“It starts with one meal, and then it turns into two and then three, and then suddenly you’re going weeks and months and years doing this thing and you don’t even realise that you have an unhealthy relationship with food,” says Jaaziyah, 23, who suffers from bulimia and anorexia.
She says her eating disorders began with an obsession with wanting to be thin.
“I was pretty big growing up and I’ve always wanted to be thin,” she says.
Similarly, Andega, another Kenyan, suffered from anorexia. She says her eating disorder was a result of wanting to be thin after reeling from heartbreak and being surrounded by a group of friends that obsessed with perfect bodies.
“At that time I was of the opinion that thinner is better and more attractive and popular and liked,” she says.
She says for years her mum commented on her body, and her aunties constantly tried different types of laxatives in a bid to not retain the food they ate.
Laxatives are substances that loosen stools and increase bowel movements.
“It made me feel like there was something wrong with my body, and that maybe if I became a lot thinner, it would fix the way I felt about myself.”
The two join a growing number of Kenya with eating disorders, a problem hardly ever talked about.
Andega’s anorexia meant she was starving herself, she would either eat one meal a day or none at all.
“Most days it was a salad which included lettuce tomatoes and olives, for dinner,” she explains.
Despite getting seriously sick, she was never formally diagnosed. “At first it was my white blood cell count that went down drastically, then I started getting various gum diseases and finally, tuberculosis.”
Andega’s tuberculosis was a result of her reduced immunity, a result of lack of minerals and vitamins in the body.
So severe was her illness that she had to undergo surgery, which, she says was her wake up call.
“Prior to this, it was like I knew I wasn't eating well, but I didn't think thinking was that harmful,” she says.
Andega was researching on the causes of low immunity, gum diseases, low white blood cell count when she stumbled upon eating disorders.
She realised then that she had anorexia.
“I was so shocked by the fact that my struggle to lose weight had caused all of this, and as a result I started eating copious amounts of food, vowing never to starve myself again, but not knowing that I was gradually wading into the murky waters of binge eating.”
It took Andega a year and a half to realise that she had substituted one eating disorder for another.
“I had to work towards recovery, I had to teach myself how to listen to my body and eat intuitively.”
34-year-old Tina was always chubby as a child largely down to comfort eating because of unhappiness.
As she grew up, she found her relationship with food began to worsen, her family would tell her to lose weight, which threw her into excessive dieting and ultimately starving herself.
Restricting her food would have a huge biological impact leading her to binge eating on weekends.
The binges became more frequent, people began commenting on her weight gain and then she went through a break-up, all of the above combined threw her into the path of bulimia.
This is an eating disorder usually characterised by periods of binging—or excessive overeating— followed by methods to avoid weight gain.
On the other hand, people with anorexia have an intense fear of gaining weight and can become dangerously thin.
“I could not control the people around me, I could not control the break-up or the comments people were making about my appearance. The act of managing my weight through bulimia and starvation made me feel like there was something in my life I could control, while the binge eating was a way of stuffing down my feelings. I would eat and then either throw up, take laxatives or over exercise to compensate,” Tina says.
BODY DYSMORPHIA AS A RESULT OF EATING DISORDERS
The most terrifying aspect of eating disorders is that even when an individual is thin, the obsession continues due to the development of body dysmorphia.
Body dysmorphia is a mental illness that involves obsessing on a perceived flaw in appearance, such as thinking you are overweight when you are not.
It can be as simple yet harmful as constantly pulling up your t-shirt to see if your stomach is flat enough.
This is why so many people who are suffering with anorexia continue to starve themselves despite being severely underweight.
We see thousands of unrealistic images on a daily basis of highly airbrushed bodies on social media and magazines and subconsciously or consciously use them as personal benchmarks or goals.
WHAT ARE EATING DISORDERS ROOTED IN?
Both Jaaziyah’s and Andega’s eating disorders may have stemmed from an obsession with being thin, however the root causes are often far deeper.
Shelina Mediratta is a metabolic balance coach and license holder in Kenya. She explains that eating disorders are caused by a complex combination of factors, including genetic, biochemical, psychological, cultural and environmental.
“Excessive dieting, being constantly unhappy with one’s body and the compulsive desire to be thin are some of the influences that may increase the risk for an eating disorder,” she says.
She explains that society too, plays a hand in encouraging this behavior, particularly in this age of social media.
“We see thousands of unrealistic images on a daily basis of highly airbrushed bodies on social media and magazines and subconsciously or consciously use them as personal benchmarks or goals.”
She says it is impossible to avoid being bombarded with unrealistic and unsustainable weight loss advice and quick fix tips, which have no scientific basis.
“Eating disorders which involve controlling weight are born from an intense desire to achieve an impossible standard,” she says.
Shelina explains that certain cultural traits also contribute to eating disorders.
“An over-emphasis on appearance, at the expense of more significant attributes alongside societal beauty principles that endorse an unrealistically slim body shape are some of them.”
She explains that often being slim is connected with positive qualities such as beauty, health, love and success, this is reinforced by the media, alongside the idea of dieting to obtain the mythical ‘perfect body’.
This also plays into the idea of demonising certain foods and food groups, all of a sudden if you eat pizza you are ‘bad’ because pizza is ‘bad’.
DO DIETS PLAY A ROLE?
We live in a culture where every so often new diets come out that promise you can ‘lose 10 kilograms in just three days’ or ‘this diet will get you a flat stomach in less than a week.’
This aspect of diet culture can further induce eating disorders. Shelina explains that if a diet is too good to be true, it usually is.
“Nevertheless in our weight-obsessed society, billions of dollars are spent on these fad diet products every year,” she says.
“The results are often a ‘yo-yo’ or weight cycling effect. It is estimated that 97% of most dieters gain back all of their weight, and often end up heavier than they were before they started.”
She says that this form of weight cycling and excessive dieting may eventually harm the physical and mental health of our teens and adolescents more than a little extra weight ever will.
“Following popular fad diets, diet pills, juice cleanses, and crash diets that are unsustainable due to excessive calorie restriction and lack of nutrition can be a gateway to eating disorders to our young, highly influenced teens who can be blinded by false promises.”
HOW ARE THEY TREATED?
Eating disorders are primarily treated in three steps, Shelina explains.
“The immediate medical concern is the restoration of the patient’s healthy weight and physical condition.”
The second phase, she explains, is to help and treat the patient’s psychological disturbances.
“Lastly, the patient rehabilitates and recovers. As part of the rehabilitation process, it is crucial that the patient learns healthy eating habits, often as a component of an eating disorder treatment program.”
EATING DISORDERS AWARENESS IN KENYA
Eating disorder awareness in Kenya is close to minimal. This perhaps is because, like most mental health issues, it is seen to be as a thing that exists only in the west.
Andega explains that she only managed to understand about eating disorders through the internet due to a lack of awareness and information among Kenya’s medical professionals.
As she began talking about her eating disorders on Instagram, she received messages from some people saying that they did not know such a thing exists.
“Some thought it was only found among white people, a lot of people didn't know about the different types, they only knew anorexia and bulimia, they were also unaware that eating disorders could impact anyone.’
“Fat people, men, old people, teenagers, people considered underweight; I definitely know a lot more awareness needs to be created here, because everything I found out was through the internet.”
Eating disorders are far more common than we think, and while some may not be fully-fledged anorexics, bulimics or binge eaters, other disordered eating behaviours linked to these are in many cases the norm.
The punishing yourself for having a piece of cake, the obsession with ‘eating clean’, the vilifying parts of your body for not looking a certain way and the measuring yourself worth based on the numbers on a scale or dress size all form part of this, and it is vital we begin to address it.
Types of eating disorders:
Anorexia nervosa is characterised by self-starvation and excessive weight loss. It is a serious and potentially life-threatening illness whose symptoms include, the restriction of food which leads to a significant loss of weight. There is a constant fear of gaining weight or becoming fat. Those that suffer from anorexia nervosa are participate in behavior that would interfere with weight gain despite already having low weight, such as fasting or excessive exercising.
Bulimia nervosa is characterised by binge eating which is followed by compensatory behaviors which can include self-induced vomiting as a means to undo or compensate for the binge eating. Symptoms of bulimia nervosa include regular binge eating behavior or a large intake of food which is accompanied by a loss of control over the amount someone is eating. It includes purging behavior, or an inappropriate amount of compensatory behaviors as a means of preventing weight gain, this can include vomiting, misuse of laxatives, or excessive amounts of exercising.
Binge eating disorder (BED) is characterized by recurrent binge eating without the use of compensatory weight control behaviours, such as those used in bulimia nervosa. The symptoms of BED include, regular binge eating or the intake of large amounts of food alongside losing control over eating behaviors. In a binge eating episode, an individual is likely to eat faster than usual, eat until they are uncomfortably full or when they are not physically hungry, and eat alone due to the embarrassment of how much they are eating. Following an episode, an individual can feel depressed or guilty. These episodes are likely to occur once a week.
