Last month, the organisers of the Madrid Fashion Week had 68 models medically assessed according to standards set by the World Health Organisa tion.
When they rejected five because they were too thin to be healthy, they probably had a very good idea of the controversy the move would create.
Within hours of their decision, fashion designers and other fashion week organisers around the world were forced to field questions about hyper-thinness and health. They were also quizzed about the detrimental influence that excessively slim models have on the minds of young women and men.
Anorexic? If, no matter ¦ what anyone tells you, you believe that you are fat, and do whatever you can to avoid food, you could have this eating disorder.
Bulimic? If you overeat or binge often, but try and counteract the weight gain by vomiting, or purging the food after your meal, you could have bulimia.
A binge eater? If you overeat whenever you feel low, you could have this disorder.
That debate has reached no real conclusion. But doctors, nutritionists and psychologists are interested in only one thing. Will this public acknowledgement by the fashion industry that being too thin, and therefore, probably unhealthy, help reduce the belief that thin equals attractive?
Because if it is even partly true that the skinniness-obsessed glamour industry is responsible for giving young women the idea that ‘bony’ is a synonym for ‘beautiful’, then the thought that ‘healthy is lovely’ might help bring down cases of eating disorders such as anorexia and bulimia.
DEPTHS OF EMOTION
"There are fashions in these things," says Mumbai-based psychiatrist Dr Dayal Mirchandani. "What is beautiful, what is not, these are ideas that people unconsciously absorb from all that is going on around them. And eating disorders have two underlying and intertwined causes: a need for security, and the influence of culture." Doctors define eating disorders as abnormal eating behaviour. When we pay an unnatural amount of attention to what and how much we eat, and judge ourselves only by that standard, chances are we have an eating disorder. And the reasons for that have less to do with the actual food than with some underlying need or emotion.
Anorexics, for example, are chronically afraid of being fat – so afraid, that often they will eat only enough to survive, but still consider themselves not thin enough. For them, their ‘thinness’ is proof that they are in control of their lives.
People with bulimia will binge, but rush to the bathroom immediately after to vomit out the food, or purge themselves of it. The bingeing signifies a lack of control, and the purging a massive sense of guilt.
Then there are compulsive overeaters – people who use food to cope with the stresses of life or their emotions. And finally, people with a binge eating disorder – like bulimia, but without the purging – for the same reasons as the overeater.
"We use food as a tool because it is central to our sense of security," says Dr Mirchandani. "A baby has only a few needs. One of these is hunger. The moment you feed a hungry baby, it feels a sense of safety and security. And this very primitive belief stays with the child. So people with eating disorders suffer self-esteem or psychological conflicts relating to their sense of security."
That lack of a sense of security is often manifested in physical terms – how attractive you think you are to the world – and a lot of that centres around the body. Which is where the cultural implications come in.
Strange though it may seem in a country that has traditionally used food as a reward and where not so very long ago, old wives’ wisdom equated plump with healthy, cases of anorexia and bulimia are on the rise.
Not just in Western-oriented upper class homes, and not just among confused adolescents, but also, according to Mumbai-based nutritionist Naini Setalvad, across all ages and socioeconomic classes, including slum dwellers. Gender is no bar either, continues Setalvad. Now that partying has become an important lifestyle element, lots of men who eat out almost every night have developed the binge and purge symptoms of bulimia.
“Eating disorders are fuelled by self hate, which is usually about body size,” says Setalvad. “And it’s aided by peer pressure, the fashion for skimpy clothes, and the desire to ape models and actors and actresses whom people don’t realise are not doing good things to their bodies.” Because of this, it is often difficult for anyone to even think that they might have an eating disorder. If being thin is good – and there is more awareness about the perils of being overweight than about the dangers of being underweight – then, so, presumably is dieting. And on a diet, surely, you will obsess about food?
“The difference between a diet and an eating disorder is,” says Mumbaibased nutritionist Sushila Sharangar, “that someone with an eating disorder refuses to maintain a healthy body weight. Whereas that is the goal of someone on a diet.”
BACK ON TRACK
Since there are so many elements involved in an eating disorder – nutritional, psychological and medical – dealing with it not only requires time, but also what Delhi-based consultant psychologist Arpita Anand calls “a multi-disciplinary approach.” “Once the person has accepted the fact that there is a problem, he or she could, in an extreme case, be hospitalised,” says Anand.
“Next, s/he must be examined by a psychiatrist, in case there is a related problem, such as depression. A doctor is needed to check his/her physicals, a nutritionist to regularise his/her diet plan, and finally, a psychologist to counsel the person and help him/her deal with the issues that created the disorder.”
Recovery is often a difficult process, but it is achievable, insists Anand, who has worked with several people with eating disorders. And at the end is the realisation: A mirror is just a mirror. And size is nothing ¦ but a number.