Anorexia, Bulimia Hitting Young Cambodian Women
With Cambodia's Economic Progress Come Eating Disorders, Say Experts
Mar 3, 2009
Although firm statistics are hard to come by in a country with such a poor mental health infrastructure, anecdotal evidence that more and more young Khmer women are purging or abstaining from food altogether is alarming and getting worse, a number of local health experts say.
What they find even more worrying is many young women are resorting to pharmaceuticals and even street drugs such as methamphetamines to speed their weight loss.
Chey Chumneas Referral Hospital, located just outside the capital Phnom Penh in Takhmau, has one of the few inpatient mental facilities in the country. It treats patients aged 15 and under.
Staff decline to disclose exact numbers of patients with diet abnormalities for privacy reasons but confirm that there has been an undeniable rise in patients, almost all girls, presenting as dangerously underweight.
For many of them, drugs including illegal street drugs are also involved. Cambodia has less than two dozen trained psychiatrists, and none currently specialize in eating disorders. Staff admit they are struggling with treatment options.
"We have to assess each patient individually and determine what came first - the drugs or a desire for weight loss," a spokesman for the hospital says. "Depression seems to be a very common underlying cause, so we often treat the depression.
"The problem is certainly becoming more prevalent. Go to any beauty parlor in the city and listen to what they talk about. It's all weight, weight, weight."
For Graham Shaw, director of the United Nations Office on Drugs and Crime, the news that drug use is going hand in hand with dieting is not surprising.
"I have no statistics on Cambodia, but it would not surprise me ... it is certainly a trend which has been well documented in other countries," he says.
Phnom Penh's United Nations AIDS office reports HIV/AIDS prevention workers are noting an "astronomical" rise in injecting drug use amongst female entertainment workers such as karaoke singers.
Although the research has focused on the dangers of injecting drug use and contracting HIV, the women are admitting to field workers that besides giving them the ability to work all night, they like the impact drug use has on their figures.
Pharmacists such as Phnom Penh's Kong Pholly say diet drugs are becoming their most lucrative market.
"Perhaps 50 women a week come to buy thin tablets," she says of her tiny hole-in-the-wall practice.
Media Blamed for Cambodia's New Diet Obsession
Since ancient artists carved Khmer celestial dancers on the walls of Angkor Wat temple nearly a thousand years ago, the "ideal" woman in this agrarian culture had always been sturdy, with wide, child bearing hips.
The country's pre-eminent psychiatrist, Ka Sunbaunat, says that has changed rapidly in recent years as Cambodia's youth has been exposed to shrinking foreign starlets such as Nicole Richie or Lindsay Lohan or the wafer thin Thai and Korean celebrities who dominate tabloid lifestyle sections and television airtime.
Professor Sunbaunat, who runs a private clinic in the capital and is the kingdom's mental health advisor to the Health Ministry, has no doubt this is due to increasing exposure to foreign, and particularly Western, media and ideals as the once communist country accelerates into a free market economy.
"Until recently there were very few magazines. Now there are hundreds," Professor Sunbaunat says. "Western media links being thin with success. There is a problem with eating disorders here already, and it will be a bigger problem in the future."
Once, arranged marriages at a young age and children was the future for most Khmer women, but as the economy has developed rapidly since the end of a 30-year civil war in the 1990s, burgeoning garment and hospitality industries have given girls the option of becoming breadwinners and even career women.
Cambodian experts say it seems that just as Cambodian women are gaining financial independence, they have become slaves to a new social demand, and many now link success with Size Zero.
In her paper 'Eating Disorders in Asia' (2000), Professor Leslie Johnson cites studies from Taiwan, Japan and Hong Kong which showed high rates of dieting and eating disorders directly proportional to the changing role of women in those societies nearly two decades earlier.
She also squarely blames Western influences for the trend and warns against the pre-conception of many that eating disorders are a Western women's problem.
Just as in other Asian nations, dieting has become a way of life for many young Cambodian women, and Dr Johnson's paper warns that from there, the step to distorted body image and eating disorders is a small one, whatever their ethnicity.
At just under 5 foot 6 (167 centimeters) tall and 35 kilos, Phnom Penh restaurant manager Srey Mao sees herself as a weight watcher, and although delighted at losing 12 kilos already in a year, admits giving up the rush of standing on the scales and seeing more weight has melted away is a hard thing to kick.
"When I was really fat, I felt like people were laughing at me behind my back every day," she says. "Now I want to cut down on my thin tablets, but it's hard. You always see where you could lose a little more, and want the feeling you get when you see a little bit more has gone."
