The private horror of body image issues

While body image issues are increasing among men, they are still more common among women. And, says Johannesburg-based clinical psychologist Linde Viviers, the patients she treats for eating disorders are getting younger and younger.

“In the past they used to be in the age group from 15 and older. But now I get a lot of requests to assess girls as young as 10 years old.”

Viviers’s observation is supported by a 2014 University of the Witwatersrand study among pupils from several Johannesburg schools which found that “disordered eating habits [are] now starting at an earlier age”.

According to the study, “the increasing desire for a slimmer shape among girls … is a growing public health concern because of its association with eating disorders and poor weight management”.

Viviers, who is a consultant at Akeso Crescent Clinic in Randburg, a psychiatric clinic that focuses on eating disorders, says these disorders need specialised attention because the illness has so many aspects.

“Patients who suffer from eating disorders don’t actively seek treatment. They usually come to treatment because they’re forced into it by their families who are very worried.

“But the person suffering from the eating disorder, especially anorexia, won’t seek treatment because they don’t think there’s a problem. So you work with a population that hides it and on some level doesn’t want to confront the illness,” she says.

According to the American Psychological Association, eating disorders are abnormal eating habits that pose a risk to a person’s health, and even their life. The most common is anorexia nervosa, when a person believes they are fat even if they “are dangerously thin and restrict their eating to the point of starvation”. A person who eats “excessive amounts of food, then purges by making themselves vomit or using laxatives” has bulimia. The third most common eating disorder is binge eating, when a person has “out-of-control eating patterns, but doesn’t purge”.