Every night, before going to bed, Aliaa has a cup of milk or juice. Feeling guilty, she forces herself to get some asleep. She doesn t want to think about what she had just done. She usually only manages two hours of sleep a night. Insomnia is not her ailment. It is merely one of the symptoms. Aliaa is anorexic. "Last year, I had a school project about anorexia, says 19-year-old Aliaa, who only weighed 37 kilos at the time. "I read about the symptoms and all of them matched my condition, said Aliaa, speaking to Daily News Egypt about her struggle with anorexia. "I am still not convinced that I am thin, she said. Anorexia nervosa is an eating disorder associated with low body weight and distorted body image and an obsessive fear of gaining weight. Although not much research on the disorder is available in the region, experts say it's almost as prevalent in Egypt as it is anywhere else, and it's on the rise. According to Psychologist Georgette Savvides, a specialist in addictive behaviors, a number of factors contribute to the recent rise in anorexia among Egyptian youth. For one, she said, the media "pressures women to look a certain way. Other factors include peer pressure and the desire to be accepted as well as "certain family patterns, such as overprotective [parents] and families who have high expectations of their children. All these factors ring true for Aliaa, who said, "My family always criticized me and my dad used to make fun of me when I was young. Just three years ago, she weighed 115 kilos, and remembers her father once slapping her for eating a potato. Aliaa was also in a relationship with someone also constantly commented on her weight, comparing her body to singers and actresses on television. "When I was eating, I felt like I was doing something wrong, said Aliaa, "I only felt thin when I went down to 35 kilos. According to a study by the Anorexia Nervosa and Related Eating Disorders, Inc., (2006), prevalence rates of anorexia in non-western countries ranged from 0.46 percent to 3.2 percent. The rates are just a bit higher in western countries, ranging from 0.1 percent to 5.7 percent. However, experts agree that prevalence in non-western countries is on the rise. Anorexia is currently on the rise in Egypt, too, said Savvides. Born and raised in Egypt, Savvides got her PhD in Psychology from the Institute of Psychiatry at the University of London. Since 2004, she has worked at Helwan's Behmen Hospital, which was founded in 1940 and became the first private psychiatric hospital in Egypt. In just a few months, Savvides will officially inaugurate a new ward at Behmen Hospital with a special section for youth who suffer from eating disorders. A number of patients are already being treated. The disease follows the "same patterns everywhere, says Savvides, and "is not as much about culture as it is about dynamics and types of family and personality. Anorexics often control body weight by voluntary starvation, purging, vomiting, excessive exercise, as well as diet pills or diuretic drugs. "Anorexia is a control disease, where food is used to replace control. The person feels empowered, in control and [that they are] an achiever, said Savvides. In addition to loss of menstrual periods (amenorrhea) in girls and women post-puberty, more serious consequences of anorexia are an abnormally slow heart rate and low blood pressure, which increases the risk of heart failure and reduced bone density (osteoporosis). Severe dehydration also occurs and can result in kidney failure. Muscle loss and weakness, dry hair and skin, and hair loss are also present. Growth of a downy layer of hair - lanugo - all over the body, is also common, a way for the body to keep itself warm. "When I was 34 kilos, I could never sleep. My mom carried me to the doctor and he thought I was 11 years old. When the doctor realized she was a teenager, he insisted that Aliaa be admitted to a hospital immediately. Aliaa s blood pressure was only 70/40, but she refused to be hospitalized. When she and her mother got home, she promised her mother that she would gain half-a-kilo every ten days. But her fear of gaining weight was stronger. "When my mother began getting me milk and chocolate in bed, I waited until she left the room, and threw the food away, said Aliaa. She also admitted that she used to stuff her pockets when her mother weighed her. "I am not worried about myself; I only care what other people say. When I was a child, my family never let me express my opinion, always saying that I was too young to know. Recently, Aliaa began noticing that her little sister was following her footsteps. That's when Aliaa realized she needed to make some changes. "I did not want to be a bad influence on my sister. I am trying to get better now, trying to have fun with my friends. adds Aliaa, whose new goal is to reach 47 kilos. It's been hard, and it will be even harder for her to get used to eating guiltlessly again. For now, she has little energy and feels weak. "I want to be a writer. I want to go to college every day but I am always tired. I always wonder how I am going to get married and how I am going to have children. In cases of active anorexia, women often suffer from amenorrhea, which means that they do not ovulate. Pregnancy becomes difficult, if not practically impossible. Women who have recovered from anorexia and maintain a healthy weight have a better chance of getting pregnant. Aliaa remains hopeful, "I feel the love and support from a lot of people around me. One of my friends promised to quit smoking if I reached 48 kilos! So they are showing me their support without pushing me, they are trying to understand. The National Eating Disorders Association in the US indicates that an estimated 5-20 percent of those who have anorexia nervosa will not survive complications associated with it. For those who receive treatment, the mortality rate is far lower, at 2-3 percent, according to the Anorexia Nervosa and Related Eating Disorders, Inc., 2006. "People are more aware of eating disorders now than five or ten years ago, said Savvides, attributing this heightened awareness to a factor that is commonly blamed for triggering anorexia - the media.
