In their cumulative 320 years of practice in Kenya, the psychiatrists had met only seven Africans with anorexia nervosa, where people starve themselves—sometimes to death—because of an intense fear of gaining weight.
“The condition is rare in Kenya,” Dr Njenga and Dr Kang’ethe concluded in a paper they published in the East African Medical Journal that year.
“The reasons for this remain unclear and traditional explanations for its cause as due to pressure for thinness may not be adequate for the Kenyan case,” they said.
Fast forward to 2024, experts say teen eating disorders are so rampant and severe in Kenya that they are among the top 10 mental problems affecting children and youths below 24 years. The burden is double in girls compared to young men.
“The rise in eating disorders in females points to issues around family dynamics, self-esteem, and body image that appear to contribute to the rise in eating disorders,” researchers say in the latest Global Burden of Diseases report focusing on Kenya.
Their study on “Burden and risk factors of mental and substance use disorders among adolescents and young adults in Kenya”, is published separately in the Lancet journal.
The GBD study is the world’s most comprehensive analysis of health indicators. It is produced by the Institute for Health Metrics and Evaluation, which is based at the US University of Washington and has collaborators across the world, including in Kenya.
The rise in eating disorders is particularly concerning because anorexia is the only fatal mental disorder recorded in Kenya. Teens with eating disorders are also at higher risk for suicide than the general population.
The researchers named anorexia as the eighth most common mental disorder in Kenya, but the only one that is fatal.
“Early intervention is critical to address growing numbers of depressive and anxiety disorders, eating disorders in females and rising substance use in adolescents,” they said.
They said historically, African mental health specialists have not paid attention to eating disorders due to a belief that they only affected a few rich people.
The researchers analysed research databases up to March 2023. They then analysed data on the number of mental and substance use disorders among adolescents and young adults in Kenya from the 2019 Global Burden of Disease Study.
They noted a poor quality of life satisfaction in female adolescents than their male counterparts, partly explaining why the burden of anorexia is higher among women and girls.
The rise in social media apps that promote slim bodies as the standard of female beauty is also a contributor.
“There are also reports on the rise of eating disorders in youth due to changes in quality of life, and urban westernised lifestyle impacts on parent-child relationships and parenting,” the researchers said.
The report notes that among 10–24-year-olds in Kenya, mental disorders are the second leading cause of disability, after unintentional injuries such as accidents.
The researchers did not present absolute numbers but disability-adjusted life years, which refers to the number of years lost due to ill-health, disability, or early death.
For instance, they noted mental disorders among 10–24-year-olds in Kenya accounted 248,935 disability-adjusted life years in 2019, they last year they covered.
The leading mental disorder is depression, contributing to a third of the burden, followed by anxiety disorders (24 per cent), conduct disorders (17.9 per cent), bipolar disorder (8.4 per cent), autism spectrum disorder (4.5 per cent), schizophrenia (3.4 per cent), Intellectual and Developmental Disabilities (2.8 per cent), eating disorders (2.5 per cent), ADHD (1.1 per cent), and others 2.1 per cent.
Health economist Prof Marcia Weaver, who was involved in the study, said improved surveillance of mental health and substance use burden at national and county levels is needed.
“Focus on timely screening and intervention for idiopathic developmental intellectual disability, conduct disorder, and substance use disorder in young boys and depression, anxiety, and eating disorders in young girls and women is critically needed,” she said.
Eating disorders covers a wider range. Bulimia Nervosa is a disorder where someone has regular episodes of binge eating (consuming a large amount of food in a short period of time) followed by intentional vomiting to rid of calories.
