ABU DHABI // Girls as young as 11 are being diagnosed with serious eating disorders but their parents are forced to seek treatment abroad because of a lack of facilities and expertise. The escalating problem is believed to stem from a growing interest in celebrities and a lack of nutritional awareness about the true meaning of a healthy diet.
Experts say that with increasing western influences the pressure on young people to be slim is having disastrous effects on both their physical and mental health. "There is so much pressure on young people here, and it is growing," said Dr Roghy McCarthy, a clinical psychologist who has practised in the UAE for a decade. "Life is becoming more stressful and demands made of these young girls are increasing. There are more imposed by the family, the individuals themselves and also society. The pressures from society are changing and this is often a way of coping, but a wrong way. They want to be the perfect daughter, mum, wife or employee. They see food as a way of controlling themselves, the starving is a control issue."
One of the worst cases Dr McCarthy has seen involved a 17-year-old Emirati girl who weighed just 27kg. "I have seen many cases of different levels, it is becoming a bigger and bigger issue and is definitely on the increase," she said. According to the International Statistical Classification of Diseases, produced by the World Health Organisation (WHO), anorexia nervosa is characterised by deliberate weight loss, induced and sustained by the patient.
It is most common among young girls and women, but young men and adolescent boys may also be affected. Symptoms include restricted diets, excessive exercise, induced vomiting and the use of appetite suppressants. According to the National Eating Disorders Association in the US, between five and 20 per cent of anorexics will die because of the condition. Dr McCarthy said she had seen girls as young as 11 presenting with anorexia and in serious risk of damaging their long-term health. One of the most serious effects of anorexia is infertility.
"The effects can be devastating if it is not treated," she said. "It is crucial we raise more awareness among physicians and also the public. "It is also now affecting boys. I have seen 15-year-olds with bulimia, this seems to be the more common disorder among young men. It is easier to treat but just as worrying." Dr McCarthy said she had seen and heard of many cases where the anorexia or bulimia had been misdiagnosed by doctors who were not trained to deal with eating disorders.
As well as a lack of understanding about nutrition and the benefits of exercise, experts said an influx of western culture in recent years had also intensified the problem. There are now more magazines on the market than ever, many including diet tips and photographs of slim celebrities such as Kate Moss, the model, and Keira Knightley, the actress. Dr Rakesh Malhotra, an endocrinologist at the New Medical Centre in Abu Dhabi, said young people were now seeing these celebrities as icons but did not know how to go about achieving a slim figure in a healthy way.
"Young people are now always seeing pictures of slim celebrities and wanting to copy them," he said. "Here I see some patients, young girls, who have been starving themselves because they do not want to put on weight. "Instead of doing exercise and having a healthy diet they simply stop eating altogether. Instead of committing to something, they start omitting something else, in this case food. A lot of people do not understand nutrition, or food labels, or vitamins."
Dr Malhotra said the pressure which existed in the West to be slim was now having an increasing impact on the Middle East. But unlike in the West, where healthy eating messages were widespread, the UAE lacked the educational infrastructure. "Maybe people do not realise the damage they are doing when they are starving themselves," Dr Malhotra said. "There is a total lack of awareness, these girls do not know what to do and when to do it - to be slim and healthy.
"Whether they are overeating or under-eating, they do not read labels on foods and understand what healthy diets are. They take things to the extreme; when they start putting on weight they just starve themselves." There are no statistics available in the UAE about the number of people with eating disorders, but it is widely acknowledged that the number is increasing. One of the major stumbling blocks faced by those wanting to improve services and raise awareness is the taboo surrounding the topic.
"There is still a stigma about even visiting a psychologist or psychiatrist," said Dr Essam Emem, a psychiatrist at Tawam Hospital in Al Ain. "It is not something people often want to accept, especially parents with high expectations. There is pressure to succeed in everything and an eating disorder is not a very accepted illness." It was, he said, "especially hard for the men, too". In Europe and the US there are many specialist clinics dedicated to treating eating disorders; the UAE, however, has none. There are trained psychologists and psychiatrists, but no medical centres offering diet and treatment plans.
Dr Atif Saleh, a clinical psychologist at Rashid Hospital, said he hoped to see the UAE doing more to help young people who were literally starving themselves to death. "If the problem continues to increase we will need to build our own facilities," he explained. "We do not always have contact with clinics abroad, only details of them, so patients have to go by themselves, it is not good. "In the past this was not such a problem so we did not really need clinics, but now the problem is much more common. We need to raise awareness and break the taboo."
The Ministry of Health declined to comment. @Email:munderwood@thenational.ae