To say �fat phobia� is a major endemic in this day and age is putting it bluntly. Its infant stage is in fact the rage at every coffee table or treadmill you may have frequented lately. I call it so because it has become unfashionable not to utter grievances such as, �Oh my, I just can�t seem to shake off these love handles.� Have we ever considered what that does to the young, callow and impressionable teens who listen and breathe in the atmosphere we create around them? We do them a disservice. In some cases, it becomes dangerous and in the worst-case scenario, it has fatal consequences. I am as serious as the deadbolt lock on your front door.
Anorexia nervosa is an eating disorder in which the main symptom is a refusal to maintain a minimal, normal body weight. There is an intense fear of gaining weight even though the person is underweight. The person may not be just thin or even skinny, s/he may be emaciated and yet s/he pathetically and almost morbidly pursues thinness. Signs of depression and anxiety are high. Its triggers are often low self-esteem, unrealistic perfectionism, over-compliance and a sense of personal failure. �I am not enough� becomes the negative mantra for the person.
It is first seen in middle school, gains popularity in high school and propels with meteoric speed into college years to become an unshakable habit as young adults and eventually a lifetime pattern that may be tough to pry apart with a crowbar.
It is quite perturbing to watch a gaunt, pale, drawn person who hunches as she walks, barely holding herself up, to contort her face in pain as she slumps into a chair and says with genuine anguish, �I am afraid I am gaining weight.� A woman could be bent over her body that looks like a skeleton with a thin muslin cloth draped loosely over it and pulls at that limp skin crying, �I am too fat.� A distorted body image along with an obsessive tendency is a deadly formula. It results in restricting of food to the point of starvation.
Reports on eating disorders in South Asian Americans have been sparse. Yet what reports do exist, point to a growing relevance for our community. A comparison study of Western and non-Western countries showed, �The prevalence of eating disorders in non-Western countries is lower than that of the Western countries but appears to be increasing.�
Interestingly, a U.K. study (2005) stated that the South Asian British adolescents who were diagnosed with anorexia nervosa showed fewer signs of fat phobia or pre-occupation with weight but more prominent signs of loss of appetite. More importantly, it is suggested in the International Journal of Eating Disorders (2007) by a study done in Singapore that Asians tend to be wary of reporting the symptoms of their disorder and this absence or under-reporting accounts for the lower percentages.
A study done in Bangalore at the National Institute of Mental Health and Neurosciences (1995) suggested family pathology or an unhealthy home environment was linked to the symptoms of anorectic behavior and its maintenance. In the Transcultural Psychiatric Research Review (1990), a pertinent observation was made about �the cultural reactive syndrome.� �Anorexia nervosa may be more prevalent during times of cultural change and confusion for immigrants and individuals in rapidly developing countries.�
Wherever one looks, phrases such as �chasm between school and home,� �cultural identity confusion,� �inter-generational conflict,� and �disintegration of extended family networks� pop up like Jacks-in-the-box. We cannot afford to be lackadaisical about it and fervently hope that the scourge does not touch us. It has and that itself makes it beyond the pale. We are not cordoned off or protected. There are no shields or force fields that make us impervious to these disorders.
If you suspect that you or someone you know may have an eating problem, get him or her evaluated by a professional: primary care physician, pediatrician, gynecologist, nutritionist, psychiatrist, psychologist or counselor. Eating disorders may have been the purview of the medical field; today, they are being treated most effectively in conjunction with psychotherapy, a necessary intervention.
Sushama Kirtikar, a licensed mental health counselor in private practice, can be reached at (813) 264-7114 or e-mail at [email protected]
