One Emirati Woman's Battle with Anorexia
Sitting in the lounge of a Dubai hotel, Samira Murshid Al Romaithi could be any other 28-year-old woman. Clear-skinned and bright-eyed, she smiles as she greets me, exposing a set of pearly white teeth and a long mane of dark hair that falls over a pretty, sensitive face.
Confident without being overbearing, articulate and charming, this is a woman who holds a senior position with the Government in Abu Dhabi; who is the vice president of the UAE Jiu-Jitsu committee and a blue-belt competitor; who is about to launch her own business selling health food snacks; and who not only has a BA and a master's but also is halfway through another master's, in diplomacy and international relations. Her zest for life is obvious.
It's almost impossible to imagine she once suffered from anorexia.
Anorexia - a word that conjures up images of skeletal-like young women and that many presume is vanity in the extreme, an attempt to achieve the perfect body gone terribly wrong and an example of just how askew our priorities have become in the complicated modern world.
But there is, of course, more to this insidious disease that (along with other eating disorders such as bulimia) is still a taboo subject in many parts of the world and especially so in the UAE.
The country's first study of the illness, released in 2009, found that almost one in 50 girls has anorexia. The research by UAE University in Al Ain also showed that in a test group of 900 girls aged 13 to 19, 1.8 per cent of them had an eating disorder. There remains no public body to deal with such problems.
Dr Roghy McCarthy, a clinical psychologist at The Counselling & Development Clinic in Dubai, has been treating people with anorexia here for years.
"People generally don't understand it," she says. "This a psychological issue. Those suffering from it are usually highly intelligent and high achievers. They feel they are losing control of their environment and that by controlling what they eat, they can control themselves. Like other addictions, they typically don't know how to deal with their emotions, and rather than expressing them, they turn the aggression inwards and harm themselves."
Al Romaithi is a case in point. Although her weight is perfectly normal now - she's tall and slim without being overly thin - at her lowest point she weighed a shocking 31kg.
That was six years ago and she has since made a full recovery. It's been far from easy, however. Anorexia first hit her at the age of 22. Before that she'd led a fairly normal life; one of three children to an Emirati father and an English mother, she'd had a happy childhood growing up in Abu Dhabi. She excelled at school, achieved high grades and was a general all-rounder, playing sport and chess in her free time.
She'd recently returned to Abu Dhabi having spent three years studying in the UK when she decided to embark on a healthy eating regime in August 2003.
"At first it was about wanting to be thin," she says matter-of-factly. "But looking back it became a way to suppress my emotions, a coping mechanism for life. I've since read a lot on the subject and it's often described as a 'good girl's breakdown'. That was definitely the case with me."
She looks me in the eye as she speaks and although her expression is calm, her bottom lip quivers slightly from time to time, showing that little bit of fragility she hides so well and yet makes her all the more likeable.
Her so-called "healthy" diet, she says, involved eliminating all junk food and adhering to a strict regime of mainly fruit and vegetables with the odd cereal bar. She also began to exercise excessively. The months passed, little by little the weight began to fall away and despite pleas from her family to eat more she was adamant that she would not. She became obsessed with food and ways to avoid eating it: shunning social occasions with friends, finding constant excuses to miss meals at home and never allowing herself enough calories to maintain a healthy figure.
Ramadan she describes as "an anorexic's dream come true". Why? Because she could go all day without eating a thing, get a daily dose of exercise and then at iftar, eat only a little. When she did eat she would do it in a ritualistic way - cutting her daily allowance of an apple into tiny pieces and eating them one after another, before washing it down with a single glass of orange juice.
She weighed herself every day. "If I had lost weight then my day would be good and if not then it was doomed to be bad," she says, adding that she began to develop all the typical signs and symptoms of anorexia. "I hadn't experienced a menstrual period in over a year and a half; my hair was coming out in handfuls; I had trouble sleeping; suffered from dizzy spells; and I constantly felt cold, not just a normal cold, though. This was like a bitter iciness which would engulf my bones. I ignored my grumbling belly and my hunger pangs. I didn't feel like doing anything. It was too exhausting and required too much effort."
And all the time she was lying to family and friends.
"Looking back I'm ashamed at what a good liar I became," she says. "I became a master of deception. I didn't want to give up my food restrictions as they were the only thing I felt I could count on. Being thin was me; if I were to lose that, I felt I would lose myself."
Yet she knew she was drastically underweight.
"I could count my ribs and it was painful to sit for any reasonable amount of time," she says. "What's more, I could no longer fit into women's clothes. A size 8 was too baggy. I remember people passing comments on my appearance all the time and as sick as it may sound, I enjoyed hearing the comments, they made me proud."
After more than a year of extreme dieting, Al Romaithi finally hit bottom towards the end of 2004. She recalls sitting on the bathroom floor, after unsuccessfully attempting to make herself sick and feeling utter despair.
"That was the lowest point in my entire life," she says. "I just knew I couldn't go on like this. I even contemplated suicide."
Turning to her mother, whom she clearly respects greatly and credits for her unfailing love and patience, she asked for help. There was, however, nowhere in the UAE that specialised in the problem and so her parents sent her to a clinic in the UK.
It was there, over a period of several weeks, that little by little she began to recover.
"At first, like most anorexics, I was in complete denial," she says. "I was told I had to put on weight and the thought horrified me. What's more, I wasn't allowed to exercise, which I hated. At the clinic I was surrounded by other girls, all skeletal and all suffering from the same problems, yet for various reasons I couldn't relate to them. In my mind they were clearly anorexic but I believed I had the opposite problem - that I had gained too much weight and couldn't stop bingeing."
At first she rebelled against the clinic - feeling angry and determined that she would not put on weight despite the strict regime of truly healthy meals she'd been put under. But when her efforts at rebellion failed and she realised she could not escape, her outlook changed.
"I'm not sure exactly what triggered my recovery," Al Romaithi says. "But I had lots of spare time to fill and I spent much of it thinking. I thought about so many things - most of all my family. I was worried by how much [money] they must have been spending for me to stay in the hospital and about how much stress and anxiety I had put them under.
"I thought about my friends, my work, where I was in life and what I wanted to do in the future. I pondered, too, the reasons as to why I had developed an eating disorder and wondered whether I would ever be able to fully recover. It felt like I was on an emotional roller coaster." She thinks for a moment. "For reasons I still don't understand, my whole outlook seemed to change overnight. Suddenly I wanted to be well again."
That was three months into the treatment, says Al Romaithi, who returned to Abu Dhabi not long afterwards determined that she would not only lead a normal life but also make a full recovery.
Indeed, it is testament to her strength of character that not only has she maintained a healthy weight all this time but also that she is so open about it.
"It's not easy," she says. "But I have developed ways to deal with negative thoughts about my image whenever enter my head. They are not logical. I mean, I don't judge other people on their appearance, so why should I expect that people will judge me on mine?"
She adds, however, that negative comments from other people are hurtful.
"I think in modern Arab culture people are often judged on how they look and they think nothing of commenting on other people," she says, "but they don't realise the harm they're doing."
In the end, though, she says she's glad she went through the illness.
"You know," she says, smiling, "I feel stronger because of what I've been through and it has made me appreciate my life. I have so much to be thankful for - a great job which I really enjoy, an amazing family who have been so supportive, good friends and my health."
She's aware that people in the UAE who read her story are bound to recognise the signs of anorexia in a friend or a family member. So how should they treat that person?
"All I can say is, don't get angry and don't approach them in an aggressive manner," Al Romaithi says. "They need to be treated with understanding, kindness and patience.
"And they need to get treatment. Unfortunately, there is no public body and no telephone help line in existence here to deal with the problem and there's clearly a need for one.
"But most importantly," she adds, "I want people out there to know that recovery is possible. Everyone goes through problems at some stage in their life, but there is a way out - recovery is possible as long as you stop focusing on the past and appreciate what you have.
"And you know what?" She pauses and smiles. "Once you do - it's great."
By Erin McCafferty