Ingabe nawe uyalawula ukudla okudlayo? Ingabe ucabanga ngokunciphisa isisindo? Lokhu kungaba yi-anorexia engavamile!

Wake waphawula ukuthi abanye abantu bacabanga kakhulu ngesisindo sabo nalokho abakudlayo? Mhlawumbe kungumqondo omuhle ukuzama ukunciphisa isisindo esincane. Kodwa kwenzekani uma uthatha ngokweqile bese uqala ukwehlisa isisindo futhi ulawule ukudla kwakho? Namuhla sizokhuluma ngesihloko esihlukile kancane, kodwa esibaluleke kakhulu. Leso yisimo esibizwa ngokuthi i-anorexia engavamile, noma `(Atypical Anorexia Nervosa)`.

Kuyini i-Atypical Anorexia?

Kalula nje, i-anorexia nervosa iyisifo sokudla. Kulesi simo, umuntu usebenzisa izindlela eziyingozi nezingenampilo zokwehlisa isisindo. Kungenzeka ukuthi uke wezwa nge-Anorexia Nervosa. Lesi simo, esibizwa ngokuthi i-anorexia nervosa, singaba nezimpawu eziningi ezifanayo ne-Anorexia Nervosa. Isibonelo:

• Ukuphambuka kwesithombe somzimba: Lokhu kusho ukucabanga ukuthi ukhuluphele kakhulu kunalokho oyikho ngempela. Ngisho noma uzibuka esibukweni, usazibona ukhuluphele.
• Ukwehla kwesisindo okusheshayo nokuphawulekayo: Ukulahlekelwa isisindo esiningi ngokuzumayo.
• Izinguquko emikhubeni yokudla kanye nokuzivocavoca: Ukudla kancane, ukungadli ukudla okuthile, noma ukuzivocavoca ngaphezu kwalokho okudingekile.

Kodwa umehluko obaluleke kakhulu lapha ukuthi umuntu one-anorexia nervosa uvame ukuba ne-body mass index ephezulu kancane (`Body Mass Index - BMI`) lapho lesi simo siqala. Lokhu kusho ukuthi abancane kakhulu ekuqaleni. Ngakho-ke, noma ngabe bancipha isisindo ngokuzumayo, kungase kungabonakali ngaphandle. Yingakho lesi simo kunzima ukusibona, futhi ngezinye izikhathi singabangela izinkinga ezinkulu zempilo nezengqondo kune-`(Anorexia Nervosa)`. Ngoba akucaci ngokushesha ukuthi kunenkinga.

Sivame kangakanani lesi simo?

Eqinisweni, inani labantu abatholakale benesifo sokungadli kahle liyanda. Kulinganiselwa ukuthi phakathi kuka-25% no-40% wabantu abasezikhungweni zokwelapha izinkinga zokudla bahlushwa yilesi simo. Lesi simo saqala ukuchazwa ngokwesigaba sezinkinga zengqondo, i-"DSM-V - Diagnostic and Statistical Manual of Mental Disorders", ekhishwe yi-American Psychiatric Association ngo-2013.

Ziyini izimpawu ze-anorexia engavamile?

Kunezimpawu eziningana ongase uzibone kulesi simo. Bheka ukuthi wena noma umngane wakho unazo yini lezi:

• Ukudla ngokweqile: Lokhu kusho ukudla ukudla okuningi ngesikhathi esisodwa ngaphandle kokulawula.
• Ukunciphisa inani lokudla okudlayo, ukweqa ukudla.
• Ukuzilolonga kakhulu kunangaphambili, ngaphezu kwalokho engingakubekezelela.
• Ukufikelwa yinto ethile engqondweni, ukuthukuthela njalo, nokuzizwa ukhathazekile.
• Ukuzizwa ukhathele njalo.
• Ukuthola ubunzima bokunaka okuthile.
• Ukungajabuli ngendlela ababukeka ngayo.
• Ukusebenzisa imithi yokuhlanza umzimba ukuze wehlise isisindo.
• Ukucabanga ngokuzilimaza.
• Ukuhlanza (ngemva kokudla).
• Isifiso esinamandla sokuba mncane ngandlela thile.
• Ukwesaba njalo ukukhuluphala.

Akuwona wonke umuntu onezimpawu ezimbili noma ngaphezulu onalesi simo. Kodwa uma kukhona eziningana zalezi zinto ezilandelanayo, kungcono ukufuna iseluleko sezokwelapha.

Yini ebangela lesi simo?

Ucwaningo lukhombisile ukuthi inhlanganisela yezici eziningana ingasiza ekuthuthukisweni kwe-anorexia nervosa. Ake sibheke ukuthi ziyini:

• Izakhi zofuzo: Uma othile emndenini wakho eke waba nezinkinga zokudla, kungenzeka kakhulu ukuthi ube nalesi simo.
• Ukuhlukumezeka: Ngezinye izikhathi, ngemva kokuhlangenwe nakho okubi empilweni, ungase uzizwe sengathi udinga ukulawula imizwa yakho, njengokudabuka, intukuthelo, noma ukwesaba. Njengokungathi uzizwa sengathi, 'Yilokhu kuphela engingakwazi ukukulawula.'
• Amathonya ezenhlalo namasiko: Imikhuba yezenhlalo efana nokuthi "ukuba mncane kuyinto enhle" ngezinye izikhathi ingasifaka ngaphansi kwengcindezi enkulu. Lokho esikubona ku-TV nakwezokuxhumana kungasenza sicabange ukuthi, "Nami ngifuna ukuba kanje."
• Ukucindezela kontanga: Ikakhulukazi uma usemncane, kungaba nzima ukuzizwa lapho abangane nabanye bekugcona ngomzimba wakho. Lokhu kucindezela kungakwenza ucabange ukuthi, "Ngidinga ukuba mncane ngandlela thile."
• Impilo yengqondo: Ukuba umuntu ofuna ukuphelela kanye nobudlelwano obungaphumelelanga kungaholela ekuziboneni ungelutho. Ezikhathini ezinjengalezi, imikhuba yokudla engaphilile inamathuba amaningi okuthuthuka.

Ubani osengozini enkulu?

Eqinisweni, noma ubani angaba nesifo sokudla esifana ne-anorexia nervosa, kodwa sivame kakhulu entsheni kanye nasebantwini abadala, ikakhulukazi amantombazane .

Ngaphezu kwalokho, ungase ube sengozini enkulu yokuthola lesi simo uma unezici ezilandelayo:

• Uma kukhona emndenini wakho oke waba nezinkinga zokudla noma ezinye izifo zengqondo.
• Uma uke wabhekana nokulimala ngokomzimba, ngokwengqondo noma ngokocansi.
• Uma unesinye isifo sengqondo esifana nokukhathazeka, ukucindezeleka, noma i-Obsessive-Compulsive Disorder (OCD).
• Uma uhilelekile kwezemidlalo lapho isisindo noma ukuma kwakho kubalulekile khona (isib. i-gymnastics, i-wrestling, ukubhukuda).
• Uma kube noshintsho olukhulu empilweni, njengokuya esikoleni esisha, umsebenzi omusha, isehlukaniso, noma ukuthuthela kwenye indawo.
• Uma "ungumuntu othanda ukuphelela" osebenza kanzima kakhulu futhi ozama ukwenza konke kahle.

Yiziphi izinkinga zalesi simo? Ingabe siyingozi?

Yebo, i-anorexia nervosa ayilona ihlaya. Ingathinta kabi izingxenye eziningi zomzimba wakho. Cabanga ngezinto ezinjengalezi:

• Ukungalingani Kwe-Electrolyte: Lapho amazinga amaminerali abalulekile (njenge-calcium ne-potassium) ephansi kakhulu emzimbeni wethu, ubuhlungu bemisipha nezinkinga zokusebenza kwenhliziyo zingavela.
• Izinso: Uma wehlisa isisindo ngokuzumayo, izinso zakho zingase zingakwazi ukwenza umsebenzi wazo wokuhlunga imfucuza ngendlela efanele.
• Inhliziyo: Ukudla okuncane kakhulu kungabangela ukushaya kwenhliziyo okuhamba kancane (i-Bradycardia) kanye nomfutho wegazi ophansi (i-Hypotension). Lokhu kuyingozi kakhulu.
• Ubuchopho: Uma umzimba ungatholi ukudla okufanele okudingayo, izimo ezifana nokuquleka zingase zivele.
• Isisu: Isicanucanu, ukuqunjelwa, ukuqunjelwa, nokuhlanza kungenzeka.
• Uhlelo lwe-endocrine: Ukwehla kwesisindo ngokushesha kungathinta ama-hormone, kubangele ukuthi amazinga e-testosterone noma e-estrogen ehle. Uma amazinga e-estrogen ehla, abesifazane bangase bayeke ukuya esikhathini.
• Igazi: Uma ungadli kahle, ungaba ne-anemia futhi uzizwe ukhathele njalo.
• Amathambo: Ukuncipha kokuqina kwamathambo, okwenza abe buthakathaka futhi aphuke kalula.
• Izinwele: Izinwele zakho zingase ziqale ukuncipha bese ziwa. Ungase futhi ube nezinwele ezincane emzimbeni (`lanugo`).

Bheka ukuthi izinkinga ezinkulu zingavela kanjani uma ucabanga ukuthi, "Kwenzekani ngokunciphisa isisindo?"!

Ungayibona kanjani i-anorexia engavamile?

Odokotela baxilonga lesi simo ngokusekelwe ezintweni eziningana:

• Ukwenza ukuhlolwa ngokomzimba.
• Ukubuza ngokucophelela ngezimpawu zakho.
• Funda ngemikhuba yakho yokudla kanye nemikhuba yakho yokuzivocavoca.

Ngaphezu kwalokho, kungenziwa izivivinyo eziningana ukuze kubonakale ukuthi lezi zimpawu zibangelwa yini esinye isimo sezokwelapha. Isibonelo:

• Inani Eliphelele Legazi (i-CBC)
• Iphaneli yegazi le-Electrolyte
• Ukuhlolwa kwegazi le-Albumin
• Ishadi lesigqi senhliziyo (`I-Electrocardiogram - EKG`)
• Ukuhlolwa komchamo
• Ukuhlolwa kobuningi bamathambo – bheka i-Osteoporosis
• Ukuhlolwa kokusebenza kwezinso, isibindi kanye ne-thyroid
• Izinga likaVithamini D
• Ukuhlolwa kokukhulelwa kwabesifazane abaseminyakeni yokuzala
• Ukuhlolwa kwamahomoni

Uma usuqedile nganoma yikuphi ukugula okubangela izimpawu zakho, udokotela wakho angasebenzisa i-Diagnostic and Statistical Manual of Mental Disorders (DSM-V) ukuze anqume ukuthi unesifo sokudla, njenge-anorexia nervosa.

Amaphuzu ayinhloko okufanele uwacabangele lapho uhlonza lesi simo yilawa:

• Ukudla okuncane kakhulu kunalokho obekuvame ukukudla.
• Ukwesaba ukukhuluphala kakhulu.
• Ukungakwazi ukubona umzimba wakho njengoba unjalo ngempela. Isibonelo, ungase ungaboni usayizi womzimba wakho wangempela, noma ungase ungaqapheli ukuthi mncane kunalokho ocabanga. Ungase ucabange ukuthi ukubukeka kwakho kuyinto ebaluleke kakhulu ngawe, futhi ungase ungazinaki izingozi zokudla kancane.

Kuphathwa kanjani lokhu?

Uma welapha i-anorexia nervosa, kuwumzamo weqembu. Udokotela wakho, isazi sokudla okunempilo, kanye nochwepheshe wezifo zokudla basebenzisana ukusiza wena nomndeni wakho niqonde futhi niphathe inqubo yokululama.

Kuye ngempilo yakho yamanje kanye nesimo sakho sengqondo, kungadingeka ukuthi ulaliswe esibhedlela ukuze uthole ukwelashwa. Lokhu kungabandakanya inhlanganisela yezindlela eziningana zokwelapha:

• Ukwelapha Ngengqondo: Lokhu kungakusiza ukuthi ushintshe indlela ocabanga ngayo ngokudla kanye nesisindo sakho. Kungakusiza futhi ukuthi ushintshe indlela osabela ngayo ezimweni ezinzima. Kunezindlela zokwelapha ezingenziwa ngabanye, ngamaqembu, noma namalungu omndeni. Uhlobo lokwelapha olubizwa ngokuthi i-Cognitive Behavioral Therapy (CBT) lusebenza kahle kakhulu kubantu abanezinkinga zokudla. Lukusiza ukuthi uqonde futhi ushintshe amaphethini okucabanga athonya ukuziphatha nemizwa yakho.
• Imithi: Abantu abanezinkinga zokudla bavame ukuba nezinye izimo zempilo yengqondo (njengokucindezeleka nokukhathazeka), ngakho odokotela bangase bakunike imithi yokwelapha nazo. Lokhu kungafaka phakathi imithi yokucindezeleka noma imithi yokukhathazeka.
• Ukwelulekwa ngokudla okunempilo: Uchwepheshe wezokudla obhalisiwe noma isazi sokudla esibhalisiwe, oqeqeshwe ukwelapha izinkinga zokudla, angakusiza ukuthi uthuthukise imikhuba yakho yokudla. Bangakunikeza namathiphu ngokuthenga, ukuhlela ukudla, kanye nokupheka.

Kuthatha isikhathi esingakanani ukululama kulokhu?

Isikhathi esithathwayo ukuze ululame ekuhlushweni yi-anorexia nervosa siyahlukahluka kuye ngomuntu nomuntu. Ukuba nesineke nokusebenzela uhlelo lwakho lokwelashwa kuyindlela engcono kakhulu yokululama.

Imigomo eyinhloko yokwelashwa yile:

• Ukuqinisekisa ukuthi impilo yakho isesimweni esihle nokuthi noma yiziphi izinkinga seziphelile.
• Ukubuyela emkhubeni wokudla ukudla okunomsoco okudingayo, kaningi ngangokunokwenzeka.
• Ukushintsha indlela ocabanga ngayo, indlela ozizwa ngayo, futhi ikakhulukazi indlela obheka ngayo isisindo sakho.

Uyini umbono womuntu one-anorexia engavamile?

Amathuba okululama ngempumelelo kwi-anorexia nervosa ancike kulezi zici:

• Usunesikhathi esingakanani unalesi simo?
• Yeka ukuthi isimo sakho sibi kangakanani.
• Uhlobo lokwelashwa olutholayo nokuthi ululandela kahle kangakanani.

Njengezinye izinkinga zokudla, i-anorexia nervosa ingaba yimbi kakhulu uma ingelashwa. Uma lesi simo sisheshe saziwa futhi selashwa, amathuba okululama ayanda. Uma singelashwa, singaba yingozi empilweni.

Ngenhlanhla, i-anorexia nervosa ingelapheka. Ungabuyela emikhubeni yokudla okunempilo. Kodwa-ke, ingozi yokubuyela emuva iphezulu. Ngakho-ke, ukwelashwa kwesikhathi eside kuyadingeka ukuze ululame. Kubaluleke kakhulu ukuqhubeka nokusebenza ngokwecebo lakho lokwelashwa. Futhi, ukusekelwa komndeni wakho nabangani kubalulekile kulolu hambo.

Ngizinakekela kanjani?

Nakuba lokhu kungase kwesabise futhi kungakhululeki, kubalulekile ukutshela abathandekayo bakho kanye nodokotela wakho ukuthi une-anorexia nervosa. Labo abaseduze nawe badinga ukwazi ukuthi ubhekene nani ukuze bakusize futhi bakusekele.

Uma udokotela ekuxilonga ukuthi une-anorexia nervosa, nazi ezinye izinto ongazenza ukuze usize ohambweni lwakho lokululama:

• Lala ngokwanele.
• Gwema utshwala noma izidakamizwa.
• Uma uphuza imithi, yiphuze ngesikhathi futhi ungaphuthelwa usuku olulodwa.
• Uma uhlanganyela ekwelashweni ngenkulumo, qiniseka ukuthi uhlangana nodokotela wezifo zengqondo ngezinsuku ezihleliwe.
• Cela ukwesekwa emndenini nakubangani.
• Cabanga ngokujoyina iqembu lokusekela abantu abanezinkinga zokudla.
• Bona udokotela ngezinsuku ezihleliwe.

Uma ungemncane, kungani kunezinkinga eziningi kangaka zempilo?

Abanye abantu bangase bacabange, "Angimncane kangako, pho kungani nginezinkinga eziningi kangaka zempilo?" Abantu abane-anorexia nervosa bancipha isisindo ngokushesha, yize bengebancane. Lokhu kungabangela izinkinga ezinkulu zezokwelapha. Bangase futhi bangatholi izakhamzimba namavithamini anele (isib. okusanhlamvu okuphelele, izithelo, imifino, kanye nemikhiqizo yobisi enamafutha aphansi), okungaba nomthelela omubi empilweni yabo.

Ungase uzibuze, "Ingabe ngigula ngokwanele ukuba ngicele usizo?" Noma mhlawumbe uqulekile emsebenzini noma esikoleni futhi awukwazi ukuthola ukuthi uzotshelani odokotela. Kodwa-ke, ungase ungaqapheli ukuthi uyagula kuze kube yilapho isimo sakho sinzima kakhulu ukuselapha. Kunoma ikuphi, kubalulekile ukubona udokotela ngokushesha okukhulu.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ukuze uthole ukululama kwesikhathi eside, wena noma othandekayo wakho kumele nisebenzele uhlelo lwenu lokwelashwa. Ungesabi noma ungabi namahloni okucela usizo emndenini nakubangane. Ukujoyina iqembu lokusekela abantu abanezinkinga zokudla nakho kungasiza.

Ungazihluleli ngokuba ne-anorexia nervosa. Izinkinga zokudla zivame kakhulu kunalokho ocabanga. Ukukhuluma ngokukhululekile ngakho kungakusiza uzizwe ungedwa kangako.

Ngokwelashwa okufanele nokusekelwa, ukululama kwesikhathi eside kungenzeka nakanjani. Uma uneminye imibuzo mayelana nalokhu, ungesabi ukukhuluma nodokotela. Awuwedwa.

i- anorexia engavamile, ukuphazamiseka kokudla, ukwehla kwesisindo, isithombe somzimba, impilo yengqondo, ukudla okunomsoco, i-anorexia nervosa