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Eating disorders as a public health emergency

People tend to think of eating disorders as problems of the middle and upper classes, but it is a pervasive issue among low-income women as well, said professor of sociology at the London School of Economics, Dr. Susie Orbach, during a seminar on eating problems and mental health held at IDB headquarters. “Only two percent of women worldwide feel able to call themselves beautiful,” said Dr. Orbach, declaring the eating disorders problems as a world-wide public health emergency.

The consequences are wide-ranging. Ten percent of women in the world become obese. Up to 3.7 percent suffer from anorexia nervosa and up to 4.2 percent from bulimia nervosa, and up to 5 percent practice binge-eating.

Economic and social consequences, while more difficult to measure, are significant, as well. Orbach’s research shows that 72 percent of all girls and 68 percent of women avoid ordinary activities due to negative self-perceptions regarding their looks. 

“The IDB recognizes the importance of this issue and is working to raise awareness about the problem, which is very important for Latin American and Caribbean women and girls in particular,” said Gabriela Vega, chief of the IDB’s Gender Equity in Development Unit

Medellín: anorexia and bulimia capital of the world

Medellín, Colombia, is known as the fashion capital of Latin America, but it also holds another world record: it has the highest rate of anorexia, bulimia and other eating disorders, standing at 17.7 percent of the population of adolescent girls in 2003, said Dr. Lucrecia Ramírez-Restrepo, associate professor of psychiatry at Colombia’s University of Antioquia and director of Medellín’s City Network for the Prevention of Anorexia and Bulimia. That compares with 5.0 percent in Spain and 10.2 percent in the US.

After doing significant research on the problem, Dr. Ramírez-Restrepo created the Network for Prevention of Anorexia and Bulimia and launched ‘Project Skinny,’ with the slogan “Skinny, Pretty, Happy?,” to combat what she found was the widespread belief among not just adolescents, but also their mothers, fathers and teachers, that being skinny equates to being pretty and happy.

The campaign uses creative advertisements on billboards around the city and in magazines and newspapers to make its point in graphic fashion, showing pictures of strange-looking “skinny” elephants, rhinoceroses and zebras, along with the tagline “It looks weird, right?…and you, how do you look?”  

“Ours is a novel project because in addition to working with teenagers, it also involves adults from each of the social sectors,” Dr. Ramírez-Restrepo said. “We’re developing four project components, using a budget of $3.8 million in cash and in-kind contributions, including a mass media campaign, an educational component to train teachers and health professionals, a social responsibility component with the private sector that seeks to avoid propagating the “Thin discourse” in areas like clothing and fashion, and a monitoring and evaluation component.” 

Dr. Ramírez-Restrepo and her team are working with 570 representatives from a wide range of sectors, from the municipality to academia, mass media and advertising, the health and fitness industry, the fashion and food industries, the entertainment industry, as well as young families and parents. “We know that interventions focused on empowering teens by themselves don’t work; we need to work on decreasing the social pressures that these teens face. That’s why including adults from all the relevant sectors is so important; female self-esteem must be added to the public agenda,” she said.