By Dr. Amitha Mundenchira
Eating disorders are abnormal eating habits that may involve either insufficient or excessive food intake leading to a decline in both physical and mental health. Bulimia nervosa, anorexia nervosa, and binge eating disorder are the most common forms. It is estimated that 8 million Americans have an eating disorder – seven million women and one million men. The stereotypical patient is a female; however, an estimated 10-15% of patients are males. Treatment of an eating disorder in the US ranges from $500 per day to $2,000 per day. The average cost for a month of inpatient treatment is $30,000. The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more. Eating disorders have the highest mortality rate of any mental illness – this mortality is related to complications from the disorder including suicide and heart problems.
The medical history is the most powerful tool for the competent medical professional to diagnose an eating disorder. The precise cause of eating disorders is not entirely understood, but there is evidence that it may be linked to other medical conditions. ADHD, mental disorders like post-traumatic stress disorder, and genetics are all risk factors for eating disorders.
Anorexia is the 3rd most common chronic illness among adolescents, most of them between the ages of 12 and 25. Media portrays idealized body-types as being “size 0” for females and “buffed up” for males. In this age where media “reality” is idealized, it sets the trap. What media does not portray is that even the celebrities in real are not as perfect as they look on screen/print and that celebrities put in a lot of time/effort to stay physically fit as it is their livelihood. The common person has to survive in the real world where physical fitness may have to take a back seat.
Eating disorders have underlying negative perceptions of body image that have roots in issues deeper than the media addiction. The South Asian culture is one such example where issues like family expectations and societal involvement disadvantage the youth even more. Comments like “you are too skinny”, “you should lose some weight”, and “use fair-&-lovely cream” are commonly heard at South Asian gatherings. As westernization takes over not only in South Asia but also in the lives of immigrant South Asian families, youth are more confused.
The youth want to fit in with the western culture. They also want to keep up their parents’ culture. Due to conflicts, the youth get frustrated; they may use their body as a means to bring some control into their lives often dictated by their families and society. The following are some examples of such conflicts:
(1) Their Caucasian friends dress as natural as possible in their daily lives. However, the South Asian society can be so judgmental that there is a pressure to look the best even for casual gatherings.
(2) Imitating the thin celebrities is applauded in Western society. The same message is relayed in a different manner in the South Asian culture. South Asian youth are pressurized to look their best physically – slim and fair flawless skin. Women are under more scrutiny than men. This stems from the importance placed on attracting a suitable spouse preferably through an arranged marriage. For instance, I have had South Asian parents ask me how I can help to improve their grade-school child’s skin complexion or height. The associated negative body image promotes anorexia- related behaviours.
(3) Another part of the South Asian culture encourages indulgence in rich food; refusing may be considered arrogant. The youth may take up purging behaviours after such food indulgences.
Peer pressure including bullying is already such a negative influence on body image. Family is supposed to be supportive and a positive influence. Instead, they don’t realize that their comments and expectations are even more overwhelming; the wrong message about “starving” is sent to the youth.
It is ok to emphasis on looking healthy but for the right reason – in order to be physically healthy and mentally positive. It is going to take time to bring about a change in our whole culture but parents can take a step towards raising youth with healthier body images. This can be done by taking care to promote healthy eating/exercise habits and to praise for maintaining health. Parents should also try to understand the views of their youth in the Western culture and adapt to them accordingly even if it means loosening on some of the South Asian views. There should be an emphasis on being comfortable with one’s own body – whatever the size, shape or colour.