Dubai: In a study, researchers asked a group of female students at Zayed University to rate their figures against nine silhouettes to know which shape they aspired to be, and a majority picked stick-thin figures.
The study group consisted of 228 female students at the University and 80 percent of this group wanted very thin bodies.
The study was done by Valsamma Eapen from the Faculty of Medicine and Health Services, UAE University, and Abdul Azim Mabrouk and Salem Bin Othman from the School Health Services, Al Ain.
Dr Osman El Labban, consultant family medicine at Al Zahra Hopsital, Dubai, says that 75 percent of this study group were unhappy with their bodies.
The doctor points out that 59 percent of the study participants were of a healthy weight, based on their body mass index (BMI), while 19 percent were overweight and nine percent were obese.
“In a country where obesity and diabetes are major issues, it is quite easy to overlook this dangerous trend in the adolescent population,” he says.
He recommends that psychologists regularly visit schools and universities to provide counselling to teens and children who seem dissatisfied with their bodies. “There are very few psychologists available and their work is presently done by social workers,” he says.
“The school administration and parents should be taught how to identify this disturbing pattern among children,” he believes, stating that many of the teens suffering from such issues never seek help.
The UAE has undergone many cultural changes over the years, and many influnces pervade the social environment and this is one reason for the emergence of eating disorders, a syndrome that was earlier only associated with the West.
“There is a lack of public awareness about the seriousness of the condition (in the UAE), with an increase in the pressure to have the ideal body shape,” he says. The pressure comes from the media, according to him, and adolescents accept as a reality that fashion models are the true representation of beauty.
The other issue that exacerbates this situation is that parents do not have time for their children, he says. “Working parents rarely have time to sit with their children and eat together, as they and their children return home at different times of the day.” This disharmony of togetherness often leaves many potential issues, including poor and imbalanced eating habits, concealed until it is sometimes too late.
A survey done last year at Al Ain University of 900 girls, revealed that 1.8 percent of the girls aged between 13 to 19 years were anorexic (see psychologist’s interview).
Compared to that, the rate of anorexics is 1 percent for girls in Britain from the ages 16 to 18 years, he says.
He quotes a counsellor at a women’s college who says that adolescents with eating disorders are often sleepy in class and struggle to focus on their studies. ‘“These students don’t come for help. We usually pick them out because they often faint in college and also due to their physical appearance,” said the counsellor.
The doctor plans to hold workshops in educational institutions on what should be the correct body weight for a child or a teen and how to calculate it. (BMI, body mass index is calculated by dividing weight in kilos by height (in metres) square= weight/height x height).
“Parents sometimes are responsible for the eating disorders among their children, who make needless remarks about the child’s weight,” says the doctor. “The child then overreacts,” he says.
Parents should identify eating disorders in their children by observing certain habits such as low food intake, excessive exercise, recurrent vomiting or abusing laxatives and other medication. “The consequences and complications of these disorders could turn serious and life- threatening,” says the doctor.
“Watch out if the adolescents tries to reduce meal portion size or leaves food on her plate, or if she frequently visits the bathroom after meals, and there is increasing social withdrawal,” says the family physician.
The doctor points out that eating disorders are more common in girls than boys. Eating disorders, he says, should be put on the health radar of all family doctors and general practitioners. They can be identified early through screening questions. Primary prevention can be done through health education, he says.
(Dr. Osman El-Labban will be speaking on ‘Adolescent Eating Disorders’ at the Family Medicine Conference at the Abu Dhabi Medical Congress and Exhibition that will be held from October 27-29 at the Abu Dhabi National Exhibition Centre (ADNEC).
Parents have to be extremely patient and understanding when teenagers start thinking that ‘food is the enemy’, says a psychologist.
During their teens, boys and girls put on between 14 to 15 kilos and they feel uncomfortable about the way they look, says Mary John, clinical psychologist, Dubai Community Health Centre. “They start wearing loose, baggy clothes to hide their shape,” she says.
Typically, during this period, 40 percent of teenage girls starting dieting and about 25 percent of the boys also start dieting when they start to add on muscle. John quotes a British study that found that during this period, 12 percent of boys and girls turn vegetarian.
“The weight and body issues among teens are universal and is not limited to any ethnic group,” says John.
There are underlying reasons for this, according to her, and that basically, it is all due to anxiety. “Once that anxiety is treated, the teen will start eating normally,” says John. “The other reason for this extreme fear of food also depends on the teen’s temperament or there could be genetic factors.”
“Sometimes, it is the parent who triggers this fear of food,” she says. “The father may make a comment such as, ‘Don’t be like your mother’ (who happens to be overweight). Or the teen would have been bullied (about his weight) his peers.”
Some children at this age also panic at what they eat and find some excuse to eat alone. Some will live on a slice of bread and fill themselves with water or liquid, she says.
The most important parenting rule is that force, humiliation or taunts are absolute no-nos. A child will never take to them kindly. “Parents should stop commenting on the child’s looks during these crucial years,” says John. For example, “Never say that the girl is looking thin or try and force her to eat a bit more; one more spoonful or one more slice of bread.”
Stbborness is a common trait that rears its head during this phase. Teenagers often insist they will only eat certain foods, prepared in a certain way. In such cases, parents have to be tactful. “You have to work around this stubbornness and find ways to sit and eat along with the child,” says John. “Talk about what’s worrying your teenager and how you, as a parent, can help. Never be the controlling parent.”
Another important pointer to teenagers’ eating problems is a sudden, dramatic loss of weight. Parents need to be very aware of it. “If a 50-kilo girl has dropped down to 43 or 40 kilos, consult a GP (general practitioner) immediately,” says John. “The doctor may then recommend a psychologist. Never neglect the child at this time thinking she will come out of this phase.”
On the highly visible trend of stick-thin pop icons and and body-obsessed celebities who have such an impact on a teen’s mind, John says, “Models starve themselves for the money, but teens need the nutrition (during this growing period.”
It is the duty of every parent to help their teens understand the diffeence between admiring a celebrity and wanting to look and be like them. It is often the neglect of parents to address this issue that pushes teens on the road to self-destruction.
The 3 types of eating disorders:
1) Anorexia nervosa: Charecterised by excessive dieting to the point of starvation, and extreme exercise and obessive calorie counting.
2) Bulimia nervosa. Charecterised by cycles of overeating and then vomiting.
3) Binge eating: Charecterised by regular periods of binge eating, uncontrolled eating. Case study
The story of Amy
Amy was 17 years old when anorexia took complete control of her life. Her main focus was to become thin.
She remembers starving herself for days and only drinking two liters of diet soda. Sometimes, she would lose her control and eat anything in sight, and as soon as she did that, she would immediately purge it.
To please her family, she had to show she was eating properly so she would eat with them. But she would carefully review her calorie intake and only ingest 600 calories. But taht according to her was too much and early next morning, she would rush to the gym and workout for three hours before going to school.
After a few months, the manager of the gym asked her to bring a doctor’s note stating that she is allowed to exercise. SO Amy went to a walk-in clinic and got a doctor’s note prescribing that she exercise 60 minutes a day for between 4 to 5 times a week.
But even the regular exercises, she believed, were not enough to keep her in shape. So she would sneak out of her bedroom window at 3am and run for two hours before going to the gym for the 60-minute workout.
One morning, the gym manager cancelled her gym membership for on grounds of health safety. So, the next day, she bought a treadmill, installed it in the basement of the house and would be on it every morning from 1 am to 5 am, without the knowledge of her parents.
She confesses that she would walk the treadmill wearing sweaters and with plastic garbage bags underneath to increase perspiration.
Such was her state of mind that one day when chewing gum, she became extremely anxious as she read on its wrapper that it contained 5 calories.
In order to induce a gag to throw up food, she would often use long-handled spoons or chopsticks.
She could not complete her Masters in Physiotherapy as she felt that if she could not help herself, how could she help other people?
(Case study as told by Dr Osman El-Labban, Consultant, Family Medicine, Al Zahra Hospital)
Excerpts from the study done at Zayed University
1) Our finding that around one-fourth of the secondary school girls in the UAE have disordered eating attitudes and behaviour indicates that attempts should be made to identify these adolescents and target them for early intervention. Awareness about the possible risk factors should help authorities to plan preventive strategies including efforts to reduce societal, peer and cultural pressures that result in thin body preoccupation and internationalisation of the thin ideal among adolescent girls.
2) Internationalisation of the thin ideal and a desire that the ideal weight should be less than the current weight seems to be an important catalyst in the development of disordered eating behaviours in this Arab population living in the UAE. This body preoccupation and social pressures have been consistently found to be important risk factors for the development of eating disorders among adolescents.
3) Currently, disordered eating attitudes and behaviours are not routinely inquired about in the school health screening programmes in the country but our findings suggest that these behaviours are sufficiently common to warrant inclusion in such screening programmes.
4) Similar to other rapidly developing and rapidly acculturating countries, the population of the UAE, especially the younger generation, seems to be caught between the opposing cultural influences of traditionality vs. liberalisation. The resulting psychosocial stress coupled with the effects of
modernisation and Westernisation is increasing the risk of adjustment difficulties in general and eating disorders in particular, where disordered eating can be viewed as a coping mechanism. Thus cultural transition, social change and globalisation are having a complex influence on the eating
attitudes and behaviours of the present young generation all over the world, and UAE seems to be no exception to this global phenomenon.