Reading Time: 4 minutes

A child born in a Pakistani household has their ears laden with discourse revolving around the weight of people. This torture continuous well within their adulthood and never really goes away. Body dissatisfaction is common among the public, especially women. Girls from a young age are monitored and often critiqued about their body weight which later results in serious psychological issues. It is similar to when Michelle Caruso, a researcher, was researching Italian women and said, “Many of these women were not allowed to determine their own food consumption during childhood, adolescence, and even into adulthood. Food was habitually pushed and forced onto them, resulting in early conflicts which have manifested as eating issues in their later years.”

Upon observation, it can easily be deduced that Pakistanis have made the topic of body weight and ensuing events and characteristics their favorite pastime. If only it was a way to pass time! Society has cultivated an obsession around the topic that has bred eating disorders.

The soul-crushing questions like “Why are you fat?”, “Should you be eating so much?”, “Your body is stick-thin, nobody will ever be attracted to you” and more are bullets that are fired at many individuals not only by strangers but also their loved ones. Force-feeding by guardians and other adults of the family is considered to be normal and even a sign of love and care but the result of it is often dangerous to the child. As Prof Mushtaq A. Khan at Islamabad’s Ali Medical Center deduced, “In many cases, the child does not eat because he or she is being forced to eat, and the mother is pushing the children to eat and eat – and pushing to the extent where the child is psychologically sick and tired of eating and is nauseous and vomits every time a bowl of food is eaten,”

Body shaming seems to run in the veins of most people in the country and the most common victims are women. As Fariha Rasheed, a psychologist, pointed out, “Body-shaming is brutal, as it can ruin a beautiful person mentally. It is usually related to physical appearances, such as skin color, body structure, acne, birthmarks, wrinkles, aging, curly hair, etc. And it is often promoted by advertisements where they want you to be perfect physically to find the perfect husband or even a job.”

Prevalent Eating Disorders in Pakistan

Bulimia nervosa and anorexia nervosa are the two eating disorders that have been identified in several cases throughout Pakistan. Anorexia nervosa is commonly known as anorexia and is the disorder where the afflicted has an unhealthy obsession with losing weight, remaining thin, and a distorted body image. Whereas bulimia nervosa is the disorder in which people tend to binge eat and later purge themselves of the extra calories due to intense feelings of guilt. They use different methods to get rid of the calories like self-induced vomiting, diuretics, enemas, laxatives, and other extreme methods. Anorexia significantly disrupts the life of the individual while bulimia can be life-threatening.

Researchers speculate that the probability of other types of eating disorders is there but since people are reluctant to come forward about eating disorders, there is not much data. What little evidence is present was collected through studies mostly. The other way that cases of eating disorders get diagnosed in Pakistan is when patients visit either gastroenterologists or dentists and there are symptoms that tie the patients’ complaints to the actual problem i.e. an eating disorder.

The increasing cases of people being at risk of and afflicted by an eating disorder in Pakistan are alarming. A study found that the young generation of students currently enrolled in the medical field either have an existing eating disorder or have a risk factor of it. Another study done on female postgraduates indicated that body dissatisfaction and Western media influence were predictors for faulty eating behavior.

Interestingly enough, there is not much data about the prevalence of eating disorders in Pakistani men. It has been hypothesized by some scholars that the reason behind this is that the Pakistani society shuns bulky women aside but praises men who are overweight, considering it to be a sign of health and strength. Another inference can be that since the culture of the country is patriarchal, women are subjected to unhealthy scrutiny and judgment.

Is It Genetic or Cultural?

When talking about eating disorders, it is imperative to remember that the list of causes often includes medical or psychiatric reasons but the sociocultural causes cannot be stricken off. Researchers have found that culture is one of the etiological factors of eating disorders. As published in Psychiatric Times, “Culture has been identified as one of the etiological factors leading to the development of eating disorders. Rates of these disorders appear to vary among different cultures and to change across time as cultures evolve. Additionally, eating disorders appear to be more widespread among contemporary cultural groups than was previously believed.”

An apparent influence on the Pakistani society of how a body should appear comes from the West. It trickles down into the circles of the common people through television, the internet, and many other forms of media. There have been many studies that conclusively prove that the Western idea of how a body should look has affected the entire world. The idealization of the Western “thin” body type has led thousands of people all over the world to not only throw themselves into crazy fads but also develop disordered eating practices. Prof Mushtaq A. Khan, a dietician and children’s specialist, commented, “Many teenage girls these days are more conscious of their figures and they are trying to copy the women they see in the West,” further adding, “Everyone wants to look like supermodels such as Cindy Crawford and Claudia Schiffer,”

Healthy Eating or Fixation?

A society such as Pakistan’s where people’s worth is based on their physical appearance has staunch and suffocating practices and beliefs in place when it comes to “being healthy”. It has been increasingly reported that more and more people are opting for strict diet regimes in Pakistan. Even people who have eating disorders and practice unsafe and unhealthy eating behavior proclaim that they are only eating healthy.

The way to battle eating disorders is a proper psychological and medical treatment by professionals. Unfortunately, the public is unwilling to come forth with reports of disordered eating patterns. Another hurdle is that eating disorders need to be treated psychologically too, keeping in mind the patient’s socio-cultural background. As the researcher, Caruso at the University of South Australia criticized, “Women diagnosed with binge eating, anorexia nervosa, and bulimia nervosa are typically treated based on psychiatry. One of the greatest weaknesses of the psycho-medical approach is its failure to contextualize the disordered eating experiences of women from diverse cultural backgrounds.”

Apart from the new approach of diagnosis and treatment of eating disorders, it is imperative that Pakistani society changes its narrative about the attraction of a certain physique. There is conjecture that once people reconsider the standards set in place for the “acceptable body image”, disordered eating behaviors, maybe even eating disorders, will abate with time.