How #selfies are creating eating disorders in kids

Sucking in her cheeks and stomach, Lisa Rebello* arched her back, stared into the camera and clicked. Within a few seconds she had posted the selfie on to Facebook, Instagram, Snapchat and Twitter and began smiling as the tsunami of likes and positive comments began.

At 170cm tall the Dubai-based 15-year-old was a worryingly skeletal 37kg – down from a healthy 58kg a year earlier. Desperate to copy her favourite stars such as Kylie Jenner, Lindsay Lohan and Beyoncé looking oh-so-thin in their selfies, Lisa had begun skipping meals, and was now lying to her parents and surviving on just soups, salads and a few biscuits a day.

‘I want to look as good as they do,’ she told herself, flicking through the stars’ social media feeds. ‘They work hard to keep in shape for their selfies, so I can too.’

She refused to believe that some of their pictures could have been altered with flattering filters, angles or photoshop so they appeared thinner.

So at dinner she played with her food. ‘I’ve already eaten,’ she lied. And the next morning, she ate barely a mouthful of muesli for breakfast before rushing off to play sport. The once-shy teenager spent the next few months starving herself and pushing her body to the limit with gruelling workouts and school sports sessions. And as the kilos dropped off and her bones began to show under her paper-thin skin, she congratulated herself almost as much as her social media followers.

‘At last I’m getting to have the body of my favourite stars,’ she said to herself.

But in reality she was in the throes of a serious eating disorder – anorexia – that made her dizzy and tire easily as her immune system weakened.

When she began to suffer dizziness and extreme fatigue her parents rushed her to a doctor who diagnosed her with one of a series of serious eating disorders that have gone viral among teenagers and children thanks to social media peer pressure and the popularity of the selfie.

‘Lisa was 15 when I started treating her,’ says Dr Thoraiya Kanafani, clinical psychologist and director of clinical services at the Human Relations Institute and Clinics (HRIC), Dubai. ‘She was clearly influenced by the pictures she’d seen online and yearned to look like her favourite stars. She then wanted to post similar selfies so she would be seen as one like them. If left untreated, such eating disorders can cause serious long-term damage to a sufferer’s body and mental capacity, and in the most severe cases result in death.’

The craze to post skinny selfies is creating havoc with the bodies of impressionable teens, says Dr Thoraiya.

‘It’s so sad to see the problem increasing so massively yet so many online images are airbrushed and not real.’

It doesn’t seem to matter that celebrities have been accused of – or even confessed – to digitally altering their selfies to make their bodies look thinner.

Lindsay Lohan sparked a storm of media outcry over a picture that showed her looking worrying thin, while model Kendall Jenner has been quoted as saying that she sometimes takes over 100 selfies a day before she chooses the right one to post on social media.

‘It’s the social media,’ says Dr Thoraiya. ‘It is promoting unrealistic body images and the obsession for sharing selfies. There is an increasing obsession with body image and looking a specific “perfect way”,’ she says.

‘The selfie is quite a phenomenon. It’s causing people and particularly teenagers to be very conscious about their body and make comparisons between them and others. Social media certainly negatively contributes to eating disorders. For example, online bullying means the problem can continue when children go home.

‘They are no longer just bullied at school, there is no haven now. It affects their self-confidence and they feel there’s no escape. Sometimes, youngsters try to control their feeding because it’s the one thing in their life that’s in their control.’

In an all-female study conducted at Zayed University, Dubai, researchers found that almost a quarter of students had poor eating attitudes and 80 per cent wanted to have very thin bodies.

The stats are startling: In the UK, the number of those aged between 13 and 19 being admitted to hospital with anorexia and bulimia has doubled in three years from 915 in 2011 to 1,815 in 2014. The number of British children under the age of 19 who were admitted to the hospital for an eating disorder jumped from 658 in 2003-2004 to 1,791 in 2013-2014, an increase of over 170 per cent.

In a 2013 study at the American University of Sharjah, of the 361 students surveyed, nearly one in three indicated they were dissatisfied with their bodies. And this is not restricted to women. A 2014 survey found that nearly 50 per cent of the male adolescents living in the UAE had a high proportion of disordered eating attitudes.

So why this sudden spike in the number of children in the region starving themselves to become thin?

Dr Thoraiya admits that valuing thinness is a relatively new concept in this part of the world. Historically, a more plump appearance has been appreciated in this region due to cultural reasons. Now that has changed to be thinner largely because of the overpowering influence of celebrities posting pictures of their lean bodies on social media channels.

‘The Western mentality and culture appreciates thinness. We are starting to see that here now due to globalisation, including TV shows, movies and on social media. It has all aided the value of thinness,’ she says.

Dr Thoraiya cannot blame the global selfie craze and social media enough for this disturbing trend. ‘Social media has a lot to answer for,’ says the expert, adding that she has treated one female patient as young as 12 in her current role.

‘It’s very sad to see young people hurt their health by refusing to eat, which in the medium to long term damages their body’s functions and ability to fight disease.’

Even more worrying is the use of social media by children as young as nine to rate whether their classmates are ‘hot or not.’ In the UK and India the latest kids’ craze is to post a selfie or video clip online, which their peers rate. The votes are then uploaded on to YouTube or Facebook pages, meaning public humiliation with no filters. Some clips have amassed more than 2,000 views.

One teenager, who asked not to be named, said, ‘If you are judged to be “not”, you don’t say anything as you don’t want the others to think you are upset. But it’s humiliating because it’s so public. Some people will try to change the way they look because of it. There are loads of these videos and there’s nothing adults can do.’

There may be some hope, however. Beneath one YouTube video recorded by a girl in her early teens, comments have included: ‘Everyone is beautiful in their own way. What is the point of doing these videos?’ and ‘I can only hope that one day, you’ll understand what a terrible thing this is to do’.

And experts are worried. Dr Carolyn Nahman, a consultant psychiatrist at Newbridge House eating disorder treatment centre in Sutton Coldfield in the UK, has said: ‘We’re increasingly concerned about the pressure of social media. With one click of a button, very vulnerable young people are able to access 10,000 images of “perfect-looking” people, which places them under a lot of pressure.’

Body image is so dangerous on social media that Facebook has removed ‘feeling fat’ from their status update options after more than 16,000 people signed the Change.org petition.

‘Having these word choices completely normalises using derogatory descriptive terms in the place of real feelings,’ said Rebecca Guzelian on the petition.

‘When someone says “I feel fat” what they’re really communicating is that they feel unattractive, unhappy, embarrassed and insecure about their body. And believe it or not, these feelings are most commonly a response to the unrealistic, culturally promoted ideals of thinness and beauty that are shoved in our faces every single day.’

Facebook didn’t hold back in its explanation about why it had agreed to remove the status. ‘We’ve heard from our community that listing “feeling fat” as an option for status updates could reinforce negative body image, particularly for people struggling with eating disorders.

‘So we’re going to remove “feeling fat” from the list of options.’

But is it enough? Lisa doesn’t think so. She never used that status, but loved the admiration she received on social media after posting skinny selfies. ‘At one point I almost stopped eating solid foods, surviving largely on water,’ she says. ‘If I had to eat then I would just suck on watermelon or eat a few sugar-free biscuits.

‘My friends who shared the obsession with weight and size encouraged me and expressed how proud they were of me when they saw from my selfies I was becoming thin. But as I began to feel increasingly ill I also felt sad, helpless, fearful, as well as an overwhelming amount of ugliness.’

Having battled the illness successfully after seeking medical help including therapy and a proper diet plan, the teenager now has a powerful message to share. ‘No one cares about what you look like,’ she says. ‘Focus on being confident and having a better personality, not on being skinny. If you’re battling an eating disorder don’t post a selfie, seek help.’

Dr Thoraiya says, ‘There has been something of a stigma around seeking help here in the UAE and elsewhere – people don’t want to say they or their children have an eating disorder.

‘They want to manage it within the family but it’s a complex issue and can be worse than it seems so people should seek professional help. It’s psychological and biological – there are a lot of factors to be taken into account.

‘We are out there to help and there is nothing shameful about asking for help. In fact, it’s one of the strongest things you can do.’

Eating disorder specialist Dr Alex Yellowlees, at the Priory Group clinic in Glasgow, has warned that the so-called “thinspiration” sites, which glorify super-thin body images, could be conveying potentially dangerous messages.

‘Eating disorders are like a form of “psychological malignancy” and should be taken very seriously by society,’ he says.

*Name changed