On World Eating Disorders Action Day, The National reports on how social media could be fuelling eating disorder fears, how one of the type, orthorexia, is still not medically recognised and the struggles a teacher faced when seeking help for her crippling bulimia in Dubai.
It is the eating disorder that few talk of – a dedication to healthy eating that can become a deadly obsession.
While awareness of bulimia and anorexia – and the mental toll they take on sufferers – is strong, orthorexia is not so well known.
It is not officially recognised as an eating disorder, despite causing increasing concern to experts in today's image-
The term "orthorexia" was first used in 1998 to describe a fixation upon healthy eating that, in a cruel twist of irony, can be dangerous for those blighted by it.
Orthorexia can trap people in a cycle of impossible expectation, often leading them into damaging
patterns of behaviour.
Dubai resident Florence Gillet, originally from Belgium, was one such victim.
Although appearing healthy to her friends, Ms Gillet was constantly fighting against an unrealistic image of unachievable perfection.
Caught in a cycle of constant dieting and extreme exercise, her daily routine was damaging her mental and physical well-being.
"I first started counting calories to avoid putting on weight in the months between the time I ordered my wedding dress and the actual wedding," she says.
“I was concerned it would not fit if I didn’t control what I ate. I also started running.
"Once compliments started pouring in about me losing weight, I got stuck – mentally and physically – in the cycle of not eating enough and over-exercising.
“It damaged my metabolism, leaving me with fertility, mental health and thyroid issues, some of which are still chronic today.”
Early signs of orthorexia can include intense dieting, leading to a point where someone is fearful about eating food they consider to be unhealthy.
Doctors in the US claim orthorexia could be a precursor to the more common condition of anorexia.
"My anxiety was so high, from work in PR as much as anything, that I could not cope," Ms Gillet says.
“I felt my life was getting out of control, and it was overwhelming. I felt I was losing my mind.
"When you become too fearful of eating or you binge because your body is resisting starvation, then it becomes a problem that is hard to break."
A podcast on "fat-phobia" opened her eyes to how a person's body shape rarely correlates to a healthy body and mind.
Therapy followed, and Ms Gillet began to accept her body shape rather than those portrayed in the media.
Although not recognised as an eating disorder by the US Diagnostic and Statistical Manual of Mental Disorders, clinicians are beginning to accept orthorexia as a serious mental-health concern.
She and experts are keen to increase awareness of the condition, and today, Sunday June 2, is World Eating Disorders Action Day.
Ms Gillet now works for the non-profit Middle East Eating Disorders Association. She raises awareness through workshops and promotes the need for more research into the condition.
The association works with other groups to help sufferers, free of charge.
A 2012 survey by Al Ain University of Science and Technology found that 1.8 per cent of 900 UAE teenagers, including young women aged 13 to 19, were anorexic.
In Britain, the corresponding figure is just 1 per cent.
A Zayed University study found that almost a quarter of the 228 female students who took part in its survey had abnormal eating habits and were at risk of developing eating disorders.
Almost 75 per cent were unhappy with their bodies and more than 80 per cent picked thin figures as their ideal body image.
The exact number of those suffering from eating disorders in the UAE is not available.
Psychologist Carine El Khazen, of the American Centre for Psychiatry and Neurology in Dubai, says there is relatively little discussion about eating disorders in this region.
"EDs are definitely under-diagnosed in this part of the world, first because of the stigma surrounding mental health in general," says Ms El Khazen, who is also vice-president of Middle East Eating Disorders Association.
“Because of the lack of awareness on this specific disorder, it’s considered ‘just an eating problem’ hence not a serious mental-health disorder that can kill.
“The reality is EDs have the highest mortality rate of any other mental-health disorder.”
Ms El Khazen said specialist institutions and hospital units offering direct support are rare.
A lack of trained eating-
disorder professionals can also make it difficult to find help.
"Even if the patient, family or first-line practitioner recognises signs of an ED and makes a referral, the sufferer won't necessarily have access to the proper standard of care," she says.
“In most cases, they will see a non-specialised mental health professional that is not equipped to deal with the disorder properly.”
World Eating Disorders Action Day, June 2, is a movement designed for and by people affected by an eating disorder, their families, and the medical professionals who support them. It aims to expand global awareness of eating disorders as genetically linked, treatable illnesses that can affect anyone.