Dying to stay thin

When the kwaito group Trompies produced their song Fohloza - in which they sing the praises of full-figured women - they could have been thinking of teenage girls who starve themselves, sometimes to death, in an attempt to look beautiful and sexy.

These teenage girls define beauty by the shape and size of the body - the skinnier one gets, the sexier one looks. Intensifying this belief are the bony models and actresses who are portrayed in the media as ideal women.
Although doctors do not agree on the extent of the problem, it is apparent that eating disorders are affecting more young black women.

Puleng Dlamini* of Soweto starved herself to death after losing a beauty pageant. ‘She thought that she had lost because she was fat, so she started dieting,” says her mother, Thuli*. Puleng died from anorexia nervosa early this year. She was 15.

Dlamini says talking to her daughter about her obsession with weight bore sour fruit. ‘She became rebellious. I thought it was teenage behaviour and that, together with her weight obsession, it would end as she grew.”

But Puleng was digging her own grave, and in time she started feeling sick. ‘Puleng complained of stomach ache. At first, I thought it was something she ate. She refused to go to the clinic and when I finally forced her, it was too late,” says her mother. ‘Puleng died two days after she was admitted to hospital.”

Christopher Paul Szabo, head of the eating disorder and adolescent unit at Tara hospital in Johannesburg, says eating disorders are now emerging among young black women. Szabo questions the validity of studies that suggest that the extent of the problem in the black community could equal that of whites, but notes that ‘since the mid-1990s we have seen a number of young black women sufferers, tending to present with bulimic symptoms.” Oddly, he says, bulimia is more common among blacks than anorexia, while anorexia appears to be more common among whites.

Szabo finds eating disorders to be a predominantly urban phenomenon but says that ‘the reason for urban environments serving as a risk factor is not clear”. He says eating disorders are manageable, but can be fatal. ‘Whether or not they can be cured is open for debate”.

While both anorexia and bulimia are characterised by a concern with weight, ‘the reasons for diet turning into an eating disorder are beyond the desire to be slim”. Bulimia can be a physical way of dealing with emotions that are otherwise difficult to express. Most sufferers are people who have been physically, sexually or emotionally abused.

‘At first the overeating may provide comfort, but the excessive eating is then followed by a state of panic and the need to get rid of what has been consumed, which leads to purging,” Szabo explains. Ultimately eating patterns become chaotic. All of the energy and emotions become tied up in the relationship with food and feelings about one’s body.”

Lara Ackerman, a 17-year-old coloured girl from Kenilworth, Cape Town, is recovering from both eating disorders. She started binge-eating when she was 13. ‘I had problems and difficulty making friends,” she says. She felt ‘the only thing I could control was eating. I could eat as much as I liked and no one would tell me not to.

‘Things became worse. I got fatter and fatter.” She blamed her weight for her problems, including her antisocial behaviour. ‘I thought being thinner would make me feel better. I was 15 and I weighed 65 kg. I started dieting and exercising a lot and when I thought I wasn’t losing enough weight, I changed from a strict diet to fasting.” Al-though she be-lieves that being thinner has boosted her confidence, she vows to ‘never go back to my eating behaviour, even if I were paid”.

Doctors at Kenilworth Clinic where she was admitted for depression last year discovered her anorexia. ‘I knew I had an eating disorder - it had come to eating only one fruit per day. I had lost a tremendous amount of weight. I had panic attacks and sometimes fainted.”

Even though she didn’t tell anyone about her disorder, she believes that her parents knew but ‘were in denial. I think they convinced themselves that I would get better and eat normally.”

Rene Labuschagne, a psychiatric nurse at the Well-being Psychiatric Day Clinic in Johannesburg, deals with patients who suffer from eating disorders. Unlike Szabo, she believes that the extent of the problem within the black community equals that in whites. ‘I see as many black patients as whites. This is not a race problem. I don’t think it ever was,” she says.

Hospitals, public and private, contacted in a number of townships, do not have figures on eating disorders. None of them have wards specifically for eating disorders.

According to Norman Freeman, director of the Mental Health and Substance Abuse department in the national Department of Health, there are no national figures on eating disorders either.

Freeman says images of beauty in an urbanised environment are portrayed according to a ‘Western way of beauty” and that could be one reason why eating disorders are growing among urbanised blacks.

* Names have been changed.

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