Conchi Fernandez is an expert nutritionist Eating Disorders (TCAs). A 24-year-old who just posted “Survive me, live with me”. A book that he has written with great courage and in which he tells in the first person how he overcame a anorexy. She later trained as an expert professional in this field, in her pages, she also recounts the keys to help patients and relatives to understand this disease and know the best way to deal with it successfully.
How would you define an Eating Disorder?
It is a very complicated disease. The difficulty is precisely that within mental illnesses it is one of the most physical consequencesyes it has. And worst of all, the mental and the physical in an TCA feed back. Malnutrition affects the brain function. On the one hand, if it is only treated with psychoanalysis, to discover the cause, it is not possible to change the behavior. What’s more, in a way, it sentences you to chronify or lengthen the process. If, on the other hand, the doctors only focus on giving you feedback, they ignore the fact that a disorder of this type, in the end, is a maladaptive response.
But is it important that a person understands what is happening to him and why, isn’t it?
Yes, it is essential that they help you understand why you are behaving in this way. The symptoms of the disease have a meaning and if we do not find it, we cannot find how to convert our behavior into an adaptive response. That is why it is very important to work both parts at the same time, the mental and the food. Focusing only on the physical consequences is insufficient to succeed in overcoming the problem.
So, from your experience, is more than one specialist needed to address these types of disorders?
The ideal scenario is that the patient has a interdisciplinary team in which all the professionals are in communication with each other so that they can share all the information on the patient’s progress and that their decisions go along the same lines.
You say this scenario is the ideal, isn’t it possible?
It’s hard. Among other things, there is the economic barrier. When deciding what type of professional to start with, you have to prioritize. If at the beginning the physical consequences of the disease are very strong, perhaps the most interesting thing is to reinforce the part of renourishing and normalize food to be able to work later on the mental field. In the event that at first there are not so many physical consequences, vital risk, perhaps the best thing to do is to start with psychological treatment and then make the diet more flexible. The important thing is that in both cases it is specialists in these disorders who treat the patient.
In Public Health there are no units specialized in this type of problem and with a multidisciplinary team?
Yes there are, but there is the problem that some are collapsed. In addition, not all of them have a nutritionist and, on many occasions, he has to attend to all the hospital services, so he is partly integrated into the unit. The same goes for psychologists, who are usually on staff.
An eating disorder seems difficult to detect until the physical consequences are not very evident. When should you see a doctor?
It is one of the great difficulties of these diseases. At first what happens is that, due to the culture prevailing in society, the first symptoms can even be applauded, in the sense that you are a person who takes care of yourself and you have discipline. Later, the environment begins to worry, but the patient cannot see it. It is an egodystonic disease, that is, that the person feels it as beneficial. He believes that he is doing well. It is not until he feels that the situation has gotten out of hand that he begins to accept help. It’s better than the relatives listen and ask indirectly instead of feeling attacked and walking away.