Anorexagenic public health? - preventing obesity associated illnesses and eating disorders in the United Arab Emirates

There is a small but growing body of literature exploring the prevalence and symptomatology of eating disorders across the Arabian Gulf states. For decades Anorexia Nervosa was thought to be a culture bound syndrome, associated almost exclusively with Western industrialized nations (Gordon 1990). Early epidemiological work within several Gulf nations has, surprisingly, found fairly high rates of abnormal eating attitudes, body image dissatisfaction, and other eating disorder related attitudes and behaviors (Eapen, Mabrouk and Bin-Othman 2005; Al-Adawi 2002; Al- Subai 1999). The authors of these various Gulf based studies fairly unanimously cite global/western influences transmitted via the mass media as the reason for this shift towards a thinner body-image ideal, and higher rates of abnormal eating attitudes. Similarly these authors argue that the traditional body image ideal of female beauty within Arab culture is one of curvaceous plumpness symbolizing family care, fertility and womanhood (Nasser 1997).

Our UAE based research has explored body image, body mass index (BMI), and eating psychopathology amongst Emirati females. We report levels of eating psychopathology comparable to those found in North American studies. Despite these similarities in the level of  eating psychopathology, we also report radically different patterns of BMI data compared to age matched western populations. We concur with previous authors that media transmitted body image ideals are contributing to the current drive for thinness in the Arabian Gulf  States. Additionally we propose that public health campaigns relating to obesity may also lead to anorexia associated eating psychopathology by providing a rationale or defense for extreme weight loss and low weight maintenance . It is important to ensure both physical and psychological consequences of sustained under-nutrition are not ignored in public health efforts targeting obesity. The authors suggest that such an omission could indirectly contribute to an increased prevalence of anorexia and bulimia nervosa.