Eating disorder … more than an obsession- Real Life Story from Kuwait

Eating disorder … more than an obsession

 

Thank you so much Amna from Doha for sending this story to me and I am deeply honored to have this post on my blog. Bless you.

Social stigmas put aside

IN A COUNTRY where obesity is an epidemic, it might come as a shocker that there are people suffering from a crippling inability to eat food. They starve to the point where their system begins to shut off slowly. They see death gaining on them, yet it’s not scarier than their single biggest fear in life: food.
Riham Al Reshaid suffered from acute anorexia nervosa for many years, starting from the age of 10. Not eating was her way of ascertaining control over her body, which gradually turned into a terrible obsession. An ordeal she lived with for many years, until finally she decided to go to the United States for treatment.

Today, she is healthy, and is in the process of mastering a survival skill most of us tend to take for granted. The skill of eating normally.  Riham tells the story of her eating disorder in this interview, putting social stigmas aside, because she knows there are a lot of people like her out there who need help, and the first step is to kick start an open discussion. The society must know that eating disorder is a psychological problem and not frown upon people suffering from it as if they were wannabe supermodels who got their diet plans terribly wrong.

Question: What is eating disorder?

Answer: Eating disorders are complicated disorders and of all the psychological disorders they cause the greatest number of deaths. Eating disorders include anorexia nervosa, bulimia nervosa and binge eating disorder. All three of them share many of the same underlying issues including low self-esteem, depression, anxiety, and for some people, trauma.
While treating these disorders, it’s important to tackle the underlying issues that the sufferer is facing. Perfectionism, the pressure to succeed, the fear of failure and need for control are only some of the common traits found in people struggling with eating disorders. Controlling food intake becomes one’s secretive, rigid and scheduled life with one goal, to lose weight.

The behaviors become an obsession to the point where the disorder begins to take control. Eventually the fear of food, the fear of gaining weight or the fear of losing control becomes so extreme that the person feels like it’s too difficult to function in everyday life. It is an addiction; however it’s different from other addictions in that the sufferer cannot cut out the source of their addiction, food.

Food is a basic necessity in life, and when that becomes your greatest fear, it’s very difficult to do the things one needs to do to recover.
I was always a perfectionist. I was a high achieving child who insisted on having things done in a certain way. I feel that had a big role in the development of my eating disorder at the age of 10. I felt that I needed to gain control over certain aspects of my life, and myself.

Q: What’s the difference between anorexia nervosa and bulimia nervosa?

A: Anorexia nervosa is characterized by the fear of food and restricting the intake of food. Whereas bulimia nervosa is characterized by binging on large amounts of food and then purging, or vomiting, to get rid of it. The body gets so used to it that it becomes very anxiety provoking to sit with the feeling of having food in the stomach. In some cases people will binge and purge up to 15 times a day or more. Of course, this is very violent on the body and causes damage to one’s body and organ functioning.

By the end of my teenage years, I had become completely consumed by my eating disorder. My weight dropped to the point where I could barely function. I stopped enjoying life. I isolated myself so that nobody could make me eat, or try to make me get treatment. It’s a very horrible way to live.
This disorder is still very misunderstood, especially in this region. People see it as, “this girl is trying to lose weight.” But it doesn’t work that way. My problem began when I was a child and I was not doing it to lose weight.
The weight loss is just a symptom of the disorder. For someone who is a perfectionist and high achieving, when you know that you are losing weight that becomes a goal for you. Achieving that goal becomes your number one priority, even if it leads to death.

Q: I am just wondering what triggers this in a child. How can a child decide to do something that goes so fundamentally against the natural urge to survive?

A: I cannot speak for every eating disorder case, but for me as a child it felt good to be in control of myself, to win over my natural urge to eat. It was something I could put all my focus and energy into.

Q: But I heard that it’s usually the wannabe models who wind up on becoming anorexic.

A: I believe that the media plays a big role in the development of eating disorders because of stereotypes it creates. Women are constantly being told that they have to look a certain way. The pressure is huge for one to be thin and beautiful, and not fitting that description, automatically makes one inadequate. This really damages one’s self-esteem and confidence. There are girls as young as 7 or 8 dieting to look like celebrities and models, and I find this very sad and disappointing.
We, as a society, need to do something about this. We need to talk about these disorders, tackle the stigma around seeking psychological help, and raise awareness. Nobody should have to suffer from this disease in silence. We have amazing therapists, psychiatrists, and nutritionists in Kuwait that specialize in the treatment of these disorders.

We need to make it clear that this is a deadly disease. If your family member had cancer, for example, you would automatically go and get them the treatment they need. This is just as deadly. Raising awareness in our society can absolutely decrease the amount of shame and secrecy that many suffer from, and encourage people to seek help and support.
I personally received treatment in a residential treatment facility for women in Chicago called Timberline Knolls. I was there for 3 months until I was able to conquer some of my fears and disordered eating. I needed a higher level of care due to the damage I was doing to my body. Slowly, I was killing myself and I knew that I needed to do something as soon as possible. I wanted a happy life, I just didn’t know how to get there.

Q: When exactly did you realize that you needed help?

A: I realized that I needed help when I couldn’t enjoy anything anymore. I couldn’t be fully present in the moment with my friends or family, or even at work. My obsession had become more important than anything else and I was self-destructing.

Q: Did it show very badly on your body? Were you extremely thin and so on?

A: At a certain point, I was extremely thin. This is not the case for everybody suffering from an eating disorder. Some women are of a normal body weight, and that was the case for me by the time I decided to receive treatment at Timberline Knolls. Even though I had reached a normal body weight for a woman of my height, I was struggling more than I ever had before.

Q: You wouldn’t have been very attractive to look at, isn’t it?

A: Even though I knew that at a low weight I was not considered attractive by society, the goal that I had to lose more and more weight was stronger than my need to be looked at as attractive. That’s the eating disorder. Everything else takes a backseat.

Q: So losing weight becomes an end in itself. You are not losing weight to achieve something.
A: Yes, it’s an obsession. Many people were telling me that I looked sick. I could barely walk a small distance without feeling that I was going to faint. It was just very lonely and scary.

Q: What’s binge eating disorder?

A: Binge eating disorder includes periods of excessive overeating. However, a person with a binge eating disorder does not subsequently induce purging, as is the case with bulimia. We often talk about obesity, but there are a lot of people in Kuwait who probably suffer from binge eating disorder and this also needs to be addressed.
There is this misconception that people with eating disorders are always extremely thin. This is absolutely not always the case. Most eating disorders have the same underlying issues, and body weight is not the first thing to be looked at.
For people with binge eating disorder, eating becomes the only thing to turn to when facing a problem. Eating becomes the way of dealing with difficult issues, or not dealing with issues. The sufferer also experiences a loss of control during these binging periods. This often leads to increased anxiety and depression and the feeling of hopelessness.

Q: Before you tell me about how you plan to bring about awareness on this neglected subject, how is a person to know that they are suffering from such a disorder?

A: If one feels like food rules their life, they may have an eating disorder. It’s always best to get a professional diagnosis in order to receive the proper treatment. Recovery from an eating disorder is possible with the right amount of support.

Q: Did you know all along that you had an eating disorder?

A: At a very young age, I did not. Eventually I realized that my obsession with losing weight had become so intense and extreme that I knew I had a problem. I could not stop what I was doing to myself.
For people who think they have an eating disorder but are not sure, it’s always good to visit a therapist or a psychiatrist, because they can diagnose you correctly. They will be able to tell by speaking to you and asking certain questions.
There are lots of studies about eating disorders. There is also a large amount of literature on the Internet on eating disorders, how to help somebody with an eating disorder etc.
The biggest step one can take is going to a therapist, or asking someone for help. The thought of letting go of this disorder in itself is very unnerving. You don’t know what you’ll do without it. You don’t know how you are going to cope with any of your problems if you don’t have that eating disorder to lean on. The thought of recovery becomes very overwhelming.

Q: So it’s like you know you have a problem but you don’t want to be normal.

A: Not that you don’t want to be normal, but it’s just that you don’t know how to function without it. You feel like you are going to lose control of your life. An eating disorder gives you this false, yet strong, sense of control over yourself. While stuck in the grips of my eating disorder, I was the one who decided how much I eat, when to eat, and how to eat. Its only when I surrendered and became open to receiving help did I start to learn new, healthier ways to gain control over my life.

Q: Are there specialized therapists for eating disorders? Who did you go to for help?

A: There are therapists in Kuwait with backgrounds in eating disorders. You can check out lots of places. There is The Soor Center and Fawzia Sultan Rehabilitation Institute. These are great places to go, and people there are understanding and very welcoming.

My hope is that in the future Kuwait or the Middle East will have a residential treatment facility for eating disorders. In most cases, a trip to a therapist for a couple of counseling sessions is not enough. These disorders are so intense and often have such a strong hold on the patients that they need to constantly be monitored to make sure they don’t act out on behaviors and harm themselves. They have to be given extra support and gently taught how to deal with the problem using new coping skills.

Q: Tell me about your treatment experience in Chicago?

A: I have had the greatest experience in residential treatment. It was a very warm, supportive environment that allowed me to work on my issues. I feel very grateful to have had that opportunity.

Q: How long was your treatment?

A: My treatment lasted for 3 months.

Q: Are you just back from your treatment?

A: I came back home to Kuwait only a month ago.

Q: Do you feel perfectly normal now?

A: I am not going to lie; I still have struggles. The difference now is that I know how to cope with them in a healthy, positive, and non-destructive manner. I continue to receive outpatient treatment in order to prevent myself from relapsing, and remain focused on my recovery.

Q: Now, you look like a normal person to me. Was it in these three months of treatment that you gained back your normal weight?

A: I restored weight throughout years of treatment, not necessarily just recently. I’ve gotten my health back, which is the most important thing to me, and I can actually function and enjoy my life. It’s such a great feeling knowing that I now am able to do many of the things that my disorder had taken from me. I now know how to deal with my problems. I now have healthy coping skills to deal with them, and don’t resort to my eating disorder for solutions to my problems.

Q: Did your treatment involve more of counseling or medication, or what was it?
A: It involved a lot of counseling, group therapy, expressive therapy, and 24/7 support from staff as well as my treatment team. I had the support of so many people, especially at times where I did not feel like I had the strength to keep fighting.

Q: That’s where a lot of you guys come together and share your experiences and so on, right?

A: I lived in a lodge with 34 other women with similar problems to mine. That’s when I realized that I was not alone in any of this and I’ve learnt so much there about others, as well as myself. I’ve learned to appreciate the things that make me unique. I’ve discovered my strengths, weaknesses, and passions. When one becomes so consumed by an addiction, these simple things are easily forgotten. The eating disorder becomes a big part of their identity.

Q: But what was that tipping point, because an obsession as intense as this one you just described, for it to go away in 3 months… tell me what was that unique insight you gained during your counseling sessions that you had missed in all these years of suffering.

A: Striving for perfection, the need for things to be very rigid and precise, putting a lot of expectations on myself… these were some of the things that I had to face, and the counseling sessions made me realize that I was not coping with things. I also realized that I needed to learn new ways of coping. I learnt that it’s very important to have positive, supportive people around me. My family has been a strong support for me. My eating disorder did not “go away”, but I choose not to engage in those behaviors any more. Everyday, I choose happiness.
It’s so very important to realize that someone with an eating disorder cannot get better alone. They will need a treatment team: a therapist, psychiatrist and a dietician. They will need the support of their family and friends. I’ve also come to realize the importance of support from others facing the same types of issues.

Q: This urge to be perfect, did it also manifest in other areas of life such as studies? Did you always want to be the best in your class?

A: I was always striving to be the best. I was always putting too much pressure on myself. Not everybody is the same, but this is a very common trait among people with an eating disorder. They are very high achievers, also very intelligent.

Q: Then what else happened in Chicago?

A: At Timberline Knolls, I learned to cope with the everyday things that I had a hard time dealing with previously. I learned new coping skills, how to live a meaningful life, how to ask for support when I need to, and also to accept myself just as I am regardless of my body shape. I’m at the point now where I can actually say I love the way I am. I am proud of my strengths, the knowledge I have, and what makes me Riham.

Q: How low did your food intake drop when your disorder was at its peak?

A: It depended throughout the years. I restricted calories. I would tell myself I couldn’t eat more than 500 calories a day. If I ate more than that, I wouldn’t eat anything for the next 4 or 5 days. At the center I learnt to eat normally, to not let food control my emotions or me. My dietician there had devised a meal plan specifically for me that I was to follow. I still follow the same meal plan, because I have lost that ability to understand how a normal person eats. It’s a little bit of a foreign concept to me. I have never really eaten normally, so I am relearning all of those basic things.
So, I will need this meal plan until I can naturally understand and listen to my body’s needs. These are basic things, and many people take that for granted.

Q: Do you have any statics on the magnitude of the problem in Kuwait?

A: I do not know of any studies or precise statistics. That’s exactly why I want there to be more discussions on this topic in the Middle East. We need to know exactly how serious this issue is in order to tackle it.

Q: When you see people extremely fat or extremely thin, can you take that as an indication of eating disorder?

A: No, and this is exactly why we need to shed more light on the topic. Some people are genetically predisposed to having an eating disorder. There are so many different factors. You can’t just look at a person’s physical build and make judgments. Some people are naturally very thin. You can’t tell. The way someone looks is just the symptom. It’s a psychological disease. A person suffering from an eating disorder may not be very thin. The obsession, the emotional state, the fear… that is the disorder.

Q: Do you have an organization to spread awareness on the issue?

A: I have started a group on Facebook called Kuwait Eating Disorder Awareness and Prevention. You can visit www.facebook.com/groups/kuwaitedap to join. I truly feel like starting such a group has been a great step in raising awareness, as many people have told me that they are relieved that the topic is finally being talked about.

Q: Do all the members in this group have an eating disorder?

A: No they do not. Many members have replied saying that they are happy that someone has taken the initiative to talk about, and reduce the stigma associated with these disorders and would like to help raise awareness in Kuwait. Some people wanted to know how they can help people they know who might be struggling with an eating disorder. The members are very diverse.

Q: Are most of them women?
A: Most of those joining the group are women at this point, but that doesn’t mean that young men don’t suffer from this problem.

Q: Isn’t it likely to be higher among women, because these stereotypes of perfect bodies, zero figures and so on are more for women than men? Probably, binge eating is found more among men?

A: Eating disorders in general are more common among women. From what I have seen, I think that is the case in Kuwait as well. A lot of young women feel the pressure to be thin, to diet and so on. There are some people that diet and lose weight, but don’t have an eating disorder. This is why I keep repeating, eating disorders are psychological disorders.

Q: Is the disorder a gradually progressing one, as in it starts off as a need to shed a few pounds, and then an inclination to continue losing weight until it becomes an obsession?

A: It could progress like that. But it depends on the person. For a lot of women, low self esteem, striving for perfection, those things fuel an eating disorder. This is not the case for everyone.

Q: When we talk of deaths due to eating disorders are we looking at starvation deaths or are we looking at suicides because at the core it’s a psychological disorder?

A: In some cases, there is a lack of nutrition to a point where the body starts to shut down. The heart and other vital organs need that supply of nutrition to function; when that gets cut off your body begins to shut down little by little.
In the case of bulimia nervosa, constant vomiting can causes electrolytes in your body to be imbalanced.
Sadly, suicide has also been a way out for some sufferers as that way of living can become overwhelming and too emotionally painful to deal with.

Q: You touched on the role of media in creating stereotypes of a beautiful woman, which creates pressure on young women to look a certain way. How serious is this problem in Kuwait?

A: I believe that it’s a big problem in Kuwait. Women are constantly comparing themselves to others. The current generation has a very strong pressure to look as thin as possible. They are always being told that the thinner you are, the better. We are constantly being exposed to images of supermodels and celebrities that are incredibly thin. What people don’t realize is that supermodels are a very small percentage of the world’s population. There are limits to each person’s body. Not everyone can reach that size. At such a young age, girls are given the message that they need to be thin, that their hair needs to be perfect, that their face needs to be perfect and so on.
What I would like to see is for more people to realize and understand that everyone is unique in their own way and that it’s the character of a person that makes them truly beautiful. These are the values we should encourage in our society. Beauty comes in all shapes and sizes.

Riham Al Reshaid was an anorexic whose eating disorder began from the early age of 10. She has a Major in Psychology from Kuwait University, and has recently returned from Chicago, USA, after successfully being treated for anorexia nervosa. She is seeking to spread awareness on eating disorder in Kuwait and has started a FaceBook group called Kuwait Eating Disorder Awareness and Prevention. You can visit www.facebook.com/groups/kuwaitedap to join the group.

 

Source: http://www.arabtimesonline.com/NewsDetails/tabid/96/smid/414/ArticleID/188708/reftab/96/Default.aspx

 

Eating Disorder Treatment Kuwait

Soor Centre



Soor Center is the largest private psychological practice in Kuwait, and probably in the Middle East. We provide professional therapy & assessments to Kuwaitis and expats alike, and our therapists work with all manner of clients from very small children to the very old.

http://www.soorcenter.com/

 



 

Fawzia Sultan Rehabilitation Institute

The Fawzia Sultan Rehabilitation Institute is a multi-disciplinary health center dedicated to:

• Providing both physiotherapeutic and psychological rehabilitative care and patient education to our clients


• Training healthcare professionals in rehabilitative care


• Becoming a hub for clinical and health services, research, training and activism in Kuwait


• Educating the greater community on physical fitness and health
  
  
  

  
  

  
  

  
  
  http://fsrikuwait.org/home.html
  
  

  
  

  
  

  
  

  
  
  
  
  
  
  
  
  
  Street Address:
  
  

  
  

  
  

  
  

  
  
  Amaia Residence, Bldg 9, Floor 2
  
  Baghdad Street, Salmiya, Kuwait
  
   
  
  Postal Address:
  
  P.O. Box: 24472, Safat 13015 Kuwait
  
  +965 2572 0338 / 2572 1757
  
  +965 2572 1677