I have been struggling with an eating disorder for the past few years. I am afraid to eat and afraid I will gain weight. The fear is unjustified as I was never overweight. I have weighed the same since I was 12 years old, and I am currently nearing my 25th birthday. Yet, when I see my reflection, I see somebody who is much larger than reality.
I told my therapist that I thought I was fat. She said it was 'body dysmorphia'.
She explained this as a mental health condition where a person is apprehensive about their appearance and suggested I visit a nutritionist. She also told me that this condition was associated with other anxiety disorders and eating disorders. I did not understand what she was saying as I was in denial; I had a problem, to begin with. I wanted a solution without having to address my issues.
Upon visiting my nutritionist, he conducted an in-body scan and told me my body weight was dangerously low.
I disagreed with him.
I felt he was speaking about a different person than the person I saw in the mirror. I felt like the elephant in the room- both literally and figuratively. He then made the simple but revolutionary suggestion to keep a food diary to track what I was eating.
This was a clever way for my nutritionist and me to be on the same page. By recording all my meals, drinks, and snacks, I was able to see what I was eating versus what I was supposed to be eating. Keeping a meal diary was a powerful and non-invasive way for my nutritionist to walk in my shoes for a specific time and understand my eating (and thinking) habits.
No other methodology would have allowed my nutritionist to capture so much contextual and behavioural information on my eating patterns other than a daily detailed food diary.
However, by using a paper and pen, I often forgot (or intentionally did not enter my food entries) as I felt guilty reading what I had eaten or that I had eaten at all.
I also did not have the visual flexibility to express myself through using photos, videos, voice recordings, and screen recordings. The usage of multiple media sources would have allowed my nutritionist to observe my behaviour in real-time and gain a holistic view of my physical and emotional needs.
I confessed to my therapist my deliberate dishonesty in completing the physical food diary and why I had been reluctant to participate in the exercise. My therapist then suggested to my nutritionist and me to transition to a mobile diary study.
Whilst I used a physical diary (paper and pen), a mobile diary study app would have helped my nutritionist and me reach a common ground (and to be on the same page) sooner rather than later.
As a millennial, I wanted to feel like journaling was as easy as Tweeting or posting a picture on Instagram. But at the same time, I wanted to know that the information I provided in a digital diary would be as safe and private as it would have been as my handwritten diary locked in my bedroom cabinet.
Further, a digital food diary study platform with push notifications would have served as a constant reminder to log in my food entries as I constantly check my phone. It would have also made the task of writing a food diary less momentous by transforming my journaling into micro-journaling by allowing me to enter one bite at a time rather than the whole day's worth of meals at once.
Mainly, the digital food diary could help collect the evidence that I was not the elephant in the room, but rather that the elephant in the room was my denied eating disorder.
The elephant in the room
As a global health enthusiast, one of my areas of research is focused on vulnerable groups of population, grappling with health inequalities. Over the years, I have learned that data and research is one way we can grab the attention of the world's neglected population, and also a way of advocating for them.
Two months ago, my team and I decided to publish a paper on the Indigenous people living in Brazil. As we were reading about their health concerns, we came up with perilous conditions in regards to their health amid the pandemic. After extensive research, we published our paper in The Nature, one of the world’s top journals.
The Nature paper motivated me to continue advocating for indigenous people. I recently read about climate change impacts on these people and realized how vulnerable these people are to climate impacts. Therefore, I decided to raise my voice again for these people that need urgent attention from the world’s leaders.
Climate change is an undeniable, human-made disaster of our generation, disproportionately impacting the lives of millions of people across the planet. The impacts climate change causes not only affect humans but also the ecosystem as well such as glacier erosion, wildfires, droughts, etc.
Of the many species that are fragile to the climate change impacts, one is Indigenous people. Living in different parts of the world (Jungles, mountains), Indigenous people continue their lives in synchrony with nature.
From the early days, they had adopted a life dependent on nature in such a sustainable way that any man-made variation in climate patterns threatens their lives, and ultimately extinction.
To this day, Indigenous people are at risk of many hazards, including climate change. In this blog, I will delve into the reasons why Indigenous people are vulnerable to climate change impacts, and what should be done to ensure their safety in this rapidly advancing world.
The loss of habitats is a major challenge for indigenous people to maintain the safety of their dynasty. Destruction of habitats due to climate change poses significant challenges, as it impacts the health, nutrition, and ultimately extinction in their generation. Sadly, climate change impacts have already caused significant disruption to their habitats, and continue to disrupt.
For instance, native Alaskans living near the shores have been impacted by climate change effects. Their provision on fishing has become scarce. When there is a lack of food, it affects nutrition and health, such as malnutrition. When all of these occur, force displacement takes place.
Indigenous people live a sustainable life in the world in harmony with nature. The loss of sustainability due to climate change is detrimental to the world, as its impacts precipitate the whole world. For indigenous people the impact is more threatening as these people do not have stable lives.
When I was drafting my Nature paper, I came across that not all indigenous people are included in the health programs of Brazil. Many indigenous people were left out of COVID-19 vaccination, as they did not have access to the country's unified health system.
This shows lack of attention in regards to their health issues. Several health issues arise from the impacts of climate change such as Dengue, Zika, and Yellow fever viruses. These Infectious diseases emerge due to bad climate conditions. These diseases are lethal and can cause serious health problems.
There is a bulk of evidence that these diseases have impacted indigenous people and even taken lives. Moreover, changes in the menstrual cycles of indigenous girls have also been linked to the changes in climate.
In search of new habitats, indigenous people are forced to abandon everything behind, including their unique social behaviors. When forced displacement occurs due to climate change impacts, these people shift their places.
This brings cumulative impacts on their lifestyle, including health and social behaviors. Forced displacement significantly impacts health. Health implications such as depression and anxiety devastate the mental health of these indigenous people. Moreover, the gradual loss of social behaviors due to displacement is worrying, until time comes when they are no longer called indigenous.
This is very concerning given that the world is quite modernized and rapidly evolving. Thus, working towards preserving the unique characteristics of these people should come as a top priority for us. There are pictures that show these people have become modernized, and lost their instinctive behaviors.
Having published on Indigenous people made me realize how vulnerable their health concerns are. I made a moral decision to continue highlighting their health problems. Climate change is yet another main concern that negatively impacts the health of indigenous people.
It is an undeniable fact of our generation, causing big troubles to the world. Indigenous people are at the center of such risks. What we observe now is the tip of the problems these people are suffering from.
More research and data are needed to highlight the devastating impacts of climate change on Indigenous people. For us to fulfill our moral responsibility, we need to advocate for their health and safety.
West African Lead, ALMA Youth Advisory Council/Zero Malaria Champion
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Dear Digital Diary,
I realized that there is an unquestionable comfort in being misunderstood. For to be understood, one must peel off all the emotional layers and be exposed.
This requires both vulnerability and strength. I guess by using a physical diary (a paper and a pen), I never felt like what I was saying was analyzed or judged. But I also never thought I was understood.
Paper does not talk back.Using a daily digital diary has required emotional strength. It has required the need to trust and the need to provide information to be helped and understood.
Using a daily diary has needed less time and effort than a physical diary as I am prompted to interact through mobile notifications. I also no longer relay information from memory, but rather the medical or personal insights I enter are real-time behaviours and experiences.
The interaction is more organic. I also must confess this technology has allowed me to see patterns in my behaviour that I would have otherwise never noticed. I trust that the data I enter is safe as it is password protected. I also trust that I am safe because my doctor and nutritionist can view my records in real-time.
Also, with the data entered being more objective and diverse through pictures and voice recordings, my treatment plan has been better suited to my needs.
No more elephants in this room