At war with the mirror

Do you like what you see when you look at yourself in the mirror? Research shows that as many as 33 per cent of women and 21 per cent of men aged 20 to 50 say that they look at the mirror as little as possible and only eight per cent of both genders say they like what they see.

No wonder that many parents without perhaps realising spread negative perceptions about their bodies and transmit these negative feelings to their children, who then grow up also dissatisfied with their bodies.

As adolescents these children will also be bombarded by images of thin models and singers with the message that thin is glamorous, thin is beautiful.

Recent research shows that a growing number of children as young as six years as old is unhappy with their bodies. There is a whole powerful industry at work today making huge profits out of undermining children's and young people's self-confidence and self-esteem.

When certain personality traits, and disturbed family and personal relations combine with these social and cultural forces, the conditions are created for young people to develop an eating disorder to try to cope with the pain inside them and stresses around them.

Research carried out in Europe and North America concludes that between eight and 10 per cent of adolescents and young people suffer from eating disorders, like anorexia nervosa and bulimia. In anorexia there is a loss of desire for food, a refusal to eat and a fear to gain weight, even though the person is underweight. In bulimia there is a great urge to overeat and then a great need to get rid of this food not to gain weight.

Launching a national Eating Disorders campaign in Malta, a few days ago, Louisa Bartolo said: "Health professionals and psychologists... have told me that the incidence of these eating disorders in Malta is very high and the resources to deal with them, hugely inadequate. Tellingly, nobody has bothered to compile statistics of eating disorders."

Addressing the same meeting, psychologist Dr Dorothy Scicluna said that the frequency rates of eating disorders in Malta seem to be similar to those found in the rest of Europe and the US. She added that in Malta we do not have an eating disorders unit and we know that these disorders have the highest mortality rates among psychiatric sufferers.

"Trouble ensues when severe anorexia nervosa sufferers require hospitalisation."

Elaine Dutton, an official at the Health Promotion Department, explained that every month the department receives an average of six to eight calls from persons who are either passing through an eating disorder or friends are who are experiencing the problem.

"I know that at the department we only get the tip of the iceberg. I know that other health professionals deal with as many cases every day!" She stressed: "An eating disorder is often only a symptom of underlying issues and often a maladaptive way of trying to cope with life - it needs to be looked at not only as a problem of those few unlucky ones, but as another piece of a very complex picture in adolescent health..."

Professor Bob Palmer, a senior lecturer in psychiatry at the University of Leicester Medical School, said that eating disorders are often "portrayed as either an exotic rarity afflicting and sometimes killing young women at the threshold of lives that had been full of promise or as the expression of the foolishness of adolescent girls who take to excess the essentially trivial concerns with appearance and slimness that are widespread in our societies".

He warned: "Eating disorders are neither rare nor trivial. They are serious disorders that deserve to be taken seriously. They may be associated with premature death and physical impairment. Importantly, they often distort the psychological development of the sufferer and can blight some people's lives. They pose a significant public health problem."

What is to be done? Campaign promoter Ms Bartolo said: "I would like to see a more comprehensive, accessible and affordable support structure set up for victims and their families. This should include a clinic run by a multidisciplinary team of health professionals.

"I would also like support groups to be set up. There should also be a helpline.

It's vital that GPs, teachers, counsellors, priests and youth workers are professionally equipped to help those suffering with eating disorders. The media should put these illnesses on their agenda and deal with them in an effective and sensitive way."

Dr Scicluna recommended the setting up of an Eating Disorders Unit through which clients could reach for support anonymously. "More professionals need to specialise in this area, including dieticians and nutritionists. A day hospital with specific programmes for sufferers should be available and research activity needs to be taken in hand."

Ms Dutton expressed her wish that "when people call me at the department (with the hope that we can make this misery end and give them back their life, that we can give back the whole family the peace they long for) I can give them a contact number of where to find help.

"A multi-disciplinary team of people within the right setting, that is ready to help people deal with their condition and help families know more about the problem of their loved one."

Professor Palmer ended the meeting on a note of hope: "No one is an entirely hopeless case. Most people recover in the end. A few do not. Services need to bring forward recovery for the majority and to ameliorate the disorder for those who remain stuck."

But recovery in Malta can only happen if we set up the necessary structures and services for effective treatments. Till we do so many young people and their families and loved ones will continue to suffer on their own and in silence.

evaristbartolo@hotmail.com