الأخرى</li>
	<li>التقلبات المزاجية العنيفة</li>
	<li>الإرهاق، الدوار والشعور بالغثيان، بدأ مشاكل صحية مرتبطة بالهضم</li>
	<li>تكرار التعرض للامراض بسبب انخفاض المناعة</li>
	<li>عند السيدات &ndash; عدم انتظام الدورة الشهرية أو انقطاعها</li>
	<li>الهوس حول الأكل ( تخزين الطعام ، وضع أساليب وطقوس للأكل مثل تقطيع الطعام أو مضغه لعدد مرات معينة ، ترتيب الأطعمة)</li>
	<li>استخدام الأدوية الملينة للتخلص من الطعام &nbsp;الذي تم أكله</li>
	<li>امضاء وقت طويل في الحمام خاصة بعد الوجبات في محاولات التقيؤ للتخلص من الطعام الذي تم أكله</li>
	<li>الشعور بالذنب والخزي والخجل عند الشعور بالجوع أو عند الأكل</li>
	<li>التفكير في الأطعمة كأنها أطعمة جيدة وسيئة</li>
	<li>فقدان الوزن بشكل ملحوظ ، نمو الشعر الخفيف على&nbsp; أجزاء الجسد (متعارف عليه مع اضطراب فقدان الشهية العصبي، النهام&nbsp; العصبي، &nbsp;النهام العصبي السكري).</li>
	<li>وجود &nbsp;تآكل الأسنان ، التهابات الحنجرة و تقرحات الفم ( متعارف عليه مع اضطراب النهام&nbsp; العصبي)</li>
	<li>الهوس بنوع ونظافة الأكل، تصنيف الأكل كصحي وغير صحي، عدم تناول أطعمة إلا التي يحضرها الشخص بنفسه. (متعارف عليه مع هوس الأكل الصحي)</li>
	<li>حدوث مضاعفات لمرض السكري، تجنب قياس السكر في الدم وتجنب حقن الانسولين، تغير الشهية، تفويت مواعيد المتابعة. (متعارف عليه مع اضطراب النهام العصبي السكري)</li>
</ul>

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Anyone can face psychological struggles with food and weight. This list shows signs that reflect a psychological issue with your eating pattern. It is significant to keep alert to any of the signs below:

<ul>
	<li>Preoccupation with food, Thinking about food all the time (Calories, Macros, eating time, always planning meals).</li>
	<li>Concerns about body weight, measurements, and clothes sizes. (weighing yourself all the time, keeping and trying old clothes, buying smaller sizes of clothes wishing to fit into them after a certain time).</li>
	<li>Wearing baggy, wide or dark-colored clothes trying to hide into them</li>
	<li>Discomfort eating around people</li>
	<li>Discomfort and anxiety around food on eating out (Due to the unplanned food, feeling the need to see menus pre going out )</li>
	<li>Choosing different food than your desire because it&rsquo;s less in calories</li>
	<li>Having a hard time deciding what food to eat or buy</li>
	<li>Restricting certain food types or whole groups of food</li>
	<li>Skipping meals and Fasting for prolonged hours</li>
	<li>Putting off gatherings and going out only not to eat out</li>
	<li>Trying every diet trend</li>
	<li>Weight changes (YOYO diets)</li>
	<li>Isolation</li>
	<li>Having fluctuated body image</li>
	<li>Over-exercising, guilt on skipping exercise</li>
	<li>Having a hard time focusing on your tasks</li>
	<li>Extreme mood swings</li>
	<li>Frequent illness due to lowered immunity</li>
	<li>Females, irregular periods</li>
	<li>Food obsession (Hoarding food, having food rituals such as cutting food or chewing food for certain times, spending time organizing food).</li>
	<li>Using laxatives and diuretics to get rid of eaten food.</li>
	<li>Spending long times in the toilet, especially after meals trying (trying to get rid of food).</li>
	<li>Guilt and shame upon feeling hungry or eating</li>
	<li>Labeling food</li>
	<li>Huge body weight drop in a short time, baby hair on the body (common with Anorexia, Bulimia, and Diabulimia)</li>
	<li>losing control around food,&nbsp; episodes of eating food you can&rsquo;t remember, noticeable weight gain (common with Binge eating disorder)</li>
	<li>tooth erosions, mouth ulceration, larynx inflammations (common with Bulimia)</li>
	<li>obsessing about if food is clean, labeling food as healthy and unhealthy, and only eating food they prepared (common with Orthorexia)</li>
	<li>Diabetes complications, avoiding testing and injecting insulin, changes in appetite, skipping follow-ups (common with Diabulimia).</li>
</ul>

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أحذر! علامات تنذر بمشكلة نفسية مرتبطة بالطعام

Eating disorders’ alarming signs

الصيام في رمضان بعد التعافي من اضطراب الأكل

رمضان هو تاسع شهر من شهور السنة الهجرية، يمتنع المسلمون في رمضان عن الأكل والشرب من صلاة الفجر لصلاة المغرب، ويتقرب المسلمون في رمضان اكتر من الله، من المفترض أن يكون شهر رمضان شهرًا للشفاء والبركات، ولكن يمكن أن يكون تحديًا كبيرًا لأولئك الذين يتعافون/تعافوا من اضطراب الطعام، يمكن للصيام أن يدفعهم للعودة إلى الحلقة المدمرة القديمة لسلوكيات اضطراب الطعام مثل الشراهة في الأكل والتفريغ وتقييد الأكل وكذلك الإفراط في تناول أطعمة معينة.

فإليك بعض النصائح للتعامل مع رمضان بعد التعافي من اضطرابات الطعام

<ul>
	<li>تواصل مع طبيبك قبل الصيام، فلديك استثناء أن تفطر إذا كان الصيام سيؤذيك أو يسبب لك انتكاسة. </li>
	<li>إذا كنت ستصوم، تحدث إلى شخص مقرب وأخبره كيف يمكنه ان يدعمك طوال شهر رمضان. تذكر دائما أنك تصوم لأن الصيام عبادة وليس نظاما غذائيا لفقدان الوزن. لا تتلاعب مع نفسك.</li>
	<li>إذا كنت لن تستطيع الصيام، فابق على اتصال مع الله، اقرأ القرآن، احضر صلاة التراويح واذكر الله أو أفعل ما يسبب لك الراحة، كن متصلا بنفسك ويقظا.</li>
	<li>عندما تستخدم وسائل التواصل الاجتماعي، استخدمها بطرق مفيدة. تابع المحتوى الذي يمكن أن يساعدك في مواجهة مخاوفك في رمضان. تجنب الفقرات المرتبطة بإعداد الطعام أو التحدث عن مطعم معين. تجنب أي مثيرات قد تسبب انتكاسة.</li>
	<li>اطلب من الله أن يعطيك القوة ويساعدك في التغلب على هذا التحدي في حياتك. إن الإيمان بأن هناك قوة أعظم يمكن أن تغير من الواقع هو أول طريق التعافي، إن الله يمنحنا الإرادة لنغير ما نستطيع ونتقبل ما لا نستطيع.</li>
	<li>يمكن أن يمثل شهر رمضان تحديًا للأشخاص الذين يعانون/ يتعافون/ تعافوا من اضطرابات الطعام، ولكنه قد يمثل أيضًا تحديًا في التحسن. لقد حاربت كثيرا للوصول، كن حذرا ومحبا.</li>
</ul>

Fasting in Ramadan after Eating Disorder Recovery

Ramadan is the 9th and the holiest month of the Islamic calendar, during Ramadan Muslims do not eat or drink anything between the fajr and maghrib prayers, this is called Fasting. In this holy month, Muslims seek spiritual closeness to God, reading from the holy Quran and doing tarawih prayers. They increase their charity and are encouraged to provide meals to those in need.

Moreover, Ramadan is supposed to be a month of healing and blessings but can be very challenging for those recovering/recovered from their ED, fasting can trigger them to fall back into the old destructive cycle of ED behaviors (binging purging, restricting). So here are some tips on dealing with Ramadan after Eating Disorder Recovery:

<ul>
	<li>Contact your Physician before fasting, you have an exception not to fast if it will cause you harm or relapse.</li>
	<li>If you are going to Fast. Make sure to talk to someone you trust and let them know how they can support you throughout Ramadan. Remember we fast for god, not for Eating disorders. Fasting is not a diet plan, it is a holy worship.</li>
	<li>If you are not able to fast, be connected and spiritual. keep contact with Allah, read Quran, and attend tawareeh prayers. Choose what makes you comfortable and mindful.</li>
	<li>When you do use social media, use it in beneficial ways. Follow content that can help you facing&nbsp;your fears in Ramadan and avoid any videos about cooking and reviewing food. Be aware of your triggers.</li>
	<li>Ask God to give you strength and help you overcome this challenge in your life. Remember that faith gives us power. Believe that there is a higher power that fuels us with willpower that can change maladaptive behaviors and accept what we cannot change.</li>
	<li>Ramadan can be a challenge for people suffering/recovering/recovered from an ED, but it can also be a challenge for them to get better. Be merciful and patient.</li>
</ul>

الصيام في رمضان بعد التعافي من اضطراب الأكل

Fasting in Ramadan after Eating Disorder Recovery

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تمثل الرياضة أهمية كبيرة لدى الكثير، وعلى مدار العقود الماضية بدت الرياضة مسألة مهمة وحيوية في حياة الرياضيين والعامة، وعلى الرغم من كم الفوائد الجمة للرياضة إلا أنها في بعض الأحيان لا تكون مفيدة بل خطيرة وتهدد صحة الشخص وتقدمه.

إن الرياضيون ليسوا فقط محبين للرياضة ولكنهم اختاروا أسلوبا حياتيا مغايرا، غير شكل نومهم وطريقة أكلهم وسلوكياتهم اليومية، ولأن الوزن والأكل في حياة الرياضي له أهمية كبيرة على اداءه وتركيزه فاضحت المسألة هوس لدى الكثير، وتحول ذلك الهوس مع الوقت لضغط وكبت عاطفي، ثم اضطراب وخلل في طريقة الأكل والنظرة للجسد.

مع الوقت أصبح الرياضي يقسم الطعام بين ما هو جيد وغير جيد ويحسب سعراته الحرارية بكل تركيز ومنه أكل أشياء معينة، ويخشى أكثر من غيره أن يتم الحكم عليه وعلى مظهره، وهو ما دفعه لمزيد من الحرص الذي آثر على صحته النفسية.

اضطرابات الأكل وتأثيرها على الرياضيين

وفقًا لجمعية الطب النفسي الأمريكية، اضطراب الأكل هو اضطراب معقد ومستمر في سلوكيات الأكل، جنبًا إلى جنب مع الأفكار والعواطف المؤلمة. اضطرابات الأكل ليست خيارًا، هناك العديد من العوامل التي يمكن أن تتسبب في تطور شخص لهذا المرض، مثل الوراثة أو عوامل بيولوجية ونفسية. ويتعرض الرياضيون بشدة للاضطرابات في الأكل حيث قد يتطلب رياضتهم البقاء في شكل أو وزن محدد، وبالتالي قد يتحول الامر إلى هوس بجسدهم أو شكلهم؛ وهذا هو سبب تأثير اضطرابات الأكل على الرياضيين أكثر من غيرهم.

تشير الدراسات إلى أن 19٪ من الرياضيين الذكور وحتى 45٪ من الرياضيات يواجهون اضطرابات في الأكل. المشكلة التي نواجهها في الوقت الحالي هي أن اضطرابات الأكل أصبحت شائعة جدًا في مجتمعنا، حيث يميل الناس إلى تمجيد تقليل كمية الطعام؛ وتصنيفه كجيد / سيئ . 

وفي بعض الأحيان يكون من الصعب حقًا معرفة ما إذا كان الشخص مصابًا باضطراب في الأكل أم لا ؛ ولكن هناك علامات معينة يمكنك البحث عنها للاعتبار ما إذا كان شخص مصابًا باضطراب في الأكل. وتشمل هذه العلامات:

<ul>
	<li>تناول طعام يصفه المجتمع بأنه &quot;صحي&quot;</li>
	<li>وعد السعرات بصورة مرضية</li>
	<li>التدرب بشدة خارج جلسات التدريب العادية للرياضيين مثل التدرب بالثلاث أو الأربع ساعات بصورة يومية</li>
	<li>إضافة إلى ذلك، أكل ما هو أقل من ما يحتاجه الجسم من طاقة.</li>
</ul>

ما هي الرياضة المفرطة؟

يعتبر الرياضيون المحترفون (أحيانًا الرياضيون العاديون أيضًا) من بين الأشخاص الذين يعانون من سلوك مضطرب غير مدرك، وهو التدريب المفرط. وهو عندما يزيد الرياضيون الأعباء تدريبية الشديدة دون وقت كافٍ للراحة والتعافي، اعتقادا منهم أن ذلك قد يساعدهم. 

ومن علامات التدرب المفرط: 

<ul>
	<li>استمرار فترة التعب والاجهاد لفترة طويلة.</li>
	<li>نقص في النوم أو نمط نوم مقطع</li>
	<li>تقلبات المزاج.</li>
	<li>فقدان الشغف.</li>
	<li>انخفاض المستوى.</li>
	<li>انخفاض الوزن بشكل سريع.</li>
	<li>خلل في الجهاز الهضمي مثل إمساك / إسهال. </li>
</ul>

التعافي من التدريب الزائد ليس مستحيلاً على الرغم من أنه قد يستغرق بعض الوقت، ولكن من السهل على الرياضي أن يعود دون إلحاق الضرر بنفسه. أهم شيء بالنسبة للرياضي الذي يعاني من التدريب الزائد هو الراحة، حيث إنها حاسمة لتعافيه؛ والراحة يمكن أن تكون مؤقتة أو قد تشمل تخفيض التدريب، وذلك يعتمد على شدة التدريب الزائد. خلال هذه الفترة يجب على الرياضي أن يحذر من عدم تناول الطعام بشكل غير كافٍ أو حرمان نفسه من التغذية السليمة. نظرًا لأن العديد من الرياضيين معتادون على الاستمرار فقد يكون التوقف عن الرياضة بكثافة مسألة صعبة ومعقدة، وبالتالي، فإن البحث عن دعم من متخصص في الصحة النفسية ضروري. قد يحتاج الرياضي أيضًا إلى دعم إضافي من أشخاص قريبين مثل الأصدقاء والعائلة خلال هذه الفترة.

عند العودة إلى التدريب، يجب على الرياضي التأكد من التدرج تدريجيًا في رياضتهم وعدم الاندفاع؛ علاوة على ذلك، يمكن تجنب التدريب المفرط عندما يبدأ الرياضي في الاستماع إلى كيفية شعور جسده فعلًا. &nbsp;تسجيل جلسات التدريب الخاصة بهم في يوميات قد يكون وسيلة مفيدة لكي يفهم كيف يشعر جسدهم خاصة عندما يبدأون في العودة إلى روتين التدريب وزيادة شدته، بالإضافة إلى توثيق والاعتراف بتقدمهم. التأكد من أن الرياضي يقدر راحته بقدر ما يفعل مع التدريب.

أنواع اضطرابات الأكل والرياضة:

هناك مجموعة متنوعة من اضطرابات الأكل ويمكن للرياضيين أن يعانوا من أكثر من نوع واحد. ولكن المقال سيتحدث عن الأشكال الشائعة التي يمكن للرياضيين أن يعانوا منها. 

النوع الأول هو فقدان شهية عصبي (أنوركسيا)، حيث يبدأ الشخص في مراقبة استهلاك سعراته الحرارية بشدة وتقليله بشكل كبير وتقييد بعض أنواع الطعام. الرياضيون الذين يمارسون الرياضات المركزة على الوزن عادة ما يعانون من هذا النوع من اضطرابات الأكل. ولا يمكن معرفة ما إذا كان شخصًا يعاني من فقدان الشهية العصبي عن طريق مراقبة وزن جسمه لأنه ليس مؤشرًا حقيقيًا، فبعض الأشخاص لديهم أجسام أكبر ولا يزالون يعانون من فقدان الشهية العصبي.

أولئك الذين يعانون من فقدان الشهية المرضي يهتمون بشكل مفرط بحقائق التغذية للطعام ويتخطون وجبات الطعام وعادة ما لا يمتلكون قدرة مناسبة على التركيز. وقد يقوم الرياضيون الذين يعانون من فقدان الشهية المرضي بالتمارين الزائدة أو استخدام التمارين كوسيلة لمعاقبة أنفسهم إذا شعروا بأنهم تناولوا طعامًا بكثرة، أو يتقيؤون عمدًا الطعام الذي تناولوه. وقد تكون اضطرابات صورة الجسم أو تشوه صورة الجسم نتيجة لفقدان الشهية المرضي، حيث يفحص الشخص نفسه باستمرار.

نوع آخر شائع من اضطرابات الأكل لدى الرياضيين هو اضطراب الأكل العصبي (بوليميا). وهذا شائع في المجتمع الرياضي حيث يركز معظم الرياضيين على تغذية أجسامهم وقد ينتهون في بعض الأحيان بتناول كمية أكبر من المألوف، أو بسبب عدم قدرتهم على تحمل قيود الطعام التي تفرض عليهم. وينتهون بالإفراط في تناول الطعام، ثم يستخدمون وسائل غير صحية للتخلص من ما تناولوه مثل التدريب المفرط، والتقيؤ المقصود أو حتى الصوم.

الرياضيون الذين يعانون من هذا النوع من اضطرابات الأكل قد يقومون بسلوكيات شائعة مثل تناول كميات كبيرة من الطعام والذهاب مباشرة إلى الحمام بعدها للقئ، وغالبًا ما يشغل الطعام وحجم الجسم مساحة كبيرة من تفكيرهم، وغالبًا ما يتناولون الطعام حتى بعد شعورهم بالشبع، ويشعرون بالذنب تجاه تناول بعض الأطعمة، فضلاً عن تصنيف الطعام على أساس جيد / سيئ.

ومن الأنواع الأخرى، اضطراب الأكل المفرط (binge eating) وهو اضطراب آخر شائع يمكن أن يعاني منه الرياضيون. يحدث هذا عندما يحرم الرياضي نفسه من بعض مجموعات الأطعمة، ويشارك في تقليل السعرات الحرارية ويتناول كمية قليلة جدًا مقارنة بما يحتاجه جسده. هذا يؤدي إلى أن يأكل المصاب بهذا الاضطراب أكثر من مدى شبعه، ويخبئ الطعام، ويشعر دائمًا بالذنب أو الخجل عند تناوله للطعام، وأحيانًا يتناولون الطعام في سرية.

آثار اضطراب الأكل على الرياضي

اضطرابات الأكل يمكن أن تؤثر على الرياضيين بشكل طويل الأمد إذا لم يبحثوا عن العلاج. نظرًا لأن الرياضيين عادة ما يتدربون بشكل زائد، فعندما يعانون من اضطرابات الأكل، فإنهم يعانون أيضًا من سوء التغذية بسبب قلة الأكل. وبالإضافة إلى ذلك، يتسبب هذا في توقف أجسامهم عن العمل بشكل صحيح. 

أخيرا يمكن أن تؤثر اضطرابات الأكل على أي شخص بغض النظر عن جنسه أو عمره أو حجم جسده والعديد من العوامل الأخرى. يتعرض الرياضيون للإصابة بالاضطرابات الأكل بشكل أكبر بسبب المهام التي يحتاجون إلى التركيز عليها مثل ساعات نومهم وجلسات التدريب وأخيرًا، نوعية طعامهم. اضطرابات الأكل هي اضطرابات نفسية وليست خيارًا.

إن المرور باضطراب الأكل صعب، وقد يستغرق الشفاء وقتًا، ولكنه سيكون دائمًا أفضل من الحفاظ على علاقة غير صحية مع الطعام والتمارين الرياضية؛ وفي النهاية، فإنه يستحق كل هذا الجهد وسيكون أفضل رحلة ستخوضها على الإطلاق. إذا كنت شخصًا يعاني من اضطراب في الأكل، فتذكر أنك لست وحدك، فالشفاء ممكن جدًا، والبحث عن المساعدة المهنية دائمًا فكرة مهمة.

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When one is invested in a sport, one will go the extra mile to excel at it, especially when one is an advanced athlete. A professional athlete will sleep a certain amount of hours for recovery, take their supplementation, and train well. If the sport heavily emphasizes the athlete&#39;s weight, the individual will direct most of their concentration into everything they consume.&nbsp;

When athletic children are being directed on food choices and quantities, it impacts their view of food. These rigorous instructions may cause them to think more than twice before eating something or cause them to develop an unhealthy relationship with food; labeling food as good or bad, obsessing over the amount of calories being consumed, and restricting certain types of food as society views food as having some kind of moral value. All of this may eventually lead the athlete to develop an eating disorder.&nbsp;

Eating Disorders and how they can affect athletes

According to the American psychiatric association, an eating disorder is a significant and ongoing disturbance in eating behaviors, along with painful thoughts and emotions. Eating disorders are not a choice, there are a lot of factors that can cause a person to develop one, such as genetics or the person&rsquo;s biology and psychological reasons. Athletes are incredibly vulnerable to disordered eating as their sport may require them to stay in a specific figure or weight, consequently, they may start obsessing over their body and how it looks; hence why eating disorders affect athletes more than non-athletes.&nbsp;

Studies show that 19% of male athletes and up to 45% of female athletes battle eating disorders. The problem we face nowadays is that eating disorders are very normalized in our society, people tend to praise restrictive eating; classifying food as good/bad and or engaging in calorie/macro counting. Sometimes it&#39;s really hard to tell whether someone is suffering from an eating disorder or not; but there are certain signs you can look to consider if a person may be suffering from an eating disorder or not. These signs include eating food that society labels as &ldquo;healthy&rdquo;, counting calories/macros, over training beyond the athletes&#39; regular training session thus they start to consume less food than their energy output (which can lead to disturbance in the female menstrual cycle, consequently affecting the female&rsquo;s metabolism ).&nbsp;

What is over-exercise?

A common disordered behavior among professional athletes (sometimes regular athletes as well) is unconsciously overtraining. When athletes are forced to perform heavy training loads without enough time to rest and recover, it is said that they are overtraining. The following are signs of overtraining&nbsp;

<ul>
	<li style="list-style-type:disc">The long period of fatigue and exhaustion&nbsp;</li>
	<li style="list-style-type:disc">Lack of sleep or interrupted sleeping pattern&nbsp;</li>
	<li style="list-style-type:disc">Mood swings&nbsp;</li>
	<li style="list-style-type:disc">Losing interest in their passion&nbsp;</li>
	<li style="list-style-type:disc">No recovery from training or delayed ones&nbsp;</li>
	<li style="list-style-type:disc">Low energy&nbsp;</li>
	<li style="list-style-type:disc">Lower body weight</li>
	<li style="list-style-type:disc">Constipation/diarrhea</li>
</ul>

Recovering from overtraining isn&#39;t impossible though it might take a while but it&rsquo;s easy for the athlete to bounce back without harming themselves. The most important thing for an athlete that struggles with overtraining is to rest as it&rsquo;s crucial for their recovery; rest can either be temporary or may include decreasing on training, it all depends on the intensity of which the athlete has been overtraining. During this period the athlete must take caution as not to under-eat or deprive themselves of proper nutrition. Since many athletes are accustomed to overachieving, this resting period may not be easy for them to accept, thus, seeking support from a mental health professional is crucial. The athlete may also need extra support from close people such as friends and family during this time, to provide support and reassurance regarding the athlete&#39;s decision to take a break. When getting back to training, the athlete needs to make sure to gradually get back to their sport and not rush into things; moreover, the athlete needs to start at half their working percentage and gradually increase until they return to their normal training session. Avoiding overtraining can also be done when the athlete starts to listen to how their body actually feels. Recording their training sessions in a diary may be a helpful way to notice how their body feels especially when they start to get back to their training routine and increase their intensity as well as document and acknowledge their progress. Making sure that the athlete cherishes their resting state as much as they do with their training can also help the athlete avoid overtraining. The athlete needs to understand that if they&#39;re falling back into unhealthy habits, they need to make sure to talk to their mental health provider.

Eating disorders types and sports

There are a variety of eating disorders and athletes can suffer from more than just one type. There are many different types of eating disorders but the article will discuss common EDs that athletes can suffer from. The first type is Anorexia nervosa, when a person starts to monitor their calorie intake as well as drastically lowering it and restricting certain food types. Athletes that are in weight-focused sports usually suffer from this type of eating disorder.&nbsp; you can&rsquo;t tell if a person is suffering from anorexia nervosa by monitoring their body weight because it isn&rsquo;t really an indicator, some people have bigger body types and still suffer from anorexia nervosa, and others can engage in the same behavior of food restriction and end up losing a&nbsp; huge amount of body weight.

 
Anorexia nervosa in athletes 

Those who suffer from Anorexia Nervosa obsess over and memorize nutritional facts of food, skip meals and usually don&rsquo;t have a proper ability to concentrate. Athletes who suffer from anorexia nervosa might over-exercise (exercise bulimia) or use exercise as a means of punishing themselves if they feel like they&rsquo;ve overeaten or they purposely vomit the food they ate or use laxatives to do so. Body dysmorphia or distorted body image can also be the consequence of anorexia nervosa, since the person frequently body checks themselves, picking on every single thing they view as a flaw and seeing themselves differently than they actually are (usually worse).&nbsp;

Bulimia nervosa in athletes

Another common type of eating disorder in athletes is bulimia nervosa. This is common within the athletic community since most athletes will focus on nourishing their body and they might sometimes end up eating more than they&rsquo;re used to, or because of the amount of food restriction, they have engaged in. They end up binge eating, then use unhealthy means to get rid of the food they ate such as overtraining, intentional vomiting or even fasting. Athletes who suffer from this type of eating disorder may do common behaviors such as binge eating and directly going to the bathroom afterward (purging), food and body size usually occupy a huge deal of their brain, and they usually eat even after they get full, they feel guilty towards eating certain foods as well as label food as good/bad, and they also may have marks on their knuckles because of the purging behavior.&nbsp;

Binge eating disorder in Athletes&nbsp;

Binge eating disorder is another common eating disorder that athletes may suffer from. This occurs when the athlete deprives themselves of certain food groups, engages in calorie restriction, and eats very little compared to what their body requires; this causes the person suffering from that disorder to eating beyond fullness, hides food, always feel guilty or shameful when they eat and they also sometimes eat in secret.&nbsp;

Effects of eating disorders on Athletes

Eating disorders can have long-term effects on athletes if they don&rsquo;t seek treatment. Since athletes are usually overtraining, when they&#39;re also suffering from an eating disorder, they tend to experience malnutrition as well due to undereating; moreover, this causes their bodies to stop functioning properly.&nbsp;

A common syndrome among female athletes is known to suffer from would be the &ldquo;female athlete triad&rdquo; where they get an irregular or disturbed menstrual cycle, lack available energy, and their bone mineral density is also reduced. Common effects of eating disorders on athletes would also include:

<ul>
	<li style="list-style-type:disc">Increased injury risk due to lack of recovery and malnutrition</li>
	<li style="list-style-type:disc">Declining performance in their&nbsp; sport&nbsp;</li>
	<li style="list-style-type:disc">Mood swings affecting&nbsp; their judgment</li>
	<li style="list-style-type:disc">Ulcers and tooth decay especially if the athlete is suffering from bulimia</li>
	<li style="list-style-type:disc">Impaired coordination ability&nbsp;</li>
	<li style="list-style-type:disc">Increased anxiety/depression</li>
</ul>

In conclusion, eating disorders can affect any person regardless of gender, age, body size and many other factors. Athletes are more prone to eating disorders due to the endless tasks they need to focus on such as their sleeping hours, their training sessions, and finally, their food intake as well as the type of food they eat. Eating disorders are mental health disorders and they&rsquo;re not really a choice. Eating disorders can have long-term effects on athletes if they keep overtraining and restricting their calorie intake; moreover, this can cause them to have delayed recovery time, feel fatigued most of the time, and affect other facets of their life. Going through an eating disorder is difficult, recovery might take time but it will always be better than constantly having an unhealthy relationship with food and exercise; in the end, it&rsquo;s really worth it and it&rsquo;s going to be the best journey you&rsquo;ll ever take. If you&rsquo;re someone going through an eating disorder, remember that you are not alone, recovery is very possible, and seeking professional help is always a great idea.&nbsp;

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اضطرابات الأكل والرياضة: القصة الحقيقية خلف معاناة الرياضيين

ُEating Disorders in sports: the real story behind Athletes' struggles

لا يمكن اعتبار التعافي من اضطرابات الأكل خط مستقيم أو طريق خالي من العقبات. إن رحلة التعافي مليئة بالعوائق والنكسات وهي مسألة متوقعة وطبيعية، ولذلك فإنه من الضروري تقبل أن فكرة التراجع واردة ومقبولة، ولكن أيضا علينا فهم أن ذلك لا يعني أنك فشلت، في كل لحظة سقوط هناك فرصة أكبر للتعلم والتقدم إلى الأمام والأهم بناء تعافي حقيقي أفضل وأقوى.

نقدم لك بعض الإرشادات التي قد تساعد في العودة سريعا من الانتكاسة:&nbsp; 

<ol>
	<li>ذكر نفسك، لماذا اخترت التعافي في المقام الأول، أكتب الأسباب التي دفعتك لتعافي من الأساس، وضعها أمامك.</li>
	<li>حلل الانتكاسة، أسأل نفسك عن المثيرات التي دفعتك لسقوط، هل هي أسباب اجتماعية كتعليقات سلبية أم أسباب متعلقة بأفكارك ومشاعرك، إن تحليل أسباب الانتكاسة يجعلنا أكثر شراسة في مواجهتها في المرة المقبلة. تجنب الأشخاص والأشياء التي قد تؤذيك أو تزيد من انتكاستك.</li>
	<li>تذكر دائما الإنجازات التي صنعتها في تعافيك، تأكد أن رجوعك للخلف لا يعني خسارة إنجازاتك، أعلم أنك سرت في هذا الطريق من قبل، لا داعي للعجلة، فلا يوجد سباق أو وقت معين للتعافي.</li>
	<li>أطلب المساعدة من متخصص أو تحدث لشخص قريب منك في الحال، لا تشعر بالخجل من الانتكاسة، لا تبقي أفكارك السلبية داخلك، افضحها!</li>
	<li>إن مشاعرك وأفكارك مهمة وحقيقية لا تخبأها أو تكبتها، عبر عن نفسك، وتأكد أنك لست وحدك.</li>
	<li>اعتني بنفسك، لا يجب أن تحب نفسك لكي تعتني بها، افعل شيء إيجابي اليوم يشعرك بالآمان، حتى لو كان تمشية بسيطة أو الاستحمام.</li>
	<li>تجنب الميزان، غطي المرايات، ابتعد عن مراقبة جسدك، تجنب تلك المثيرات التي قد تسبب مزيد من التدهور.</li>
	<li>تحدى نفسك بأكل شيء مريح ومطمئن، لا تأكل وحيدا، ولا تمتنع عن الطعام، فالامتناع جزء من الانتكاسة.</li>
	<li>لا تستغل الانتكاسة كعذر لتدمير نفسك أكثر أو معاقبتها، ستواجه أفكار تقنعك أن كل شيء انتهى وانهار، تلك أكذوبة كبير لا تصدقها!</li>
	<li>تمسك بالأمل، ضع هدفا وابحث عن أشخاص إيجابيين يفهمون معاناتك، وتذكر دائما هناك تعافي.</li>
</ol>

وأخيرا، لا تكن قاسيا على نفسك، ستكون فترات الانتكاسة مؤلمة ومزعجة ولكنك لست وحدك، الجميع مر من هنا، المهم هو تحليل أسباب الانتكاسة وفهم ما حدث، حتى تكون أكثر قوة في مرة القادمة.

Recovery is not linear. It is common during the journey of recovery to meet many obstacles or lapses. Therefore, it is significant to understand that it is ok to relapse. However, You have to know also that a relapse doesn&rsquo;t mean that you have failed. Instead, view it as an opportunity to learn, move forward, and become stronger in your recovery.

&nbsp;

Here are some guidelines that can help you get on track again:

<ol>
	<li>Remember why you chose recovery in the first place. write a list of reasons and always keep it in front of you.</li>
	<li>Analyze your relapse. Be aware of what triggered your relapse, and learn how to cope with them. It is significant to understand what happened. Stay away from toxic people or things that would fuel your ED voice.</li>
	<li>Always remember that the progress you&#39;ve accomplished hasn&#39;t gone downhill, relapse does not mean you have failed, because you have been through this, and can do it again. It&#39;s not too late.</li>
	<li>Seek help from a professional or talk to someone you trust, do not be ashamed to do that. They are here to help you.</li>
	<li>إour&nbsp;emotions, feelings, and thoughts are valid, do not bottle them up.</li>
	<li>Remember to take care of yourself, You don&#39;t need to love yourself to care about it, you can care about it until you love it, do something that makes you feel safe, go for a walk, or take a shower. you deserve it</li>
	<li>Throw out scales, cover mirrors and stay away from body checking, these can trigger a full-blown relapse.</li>
	<li>Challenge yourself to eat something &quot;comfortable&quot; for you with someone you love, it doesn&#39;t need to be what others are eating. As long as you&#39;re fueling your body in some way.</li>
	<li>Do not use this time of struggling as an excuse to do what your Eating disorder says to you. I promise i know how it convinces you that &quot;since you&#39;re doing everything so bad, this doesn&#39;t matter&quot; it&#39;s all lies.</li>
	<li>Have hope, even if you&#39;ve hit rock bottom, there is always hope. Try to stay positive, have a distraction, create a goal, surround yourself with positive people, and never forget that it&#39;s not too late to recover</li>
</ol>

Finally, don&#39;t be harsh on yourself, You are not alone. Although, at times, it can feel like the loneliest place on the planet. It is also important to keep in mind that not every relapse is the same, the warning signs can vary, and the coping mechanisms that work for one person may not work for the next.

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١٠ طرق تساعدك للعودة للتعافي بعد الانتكاسة في اضطرابات الأكل

10 ways to cope after a Lapse/Relapse in Eating Disorder recovery

يمثل الوعي والفهم المبكر حائط الحماية والمواجهة الأول للمشكلات النفسية، فكلما زاد إدراك علاقة الصحة النفسية بالأكل، قلت فرص الإصابة أو تدهور حالة الشخص المصاب، وبدى فرص التعافي أعلى وأكثر استمرارية دون خجل أو وصمة

Awareness can lead to prevention and early diagnosis and treatment. Familiarity with the relationship between mental health and Eating can lead to increased consciousness and empathy for those who are suffering or struggling while decreasing the stigma often associated with these mental illnesses.

أدوات الدعم والتعلم