Over the past three decades, eating disorders have become increasingly common in the Gulf region and Western Asia. Sociocultural changes have affected the way young people think, feel, and behave, and the mental health challenges they face. The spread of Western beauty ideals across the region has changed the way young people perceive their bodies, and eating disorders have become more likely.
Anorexia nervosa is a type of eating disorder where someone has a very low energy intake. It usually develops during adolescence, although it can begin in pre-teens or even earlier. The causes of anorexia are complex and vary for each individual, including interpersonal difficulties, ways of thinking, personality traits, and beliefs about body shape and weight.
For teenagers with anorexia, early interventions are really important. The longer that anorexia persists, the harder it is to treat, as co-occurring disorders develop and complicate the recovery process. This means that looking out for the signs of anorexia and seeking help quickly is vital.
This blog offers some information about anorexia nervosa among 11-18 year 18-year-olds in Dubai, and the types of treatment available that can support young people in psychological, social, and physical recovery.
What Is Anorexia Nervosa?
Anorexia nervosa is a type of eating disorder where someone has a restricted energy intake. This can involve eating very little food, exercising excessively, or using laxatives. Young people with anorexia nervosa are often preoccupied with their body weight or shape and are very afraid of becoming heavier.
While teenagers with a diagnosis of anorexia nervosa have a low body weight, young people at a normal or higher weight can also live with anorexia. At the moment, this is usually diagnosed as atypical anorexia. However, many experts argue that weight should not be an important criterion in an eating disorder diagnosis, and young people should receive the same diagnosis regardless of the body they live in.
What Causes Anorexia Nervosa in Young People?
It’s often assumed that anorexia is all about food or body shape. But its causes are much more complex. Disordered eating behaviours are underpinned by thinking patterns, emotions, and experiences which are themselves influenced by a young person’s biology, relationships, and environment.
Recent research suggests that certain ways of thinking, such as rigid thinking or sensitivity to criticism, and interpersonal difficulties, often play a key role in the development and maintenance of the disorder. When young people become isolated from friends and family, it’s easier for ideas about body shape and weight to take over their everyday life, dominating their self-value and identity.
Experiences of trauma are also common among young people with anorexia, affecting teenagers’ ability to manage emotions, form trusting relationships, and feel good about themselves.
Understanding the Rise of Anorexia Nervosa in Dubai
There are many different risk factors for anorexia nervosa that make developing the condition more likely. Some of these risk factors reflect individual or biological characteristics, such as personality traits. But others are social and cultural conditions that shape the way young people think, feel, and behave.
When these social risk factors are present, it’s likely that more young people will develop anorexia than in places where they aren’t. And because societies are always evolving, the social risk factors will also change over time. Some researchers speak about eating disorders being culturally-reactive: that is, they are responsive to the characteristics of a culture and society.
In the past few decades, Dubai has undergone rapid social change. With these changes, several possible risk factors for eating disorders have become more present. These include:
- exposure to Western cultural values, particularly the ‘thin ideal’
- exposure to mass media and advertising that promote these ideals, such as magazines with dieting advice
- socio-economic changes, such as industrialisation and increased affluence
These changes mean that teenagers in Dubai are now at a higher risk of developing eating disorders.
Eating Disorders in Dubai and the UAE
While there is limited research on the prevalence of anorexia nervosa in Dubai, there are studies that explore the prevalence of eating disorders, body dissatisfaction, and disordered eating attitudes in the region.
Studies have found that:
- In the UAE, 78% of female and 58% of male adolescents experienced body dissatisfaction
- In Al Ain City, 23.4% of children and adolescents under the age of 16 were at risk of developing an eating disorder
- In the UAE, 23.4% of female school-aged adolescents had disordered eating attitudes
- 33.1% to 49% of male adolescents in five UAE states had disordered eating attitudes, especially in Dubai and Al-Fujairah
Some groups of Dubai teenagers are more likely to develop eating disorders than others. Disordered eating attitudes have been linked to many factors, including age, BMI, and internalisation of the thin idea.
A review of eating disorders in Arab countries identified several risk factors that studies have linked to eating disorders in the region. These include:
- media use
- Western influences
- female gender
- increased affluence
- body weight teasing
- internalised stigma about body shape and weight
- stress
However, it’s important to remember that anyone can develop an eating disorder, regardless of their age, ethnicity, religion, gender, or socioeconomic background. Parents, teachers, and healthcare professionals should always look out for the signs of eating disorders, whatever a young person’s story.
What Are the Warning Signs of Anorexia Nervosa?
Eating disorders like anorexia are most easily treated in the early stages of the disorder. This means that the sooner an eating problem is recognised, the better. Sometimes, early interventions can prevent an eating disorder from fully developing.
It’s not always easy to recognise when someone is developing an eating problem. Young people often try to hide disordered eating behaviours and may find it difficult to talk about what’s going on. However, there are some signs of anorexia nervosa to look out for. These include:
- Lying about when or how much they have eaten
- Preferring to eat alone
- Eating very slowly or cutting food into small pieces
- Weight loss
Treatment and Support for Young People with Anorexia Nervosa
Every young person with an eating problem requires professional support. For some young people, this may involve outpatient care: regular sessions with mental health and social professionals that offer the necessary support to recover and grow. Other children and adolescents might need a residential setting to stay safe and receive the intensity of treatment they require.
There are several evidence-based treatment approaches that can support children and teenagers to recover from anorexia nervosa. Most young people benefit from a combination of treatment modalities. Some children and teenagers may try several options before they find the one that best suits them.
Some treatment modalities include:
- MANTRa
- Family-based treatment
- Enhanced cognitive-behavioural therapy (CBT-e)
- Integrated trauma therapy
MANTRa (Maudsley Model of Anorexia Nervosa Treatment for Adolescents)
MANTRa is a treatment approach for anorexia based on the theory of the cognitive-interpersonal maintenance model of anorexia nervosa. The cognitive-interpersonal model understands anorexia to be caused and maintained, to a large extent, by a young person’s cognitive traits (ways of thinking) and their interpersonal relationships.
MANTRa sessions involve addressing the personality traits that underpin anorexia nervosa and improving interpersonal skills and relationships. They also identify any ideas and perspectives that may help maintain the disorder, making positive adaptations that promote lasting change.
Integrated Trauma Therapy
Many young people living with anorexia nervosa have experienced at least one form of trauma. Studies among people receiving treatment for anorexia frequently report that 90 – 100% of individuals have survived a traumatic event.
Disordered eating behaviours can develop as a way to cope with or respond to the impact of trauma. This means that recovery from these behaviours involves healing from the trauma that lies beneath. With integrated trauma therapy, trauma is addressed from the very start of a treatment program, promoting whole-person psychological and physical recovery.
Enhanced Cognitive-Behavioural Therapy
Enhanced cognitive-behavioural therapy focuses on the over-evaluation of shape and weight as the core pathology of anorexia nervosa and other eating disorders. CBT-E emphasises the interactions between thought patterns and behaviours, exploring and transforming the ways of thinking that underpin anorexia.
The broad version of CBT-E also addresses other underlying issues, including perfectionism, low self-esteem, and interpersonal difficulties.
The Wave Clinic: Specialist Support for Eating Disorders Around the World
The Wave Clinic provides specialist treatment for eating disorders among children, teenagers, and young adults. Our programs offer a diverse selection of evidence-based treatment approaches, carefully and sensitively addressing experiences of trauma and co-occurring disorders. We emphasise the role of the family in a young person’s recovery, fully involving family members in the planning and practice of each treatment program.
If you’re interested in finding out more about our programs, get in touch today.
