THE pressure to be thin starts early for girls, even in childhood, but when this takes a wrong turn, it results in eating disorders like anorexia.
Individuals with anorexia have an intense fear of gaining weight and they starve themselves, sometimes to the point of death.
In a study conducted in 2020 called “Estimated prevalence of eating disorders in Malaysia based on a diagnostic screen”, over 50 per cent of participants involved reported having symptoms of an eating disorder.
This implies that the prevalence in Malaysia is quite high and future studies need to be done to better understand and manage the local population’s eating pathology, says IMU Healthcare clinical psychologist, Dr Serena In.
Anorexia can be caused by psychological, environmental and genetic factors, among others, she explains. Someone who is vulnerable to depression and anxiety, has a low threshold for managing stress, is a perfectionist, or has high expectations of themselves, would be more likely to develop an eating disorder if they do not learn healthier coping mechanisms, she says.
Those who have experienced extreme academic pressure, bullying or abuse, criticism about body weight and size and have difficult family relationships, may also be more susceptible to unhealthy eating patterns that lead to an eating disorder.
THE WRONG MESSAGE
The fact is that being slim or thin results in compliments and gets you attention, more so in the age of social media. Young girls who see “size zero” models on runways or billboards aspire to be like them.
Educational psychologist and programme director for Bachelor of Psychology at Taylor’s University School of Liberal Arts and Sciences, Rajalakshmi Ganesan, says when young girls see those with a thin body receive compliments, wear fashionable clothes or receive attention, they too want those same things.
It doesn’t help that fashion trends these days create even more pressure for girls to strive for a thin body, she adds.
“The desire to belong, the need for attention and the fear of being left out are all possible drivers towards developing an eating disorder.”
Young girls spend a lot of time accessing media that’s flooded with images that value and praise thin people, she adds.
In some cases, it just takes one critical comment about eating, body shape or weight from a family member or person of high value for a girl to succumb to anorexia.
YOUNG AND VULNERABLE
Adolescent girls are more likely to experience hormonal fluctuations and emotional instability.
Rajalakshmi says changes that girls undergo during puberty can influence the way they perceive their bodies.
Girls are also more prone to internalising societal expectations of beauty and become critical of their body image to the point of irrationality.
“Awareness and education on this matter is essential to provide support and engage in early interventions as anorexia nervosa can be fatal,” says Rajalakshmi.
KPJ Penang Specialist Hospital head of dietetic and food services Najihah Mohd Rasman says anorexia generally affects girls aged 10-20 and prevalence is believed to be around one per cent in Malaysia.
She says we need to ask ourselves why girls are feeling the pressure to look a certain way, even if it leads them down a dangerous path which compromises their health.
“It’s normal to want to be healthy and slim but when you develop an obsession with losing weight at any cost – even your health – it becomes a problem that can have tragic consequences.”
Najihah says treatment for anorexic individuals is multidisciplinary. Nutritionally, it is done in phases. The objectives among others are to correct starvation, improve electrolyte imbalances, avoid underfeeding and promote a healthy weight gain.
In-patients will be under monitoring to achieve 0.5-1kg of weight gain per week, while outpatients will be targeted at 0.2-0.5kg per week.
However, promoting weight gain among anorexics is not an easy task. The journey to recovery can be very challenging and requires strict monitoring from physicians and dietitians.