Food cravings, disordered eating behaviour and alcohol abuse in Bhutonmadas - An exploratory review

Abstract

Various psychiatric and neuropsychiatric conditions are described under a broad disease entity called Unmada in Ayurvedic classical texts. Bhutonmada or Grahonmada is a specific type of Unmada that has multiple phenotypic clinical presentations. Bhutonmada is multifactorrial, heterogeneous, and idiopathic in nature. Different types of food cravings, abnormal eating behaviours and alcohol abuse related symptoms are mentioned in the literature of Bhutonamada. The present study is aimed to explore and analyze the clinical features of Bhutonmada related to food cravings, abnormal eating behaviours and alcohol abuse with the help of literature based on contemporary nutritional psychiatry. Abhipraayam, Ruchim, Priyam, Ratim, Sakta Drishtim and Yachinam are the various terms quoted in the context of Bhutonmada, represents variability of food cravings depend upon various factors such as intensity, frequency, quality, mood, inter-individual, and socio-cultural. Various abnormal or disordered eating behaviours such as hypophagia (Alpaahaara), hyperphagia (Bahvaashinam/Bahu Bhuk/ Bahusha Yachantam), emotional eating (Lolam), binge eating (Annapaana Ratim), strange eating habits (Bhramad Bhojinam) etc are mentioned in Bhutonmada literature. Appetite abnormalities such as Anannabhilasha, Arochaka, Na Kshuda, Kshudaatura etc manifests into either excessive (Bahvaashinam/ Bahu Bhuk) or low food consumption (Alpaahaara/Anna Dveshinam) are also described in the Bhutonmada context. Terms such as Abhiprayam, Ruchim, Priyam, Ratim and Sakta Drishtim pertaining to alcohol use/abuse in Bhutonmada could possess different contextual meanings. The present exploratory review will provide various new insights and better understanding of the terminology related to food cravings, eating disorders and alcohol use disorders in Bhutonmada and paves the way for the development of questionnaires and dietary or nutritional guidelines in the diagnostic and/or management protocols of Bhutonmada.