About 1,675 young people in Malta, aged between 10 and 16, suffer from eating disorders, according to a new study that highlights the need to combat social pressure brought about by images of idealised beauty.

The study, the first to shed light on eating disorders among this young age group in the country, shows that, as expected, the majority of Maltese children (aged 10 to 16) do not have an eating disorder.

However, 5.5% are affected: 3.25% are girls and 2.25% are boys – amounting to 1,675, consisting of 990 girls and 685 boys.

This shows that, while more girls than boys are affected, the proportion of young males is relatively high.

The August 2020 study, which surveyed 400 children, was commissioned by Fondazzjoni Kenn għal Saħħtek, a foundation set up in 2014 by the Malta Community Chest Fund and the Health Ministry to run Dar Kenn Għal Saħħtek that offers holistic treatment for patients with eating disorders such as anorexia, bulimia and binge eating, as well as obesity.

Dar Kenn Għal Saħħtek director Darleen Zerafa explained that, over the past three years, they had noticed an increase in younger people seeking help for eating disorders – in line with international trends. The foundation wanted to address a gap in research into this age bracket to get a clear idea of the situation in the country.

“Since 2017, we had about 80 people between the ages of 10 and 16 coming to us. Many shared a common trait: they felt excluded by peers and some were victims of bullying,” Zerafa said, adding that the most common eating disorder in that age group seemed to be anorexia.

However, she said, they were seeing disorders in children as young as eight to 10, suffering from Restrictive Food Intake Disorder – a type of extreme picky eating or food phobia.

Many shared a common trait: they felt excluded by peers and some were victims of bullying

The foundation now planned to carry out a study to assess the situation in younger children and will be setting up services tailored to young people.

As a first step, the foundation commissioned the study ‘Eating Disorders Amongst Young Persons in Malta’ that was carried out by the University of Malta Faculty for Social Wellbeing’s professor Andrew Azzopardi, project manager, and research officer Annabel Cuff.

Azzopardi said this was a timely survey that highlighted a need for society to address the way it valued people and the way people valued themselves.

Psychiatrist Anton Grech, chairman of the foundation, said the triggers for eating disorders were multifactorial.

“Eating disorders occur within a context where society identifies beauty with being thin. This is reinforced by the images of the media and in certain professions like modelling,” he said.

“Thus youths, particularly those who are slightly overweight, start to take measures to become thin in their pursuit of beauty.

“This leads to dieting that can get out of control and manifests itself as eating disorders. Not everyone who starts a diet ends up suffering from eating disorders but certain individuals, due to perfectionistic tendencies in their personality or because of their environment, are more at risk than others,” Grech added.

The study goes on to list recommendations for the way forward.

Policy recommendations include suggestions for measures to combat images of idealised beauty that give rise to body-dissatisfaction among young people, the dissemination of information and raising of awareness of eating disorders and working with primary care professionals and others who could be at the frontline in recognising eating disorders among young people.

What are eating disorders? 

Eating disorders are abnormal habits that can threaten health or even life.

Eating disorders cause disruptions to normal perceptions and attitudes to food whereby, depending on the disorder, the sufferer exerts intense control over food intake.

People afflicted with eating disorders suffer a number of adverse medical and psychological problems. Eating disorders put the body under great strain and the medical impact of an eating disorder touches every organ system inside the body.

The most commonly recognised and prevalent of these disorders are:

Anorexia: characterised by an extreme fear of gaining weight, an abnormally low body weight and a distorted perception of weight.

Persons suffering from anorexia have a strong wish to control their weight and shape and use extreme efforts, including starvation, to achieve this objective.

Bulimia: characterised by frequent and uncontrollable episodes of overeating or binges, habitually consisting of the consumption of thousands of calories in a single sitting, accompanied by extreme efforts to avoid gaining weight, such as purging.

Binge eating disorder: compulsive eating without purging behaviours.

It is characterised by recurring episodes of excessive food consumption over a short period of time, often to the point of discomfort.

Restrictive food intake disorder: a type of extreme picky eating or food phobia that is characterised by a restriction or avoidance of certain foods that sufferers find themselves unable to eat – to the extent that sufferers cannot meet their nutritional needs through food intake alone.  

How can parents notice if a child has an eating disorder?

Generally those who suffer from eating disorders, especially in the initial stages, manage to hide it very well.

Psychiatrist Anton Grech says parents must always be on the lookout for any changes in the behaviour of their children.

These changes need not be specific to eating disorders but can be more generic. Examples include a drop in performance at school and increased erratic behaviour.

More specific to eating disorders, parents must be on the lookout for any changes in eating patterns and food amounts... if they start to eat on their own... or if they leave the table immediately after eating. Big swings in weight are also key signs.

What kind of help would someone with an eating disorder need? 

A person with an eating disorder needed a lot of compassion and love, Grech said.

“Many times the love has to be of the ‘tough love’ type. It is important that one seeks professional help,” he said.

“So, it must be given from a team of professionals. Such teams can consist of psychiatrists, doctors, psychologists, nurses, nutritionists, physios, occupational therapists and others.

“Treatment can be given either at home or as an inpatient, depending on the severity of the condition,” Grech said.

Dar Kenn Għal Saħħtek can be reached by calling 2145 3690, by visiting their website www.dks.org.mt or finding them on Facebook.