Treatment and care for eating disorders in the UAE still lag behind those found in other parts of the world, forcing a growing number of people to travel abroad for help. There are no specialist centres in the UAE to treat anorexia or bulimia patients, leaving sufferers to seek help in countries such as the UK, Switzerland or the US.
This not only disrupts families, but also increases the chances of relapse, experts warn. Dr Roghy McCarthy, a psychologist who has worked in the UAE for more than a decade, said the number of people affected is increasing rapidly, particularly among young men. The country's first study of the illness, released last year, found that almost one in 50 girls have anorexia. "Eating disorders need handling by a big team, not just one person," said Dr McCarthy. "I can diagnose and give suggestions, but they need more than that.
"Most of the time they need to be in hospital, and they don't have the facilities here." Patients with an eating disorder often require a support team of about 10, including nutritionists, therapists, counsellors, physicians, specialist nurses and psychologists. They also often need surveillance to ensure they are not trying to burn extra calories by pacing or standing for long periods of time, Dr McCarthy said.
"It needs constant care and all-round treatment," she said. "It's a very complicated illness to treat." Dr McCarthy has often been forced to refer many of her anorexic and bulimic patients to professionals in other countries. "If they are not treated properly it costs more to society," she added. "It can carry on and affect their marriage and children." Results of a study released last year by the UAE University in Al Ain showed that in a test group of 900 girls aged 13 to 19, 1.8 per cent of them had an eating disorder.
The study noted that "of concern is the relative frequency among UAE [national] girls, 14 in 365, compared to foreign girls, three in 372". According to the UK charity Beat, up to one per cent of British women are affected by the illness. Dr Justin Thomas, an assistant professor of natural sciences and public health at Zayed University, studied eating attitudes and body image concerns among the university's female students.
He found that almost a quarter of the 228 students questioned had abnormal eating attitudes, putting them at risk of developing anorexia or bulimia. With better prevention and treatment, he said, the numbers might not be so high. "There is no specialist provision here," he said. "There are a few therapists who have had limited experience with these disorders, but they are quite difficult to treat, especially anorexia."
The lack of awareness could also contribute to an increase in incidence. If young women are not fully aware of the dangers, he added, they could adopt an attitude of "wanting a little bit of that". "They need to realise that eating disorders are extremely dangerous," he said. "They can cause irreversible reproductive problems, excess hair and cause nails to fall out. "The problem is without the awareness they might not look to find proper treatment anyway."
SE, a 20-year-old Arab living in the UAE, confirms Dr Thomas's theory. She admits to purging for the past year, but is unable to fully accept her bulimia. "I've been bulimic for over a year," she said. "I don't think there is anything wrong with me, I just know I am fat, and I am not imagining it. "I didn't seek help, and I am not planning to, there is no one that will understand. No one I know who is bulimic needed help, so why do I? It is not a big deal."
She maintains that her health is good and she has "lost a lot of weight", but admits that it "is hard to stop" the bulimic behaviour. Without more detailed statistics, Dr Thomas estimates that the rates of bulimia, particularly among the local population, were "at least" comparable to rates in the West. "Students tell me that in every high school for Emiratis there was an outbreak of anorexia, and the schools flew in a group of specialists to do awareness raising around the issue."
Dr Rami al Shihabi, a senior clinical psychologist at Sheikh Khalifa Medical City in Abu Dhabi, said about three per cent of his cases in the past three years suffered from anorexia or bulimia. The hospital doesn't have a specialist clinic for the diseases, but offers some in-patient treatment. "I usually don't co-ordinate with other departments because of lack of time and so many patients on caseload," he said. "But I do ask my clients to seek out dietitians or nutritionists for additional help."
Health authorities were unavailable for comment. munderwood@thenational.ae * With additional reporting by Ola Salem