When it comes to the relationships that we nurture as human beings, it is perhaps the ones we have with food and our bodies that are the most problematic. We are, as the headlines daily scream, in the midst of a global obesity crisis that is the greatest threat in history to our collective health.
But there is another extreme when it comes to the weight and health spectrum. The pressures some of us feel to conform to what are (often wrongly) presumed to be society’s ideals, at least when it comes to physical appearance, are increasing exponentially, and manifesting in conditions such as anorexia nervosa, bulimia and body dysmorphic disorder.
The problems of negative body image, particularly in adolescents, are undoubtedly exacerbated in the 21st century by the pervasion of social media in all its forms. As Aisling Prendergast, who works in addiction psychology and counselling at LightHouse Arabia in Dubai, points out, despite the official age restrictions placed on having a Facebook account, practically every child with access to a computer, tablet or smartphone is present across various online channels.
In these largely unpoliced online spaces, young people can come across images and ideas that are potentially damaging. Adding fuel to the fire is the media in general, with its constant bombardment of paparazzi shots making fun of famous people for not looking “perfect” 24/7. It all conspires to make insecure people feel even worse about their physical appearances.
Body image is an issue close to Prendergast's heart. She spends much of her time helping young people deal with eating disorders and overcoming body-image issues. "The youngest patient I've seen was just 11 years old," she says. "But there are no age limits to eating disorders or body image issues. I've treated people in their 50s who despise how they look, and it's a problem that is just getting more prevalent as time goes on.
“We’re not immune in the UAE and it’s important for us to recognise that these issues are affecting many of us. Like any aspect of mental health, we should be openly discussing matters, and helping those suffering to see that they’re not alone and that their problems can be treated with love and kindness.”
People can and do overcome eating disorders, although often there's no complete mental turnaround. Jane, a 40-year-old British expat who doesn't want to reveal her full name, was 17 when she developed an eating disorder, brought on, she says, by cruel remarks made about her having put on a bit of weight. "Looking back, it was just what you might term puppy fat," she recalls. "I was maybe a UK dress size 14, which can be perfectly healthy, but as an insecure teenager I didn't feel very good about myself and then one day I just stopped eating."
Over the course of just three months, she says, she dropped to a size eight. “I wouldn’t have a proper breakfast – just a couple of biscuits and maybe an apple – and when I got home from college, I’d tell mum I’d eaten a big lunch, so she didn’t expect me to join in with the family dinner. After a few days of this, I ended up gorging at the weekend, which was such a shock to my system that it made me throw up. When that happened, I thought to myself, that’s a great idea, and so my bulimia began, which soon spiralled out of control.”
Before long she became lethargic and moody, and looked unhealthy. Eventually, one of her college tutors pulled her to one side and expressed concern, so she agreed to see the campus counsellor. “By this stage my parents had twigged that something had gone badly wrong, but I felt more comfortable opening up to a stranger. I’m glad about one thing, though, and that’s the fact that I went through this before social media came along. What impacted me was what I saw in fashion magazines and the fat shaming carried out by certain newspapers when a celebrity had been photographed after putting on a few pounds.”
Interestingly, more than two decades after getting well, she admits that being thin is still an obsession; it’s just that she’s discovered ways of dealing with it, rather than letting it get out of control. “Yoga has been a massive help,” she admits. “It makes you become at peace with yourself – it’s been a lifesaver.”
Prendergast says that social media can be hugely problematic for youngsters when it comes to how they see themselves. “We now have children communicating with others who might be thousands of kilometres away, on the other side of the world. Online bullying is horrendous, and it’s imperative that parents keep a close eye on what their children are doing while on their computers or devices. It’s easy for someone in a different time zone to express cruel and nasty sentiments – far easier than if they were standing face-to-face with their victims in school playgrounds.”
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She adds that teachers in UAE schools are becoming more proactive in identifying and helping students who might be about to slip into eating disorders. But if someone does end up with such a condition, how does she help them overcome it?
"It's vital to show compassion and empathy," she says. "Many of the young people we treat – and we're seeing more and more boys with these problems – are academically gifted and already put pressure on themselves in many regards. If they become insecure about their looks, too, it can be very difficult to deal with, especially for parents here, who tend to lead extremely busy lives. What I try to do is get them to realise that, just because they think something, that doesn't mean it's a fact – it's just a thought and we can train ourselves to process thoughts and get them out of the way.
“It’s not all about wanting to look like JLo or Kim Kardashian, either,” she adds. “We put too much emphasis on inaccurate markers like the BMI, which can warp our views to the point that many people who are perfectly healthy become obsessed with losing weight. There’s no one size fits all with any of this, and we should readjust our views on food – eat for our health, rather than our appearance; and make good choices with what we eat and drink so that we can live longer, more fulfilling lives.”
Body dysmorphic disorder is an increasingly common condition affecting many men, women, boys and girls, of all age groups. The name may be unfamiliar, but it's a commonplace anxiety disorder that causes some people to view aspects of their appearance as deeply flawed, to the point where it becomes an obsession. These sufferers dwell on their (often imagined) imperfections for hours a day. Fearing accusations of vanity, many are reluctant to talk to others about it.
But for Lisa Roberts, social media has been a help rather than a hindrance in dealing with her previously debilitating dysmorphia. She's 51, single, and detests her face. "For me this started later in life," she says. "I was perfectly happy with the way I looked when I was in my teens and 20s, but when my mum began teasing me as an adult, saying I looked like some popular cartoon character, I began to detest my appearance."
Looking at her, it's impossible to reconcile her youthful looks with her mother's bizarre observations, but they did a lot of damage and continue to do so. "No matter how many compliments I get about my looks, I can't quite take them seriously. And it wasn't until late 2016 that I signed up for Facebook, on the advice of my therapist. She suggested that I post lots of photos of myself and make friends with people who were likely to be kind with their comments, so that's what I've done. It's weird, but Facebook has made life much more bearable and, for the first time in a long time, I'm learning to accept positive remarks about my looks."