Dieting dilemmas

By Gihan Shahine
Was thin always beautiful?
"Battle of the bulge?" "Are you tired losing the dieting game?" "Obesity a problem?" These are the questions posed by ads promoting new clinics, diets, drugs and weight loss devices.
The ads are everywhere and the questions are fodder for exciting conversations among the younger generation, especially girls. The slimming bug seems to have spread from wealthier social strata, where Western aesthetic standards have held sway for far longer, through society at large.
The trend is important enough to have spawned a number of "clinics" -- very diverse in terms of the services offered and promises made -- that cater for a growing clientele. Nutritionists, whether self-styled "diet doctors" or qualified dietitians, are almost impossible to track down for an interview: many of them work from 12pm until 2am!
Is obesity sufficiently widespread in Egypt to justify the new obsession with weight loss? Or is dieting simply a fad, proof of one's membership in a moneyed, slender clique?
"It's an obsession," says 23-year-old Sally. "It's really amazing; everybody is dieting or at least discussing new diets. All my friends are obsessed with losing weight, even when they don't need to."
Sally herself once battled with her weight. "I used to exercise excessively before and after going to college while eating almost nothing during the day," Sally recounts. "My health deteriorated and I would vomit every time I ate. I wasn't fat at all, but I didn't want a single extra pound on my body. It was a silly obsession."
Yasmine lost six kilos with the help of a dietitian two years ago. Now, however, she is regaining weight. "I wanted to lose the weight for my sister's wedding, so that I could look slim in my tight evening dress," she explains.
Amani, too, is gaining weight again -- but she does not accept it with the same equanimity. She has already regained 15 of the 20 kilos she lost last year. "It is really unhealthy to be fat," she admits. "But most people go to a well known nutritionist just to show off. It is a trend more than anything else."
Obesity, especially in women, was once valued as a sign of the family's wealth. Today, at least in Egypt, it is no longer considered beautiful among the privileged; still, the members of the better-off classes continue to suffer from it, albeit for different reasons. Nutritionists blame excess weight on poor eating habits and lack of exercise. "Most people, however, diet not because it is unhealthy to be overweight, but because it is in to be thin," laments Dr Nagi Boutros, a physician who works in the field of dietetics. "In many cases obesity is not the issue -- a woman is simply upset because she has gained two kilos and cannot wear an imported evening dress."
Jawad Fatayer, professor of psychology at the American University in Cairo (AUC), explains that dieting is becoming an obsession in Egypt, especially among girls, because it is linked to one's image -- an important factor in being liked and accepted by others. "Dieting is sociologically constructed and has a serious psychological impact," Fatayer maintains.
People diet to look better. But the very idea of "looking better," Fatayer explains, is determined by society, which puts more pressure on women to look a certain way. In a man, however, a paunch will raise no eyebrows.
"That pressure, enhanced by ads and fashion magazines, drives women to extreme, sometimes hazardous, dieting," Fatayer says. A woman who sees herself as ugly and unattractive because she is overweight is actually reflecting others' view of her, he adds.
"The way others view and assess us conditions our self-image and esteem," Fatayer explains. "In a materialistic society that focuses on physical appearance, overweight women are likely to suffer severely simply because they don't fit the criteria set by society. They may shun men altogether."
The extent to which these criteria are socially determined is revealed when one looks at their historical evolution. Hind Rustum was once the symbol of sexy in Egypt -- our own home-grown Marilyn Monroe. Today, both would be considered fat.
"The international standard is slim muscle," explains Hani Abul-Naga, a nutrition and fitness specialist with a certificate in dietetics from Miami University. The concept of ideal weight has changed significantly, he continues. Previously, a man who was 170cm tall would ideally weigh 70 kilos. Today, he should weigh 60 to 65 kilos to fit the ideal standard.
"Furthermore, the ideal now no longer depends on weight, but on the proportions of weight and height in relation to other physical measurements," Abul-Naga adds. " So the fashion is not just slim, but slim and proportional."
Body weight, dietitians agree, is largely a reflection of one's culture, lifestyle, marital status and age.
"The dieting craze is more prevalent among the younger generation, the well educated and well-off who have access to satellite TV, the Internet and fashion magazines, and who can afford to go to the gym," Abul-Naga maintains. The higher one's socioeconomic standards, the slimmer one is likely to be.
"The lower social strata still appreciate fat as healthy, while the new rich regard [belly dancer] Fifi Abduh as sexy," Abul-Naga jokes. "For both categories, slim would be seen as skinny, unhealthy and unattractive."
Women, at any rate, are more stringent judges of their own body image than men are. This is the case even among married women and mothers, who were once encouraged to derive their self-esteem solely from their role within the home. Some dietitians feel that a married woman will try to lose weight in order to regain her husband's interest, and not simply because she wants to appear more fashionable.
While cases of anorexia among young men have been publicised in the US and Britain, Egyptians are more concerned with "pumping up their muscles than with losing weight," Abul-Naga notes.
The growing awareness of body image, at any rate, has generated an industry revolving around diet pills, liposuction and "fat-burning" devices -- which at best have no effect, and at worst could be extremely harmful.
Having experienced first-hand the drawbacks of the cabbage-soup diet, made popular abroad by fashion designers and top magazine editors, some Egyptian women have turned to the so-called chemical diet (based on combinations of certain food groups, like its forefathers, the Hayes and Montignac diets). Experts in nutrition, however, think that its side effects can include all those associated with rapid and excessive weight loss: depression, stretch marks, hair loss, hormonal changes, lowered immunity -- and, at the end of this long and arduous path, weight regain as soon as eating habits return to normal. Still, many dietitians tend to prescribe it to patients who are desperate for quick results.
"Many of those who prescribe diets are not actually specialised in nutrition; for them, it's a business, which can be dangerous sometimes," warns Fahmi Seddiq, professor of food hygiene at the Nutrition Institute. "Dietitians are not even subject to supervision from the Ministry of Health." Nutrition, in fact, is glossed over at medical schools, and is not considered a specialisation in Egypt.
"Dietitians should at least obtain licences from the Ministry of Health," agrees Dr Ahmed Mar'i, deputy minister of health for curative medicine. "Supervision may have been lacking, but now since many clinics are working in the field, we will have to start running surprise investigations."
This is especially necessary when one considers that few self-proclaimed "diet doctors" bother to put their clients through a medical check-up before putting them on a diet. An unbalanced nutritional plan can be harmful to those with heart problems, as well as kidney patients and diabetics, according to Boutros. Drastic weight loss can also trigger eating disorders like bulimia and anorexia nervosa, Fatayer cautions. A nutritionist must therefore be well acquainted with a patient's medical history before prescribing a diet.
Many diets also cut out carbohydrates altogether, which could induce or increase depression, since they are known to affect the production of a brain chemical (serotonin) that regulates mood. Certain vitamin deficiencies are also associated with depression, which means that dietitians must ensure that meal plans offer dieters a full range of nutrients.
"A decrease in levels of blood sugar [hypoglycemia] and vitamin intake causes depression, but human beings are also anti-rules and the obligation to eat certain food at specific times can be depressing in itself," Abul-Naga chimes in.
Fatayer reasons: "When the body aches, the mind suffers. People suffer when they fail to sustain a balanced relationship between their physical needs and outlook. The sense of deprivation is depressing."
Dieting, however, does not necessarily mean starvation, Abul-Naga insists. A diet based on calorie-counting, he adds, "simply distributes the calories your body needs, depending on daily activity and gender, among three or four well-balanced meals. You don't feel deprived. It may be slow, but it is effective; and regaining weight is less likely."
The best of intentions, however, can be foiled by the simple fact that, once the diet is done, it is no longer possible to return to one's old eating habits. "To maintain your weight loss, you normally have to reduce your intake of high-calorie foods and change your bad eating habits," explains Boutros.
Does that mean people must go on dieting forever? "No, I would rather put it this way: adopt a life-style based on healthy eating and exercise. A dietitian just explains to people how to manage their bodies, how to eat without gaining weight," Abul-Naga concludes.
Fatayer has another tip: "Accept who you are to have peace with yourself and harmony within. If society does not accept you the way you are, then society has to deal with it."
Recommend this page
Related stories:
Burn the fat, not yourself 11 - 17 June 1998
© Copyright Al-Ahram Weekly. All rights reserved
Send a letter to the Editor