The Scale is the Enemy: Eating Disorders in Egypt
By: Farah Rafik
@farahrafik
For several years, Amna* struggled with doing something as mundane as trying on a pair of old blue jeans. Her anxiety would multiply when looking in the mirror to see how she looks and comparing herself to unrealistic expectations of body image.
“My anxiety is manifested in overthinking and over-analyzing. The first thing I overthink is my body image. Even at my thinnest, I would look in the mirror with all the possible angles to try and find something wrong with my body,” the 20-year-old told The Caravan.
After being a gymnast for 13 years, she began to struggle with weight gain when she quit the sport in her mid-teens.
“When I gained almost double the weight, I felt a tremendous amount of insecurity. I started getting into the eating disorders loop by refraining from eating in front of people. When this didn’t work out, I started refraining from eating once and for all,” she added.
The former gymnast shared how she alternates between boycotting foods for extended periods and between overeating with the desire to purge it out, also known as binge eating disorder (BED).
Body dysmorphia, a mental illness that entails continuous negative perceptions about one’s appearance, is mentally, physically, and emotionally draining.
According to the Anorexia and Depression Association of America, the body dysmorphia disorder is a body-image disorder characterized by ‘persistent and intrusive preoccupations with an imagined or slight defect in one’s appearance.’
And it is an urgent global phenomenon that transcends culture and social norms.
In 2014, nutrition researcher Somaya Mahmoud conducted interviews with 500 Egyptian girls attending both private and public schools.
Her findings indicated that 1.6 percent of the girls were bulimic and 0.5 percent were anorexic, statistics nearly identical to those in the US.
Bulimia Nervosa is associated with eating extremely large amounts of food and then purging the body of the consumed food.
Anorexia is associated with very low body weight to the point of looking emaciated, and refraining from food almost entirely.
For bulimia nervosa, the symptoms can be easily identified. “You can spot people with bulimia in public, as soon as they finish a meal, you find them rushing to the bathroom,” said Noha El Nahas, professional counselor and adjunct faculty in the psychology department.
Lina* says she suffered from bulimia for years, caught in an endless debate “to vomit or to not vomit.”
“I was trapped in a cycle, consumed by the need to binge and vomit, every minute of every day worrying about body image,” she said.
“I don’t think I remember a time where I could eat one full meal without chugging a glass of water after it so I can binge easily.”
She finally realized that she needed help after her friend caught her vomiting in the bathroom during a trip to the North Coast.
Body Image Between the Media and Reality
The idealistic image of the human body is fueled through the pressure of the media, El Nahas says.
She did acknowledge that there are different factors to developing an eating disorder, however, she says peer and media pressure to look a certain way are root causes.
Young people are connected through social media and stream global content on their smartphones and devices.
It is here they are subjected to unrealistic ideas of body image. As they grow older, they develop a distorted version of body weight and image which they feel they must reach.
The struggle – or failure – to reach this idealized body image ultimately leads to anxiety.
“Anxiety could be resulting from peer pressure or simply using eating as a habit or a coping mechanism. The emotional eating mechanism definitely highlights how anxiety could result in an eating disorder,” El Nahas said.
BED is the most prevalent eating disorder because it temporarily reduces anxiety and increases positive emotions, due to increases in serotonin and dopamine
“Internalizing emotions can be done through developing an eating disorder. An irregular pattern of eating can easily become a refuge from all the stressors and problems. Sometimes it’s a magical wand that they think can fix their problem,” she added.
El Nahas said that anyone is vulnerable to developing a psychological disorder at any point in their lives.
“No one is 100 percent safe from developing a psychological disorder. Everyone is prone to developing an irregular pattern of eating. If a person went through a difficult break-up, they can find comfort in eating large quantities of chocolate, and so a binge eating disorder can develop,” El Nahas added.
Global Problem
Egyptian psychiatrist Mervat Nasser authored a book called Eating Disorders and Cultures in Transition in which she compares eating disorders in the Arab region and Western world.
Her conclusion was that eating disorders don’t only exist in Western countries, but rather, they exist more closely in the Arab region than one would think. Her findings validated the research conducted by Somaya Mahmoud.
Another study conducted at Ain Shams University to examine the prevalence of body image dissatisfaction of high school students who had high risk of eating disorders showed that the results were partially consistent with those reported in Western nations, such as the US.
Nearly 29 percent of the survey sample of 416 Egypt female adolescents aged from 15-18 years, 28.8% had low body image satisfaction correlated to negative eating disorder beliefs.
“When people develop an eating disorder, they do not think of the consequences, they think of the immediate result they are getting,” El Nahas concluded.
