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Close-up of feet standing on a scale. (National Cancer Institute)

Eating Disorders a Growing Problem in the Middle East, Researchers Say

Issue has long been overlooked in the region due to a lack of awareness and accurate data, according to specialists

Eating disorders are a growing concern in the Middle East and their incidence rates therein could be higher than in Europe and North America, preliminary research suggests.

“[The matter has] clearly been overlooked and not much attention [has been] given to researching this specific mental health illness,” Dr. Jeremy Alford, a clinical psychologist and president of the Middle East Eating Disorders Association (MEEDA), told The Media Line. “On a personal clinical level, I have noticed an increase in prevalence when I compare to 2003.”

A few years ago, MEEDA conducted a pilot study with 200 college students from Lebanon and the United Arab Emirates (UAE) aimed at assessing the level of awareness in that age group regarding the problem. Participants completed a set of questionnaires which also screened them for possible eating disorders. It was found that those who had a higher awareness of eating disorders had a higher potential of developing them.

Dr. Alford, who also runs the Indonesia-based Choices Retreat, qualified, however, that the matter “needs further investigation.

“As of yet, there is still no accurate [data on] bulimia and anorexia in the Middle East,” he explained. “We assume at this point that [the prevalence] may be the same or more than in the West, though this remains speculation for now.”

Nevertheless, Carine el Khazen, a clinical psychologist at the Abu Dhabi-based American Center for Psychiatry and Neurology and vice-president of MEEDA, told The Media Line that the studies conducted in the UAE “show that the numbers in the Middle East could be double those in the western world.

“Dieting has now become the norm [in the region] and all [eating disorders] start with a diet,” el Khazen noted, adding that the main techniques used as remedies are, among others, cognitive behavioral therapy and family-based treatments.

MEEDA is currently working with health ministries in several Middle Eastern countries to address the pressing issue and develop prevention programs as well as additional therapeutic treatments.

Professor Justin Thomas, an expert on eating disorders at Zayed University in Abu Dhabi, told The Media Line that the worrisome trend has swept across the region.

“Eating disorder symptoms…are particularly high in the [Gulf Cooperation Council] nations,” he said. “We don’t know for sure if that translates into actual cases, but it is not a good thing that symptom levels are where they are.”

While eating disorders were previously thought to be primarily limited to wealthier western countries, Prof. Thomas said that “there appears to have been an [increase] in many developing nations since the 1990s. The big factors associated with a rise in eating disorders have traditionally been changes to the economy, the female body image ideal, and, at times, conflicting gender roles for women [as well as growing] rates of obesity.”

According to researchers, some additional factors include the growth of the diet industry, the popularity of social media and the resulting pressures, and genetics.

Dr. Rachel Bachner-Melman, president of the Israeli Association for Eating Disorders and a senior lecturer at the Ruppin Academic Center, told The Media Line that the pervasiveness of anorexia and bulimia in Israel is “pretty much on par” with Europe and North America.

However, she emphasized, “I don’t think we have serious epidemiological studies to really say that the rates are going up. But certainly the impression from a number of people in treatment programs and [those observing] young people’s mentalities [is that] it’s certainly not getting better and could well be getting worse.”

Bachner-Melman noted that Israel recently ranked high on the list of global nations plagued by high rates of eating disorders. She partially attributed this to the widespread use of social media, with young adults and teen girls often comparing themselves to images posted online.

The US-based National Eating Disorder Association found that between 0.5 percent and 3.7% of all women suffer from anorexia nervosa at some point in their lives. An estimated 1.1%-4.2% of women will become bulimic, and roughly 3.5% of women, 2% of men and 30-40% of those seeking weight loss treatments will be affected by the newly-recognized binge eating disorder.

According to Dr. Bachner-Melman, not enough campaigns have been launched to combat the problem in the Middle East.

“We need more early detections, we need more psychoeducation for parents, teachers and peers,” she said. “People need to know the warning signs much better.”

To this end, MEEDA has been intensifying its efforts to combat the issue by encouraging those who believe they might have an eating disorder to seek qualified help.

“It is important to note that eating disorders are a specialty, which means that not all psychiatrists, psychologists, nutritionists are necessarily [knowledgeable] in treatment or intervention,” Dr. Alford, MEEDA’s president, concluded.

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