x Abu Dhabi, UAETuesday 25 July 2017

We stay silent as a killer - anorexia - stalks our children

Some ailments are notorious, but anorexia, a deadly disorder, is doing its deadly work with too little attention.

No words can express the anguish of a mother who loses her only child to anorexia nervosa. Imagine watching your 15-year-old daughter slowly starve herself to death. Imagine the twisted irony of living next to a grocery shop, while simultaneously witnessing your child wither away. Some pain is best left unimagined.

Over the past few decades, anorexia nervosa has achieved near celebrity status. To some extent this is due to tabloid speculation about which Hollywood A-lister might be "Ana" - yes, the disorder even has its own pet name. And there are the tearful confessions of Hollywood C-listers, who occasionally recount their long-standing battles with eating disorders for the TV cameras. To date, however, anorexia and its cousin bulimia have evaded the limelight in the Gulf.

There are two mutually exclusive explanations: eating disorders are not a problem in the region; or these disorders go unreported and untreated due to the social stigma surrounding all things psychiatric.

Regional research repeatedly finds dietary habits associated with anorexia, and a preoccupation with thinness among young women that is as prevalent as in western countries where eating disorders have been common for decades.

Similarly, historical and cultural observations suggest eating disorders tend to arise within societies experiencing significant social or economic transition.

There is also anecdotal evidence that anorexia and bulimia are present in the Gulf. In her book, You Are What You Eat, Emirati author Samira Al Romaithi discusses her own experience with anorexia, and her eventual treatment and recovery in a UK hospital. In my psychology classes at Zayed University, discussions of anorexia invariably result in someone disclosing a "distant relative" or a "friend of a friend" receiving treatment for an eating disorder - always overseas.

Perhaps another factor in the relative anonymity and neglect of anorexia in the Gulf is the disproportionate attention given to obesity. Based on 2010 Ministry of Health data, more than 50 per cent of UAE school children are either overweight or obese. But what are the figures for children who are actually underweight?

Being under weight is not seen as a problem, and perhaps some people even view it as desirable, especially given the dangers of being overweight.

No one is suggesting that obesity is not a problem; it obviously is. However, there is a missed opportunity in the failure to recognise that some young people have unhealthily restrictive diets and excessive exercise regimes with severe health consequences.

The overemphasis on obesity can provide a smokescreen for the budding anorexic to relentlessly pursue her (or his) "killer body". It is a classic example of iatrogenic public health, in which the medical process contributes to an illness.

There are a small number of cases I know of in the UAE, in which people have come forward for help with their eating disorders - and they have been met with a fairly insurmountable problem: there are no specialist services for eating disorders in the UAE. As far as I'm aware, there are none in any of the Gulf states. This is probably why most of the "distant relatives" and "friends of friends" get treatment in Europe or North America.

Unfortunately, those who are not able to make it to the Priory Hospital Roehampton in London are likely to wind up receiving antidepressants from a well-intentioned psychiatrist. Antidepressants, as the name implies, are not a specific remedy for eating disorders.

My friend and former colleague, I'll call her Patricia although that's not her real name, lost her only daughter to anorexia. "Melanie" was 15 when she died. At the time of Melanie's death, there were no eating disorders services in the area of Britain where they lived.

Patricia channelled the unfathomable pain of losing her only daughter into action. Her locality now boasts one of the finest and most well-resourced eating disorder services in the UK.

To this day, my friend still has a leadership role in the service. I pray it does not take that kind of painful experience to affect change in the UAE.

 

Justin Thomas is an assistant psychology professor at Zayed University in Abu Dhabi