Warning: This article speaks frankly about eating disorders.
Jasmine* remembers first feeling uncomfortable in her body when she was 10.
"There is a note from that year in my diary where I write that I wish I was skinny and could lose all my fat," she says. At 14, her desire to be thinner became an obsession with counting calories which has carried over into her adult life. "Restrictive eating and dieting are commonplace for me, unfortunately," she says.
I have similar memories of trying to control my diet at school. Carbohydrates became my enemy, I exercised compulsively on an empty stomach and I weighed myself three or four times a day. According to statistics published by the UK's eating disorder charity, Beat, mine and Jasmine’s experiences, as South Asian women, aren't uncommon.
"It is shocking but the statistics don't surprise me," says 25-year-old Sravya, who has suffered from disordered eating since she was 15. "In South Asian communities, people often feel they have a right to talk about your body," she says. "Growing up, being thinner was linked to success or getting married."
Jasmine, too, feels her culture played a role in the development of her body dysmorphia. Despite having a relatively liberal upbringing, her family spoke openly about her appearance throughout her youth. "Because of this, I am very self-critical," she says.
Food and communal eating is at the heart of South Asian culture but this can be confusing when it feels like your body is under constant assessment. "The same people who keep trying to feed you are making the comments about your weight," Sravya says.
When I was younger, I lusted after the white, thin bodies I saw celebrated in the mainstream media. But having limited exposure to anyone in films, TV or online with my skin colour or body type made me feel like an outcast. Twenty-four-year-old Aleesha* blames never seeing people who looked like her on screen for the anorexia she suffered with throughout her teens and her continued body dysmorphia. "I was very aware of how different I was from an early age," she says. "I had hair all over my body, I had a bigger nose and I wasn't white."
Growing up with a very small number of non-white friends and living in a world that favoured those who fit into the "white beauty standard" also made it difficult for Jasmine to accept the way she looked. "I struggled with a lot of things my friends didn't, like easier scarring and more apparent stretch marks," she says. "Still, within my own Indian household, mental health and body image just wasn't understood."
Dr. Bhavisha Dave, a clinical psychologist who has specialized in the study of eating disorders in South Asian communities, agrees that shame around the subject still exists in our culture today. "There is no literal translation for eating disorder or mental health in our languages, and anything close is pretty derogatory," she says. "This stigma has a huge part to play in people not getting help."
Despite recent NHS statistics showing that hospital admissions for eating disorders are rising fastest among ethnic minorities, a study commissioned by Beat in 2019 found that BAME people felt less confident than white people in seeking help from a health professional for an eating disorder. "The South Asian population only access help for eating disorders when they are at acute stages," Dr. Dave says. "But if [these disorders] become less of a taboo subject, then treatment, support and intervention could all be provided earlier."
Dr. Dave's thoughts align with the findings of a 2017 research project which identified a lack of knowledge around eating disorders and stigma within communities as barriers to many South Asian people seeking help. "Eating disorders aren't easy to talk about in the majority of South Asian families because there is a lack of education and understanding about them," Dr. Dave says. Jasmine agrees: "Whenever I bring up my insecurities, it's either 'Do what you can to change them' or 'Don't say that'. So it's never really a discussion."
Sravya says that talking through her problems with a "culturally competent therapist" has "really helped" but many South Asian women find it difficult to access adequate mental health support. "There really needs to be more options available," Jasmine says. "I've already done one round of CBT but I'm actually back in therapy because I've recently relapsed – whether that's because of the pandemic, I don't know."
Psychiatrists fear that the past year has caused a rapid rise in the number of people experiencing anorexia and bulimia. For many South Asian people suffering from an eating disorder, spending more time at home or with family has had a negative effect. "Lockdown has made me feel I'm being constantly monitored by my family," says Sravya. Aleesha says the free time "put a magnifying lens" on what she was eating, which proved to be detrimental to her recovery.
Dr. Dave thinks that education within South Asian families is essential to solving the growing problem with eating disorders in our communities. "We need people to be aware of what this mental health disorder is, so they know how to help," she says. "It needs to be spoken about as freely as we do with our physical health."
Speaking directly to anyone in the South Asian community who notices themselves developing disordered eating patterns, Dr. Dave says that there are people out there who want to help. "The NHS can offer a tailored, sensitive service and accessing help earlier is much better for your recovery. It's a big hurdle to overcome but you are not alone." Canadians can refer to the National Eating Disorder Information Centre.
*Some names have been changed.
This story was originally published on Refinery29 UK. If you are struggling with an eating disorder and are in need of support, please call the National Eating Disorder Information Centre hotline at 1-866-633-4220.