Eating Disorders on Rise for South African Blacks

The pencil-thin models in the glossy Western fashion magazines seemed to beckon to Gcina.

A rape victim with low self-esteem, the attractive black teenager began to copy their looks and style.

On some days she would starve herself; on others she would binge on junk food, purging later with vomiting or laxatives. She followed a rigid exercise regime--two hours a day, seven days a week.

Still, at 5 foot 3 and just over 100 pounds, at her heaviest, Gcina considered herself fat, and her then-boyfriend agreed.

“To me, [supermodels] were normal because they were thin,” said Gcina, 17, who requested that her last name not be used for reasons of confidentiality.

More and more black teenagers in South Africa appear to be adopting this view. Experts on eating disorders have noticed a marked increase in the number of cases of anorexia and bulimia among blacks in recent years.

In the white community, such disorders have long been in the public spotlight, but there is a general lack of awareness among blacks, whose medical and psychological well-being was given second-rate attention under apartheid-era regimes, medical experts said.

Rotundity is still considered a sign of good health, prosperity and allure in many traditional African societies; slim women are often viewed as being less feminine and unlikely to be able to bear children. For this reason, many young blacks struggling to cope with an eating disorder often suffer in silence, their families ignorant of their condition.

“It’s an emerging problem, the extent of which we are not quite clear on,” said Christopher Paul Szabo, a professor of psychiatry and head of the eating disorders and adolescent unit at Johannesburg’s Tara Hospital.

However, anecdotal evidence and the numbers of black patients being admitted to hospitals for treatment suggest that eating disorders among blacks are on the rise, Szabo said.

So popular is the quest to be thin that many black teenagers and young adults are even having their jaws wired shut for a few weeks and consuming only liquids through a straw, according to local news reports. The procedure typically is used to immobilize fractured jaws, and the country’s main dental association says using it for weight loss is unethical.

Since the end of apartheid and the installation of black-led governments in South Africa, black women have adopted a more dynamic and high-profile role in the country. Looking good--read, in shape--is a prerequisite for high-status jobs, some women executives say.

An onslaught of Western culture and diet fads in recent years has also influenced African perceptions of beauty.

“What we’re seeing is a kind of departure from tradition,” Szabo said. “We all have in our minds the stereotypical image of traditional black beauty. The truth of the matter is those stereotypes might be shifting. We are starting to see the slender hips, the Westernized idea of beauty.”

That’s what Gcina was aspiring to, until her friends detected her curious eating habits and rapid weight loss, and persuaded her to check into Tara Hospital in October.

“I hit rock-bottom,” said Gcina, whose weight plummeted to about 70 pounds. “I was collapsing all the time. I was scared I was going to kill myself.”

Like many African parents, Gcina’s were not initially convinced that their daughter had a real ailment.

“My father thought it was too white,” said Gcina, who is scheduled to remain in the hospital until Feb. 1. “My mother tried to understand, but she didn’t.”

Medical experts said the reaction is common among traditional older-generation blacks, who simply don’t understand why eating disorders occur.

No matter the patient’s race, Szabo said, anorexia and bulimia typically are linked to problems in personal relationships, control issues and trauma.

In 1999, Gcina was raped by a stranger after she got lost on her way to a job interview. Fear and shame prevented her from reporting the crime. She felt hopeless, and when her boyfriend told her she was getting too heavy, her long-held desire to be thin became an obsession.

“The slimmer I got, the more confident I felt,” Gcina recalled. “I felt I was so much in control.”

One effort to change the perception that being big equals being unattractive is South Africa’s Miss Fats, a local beauty pageant open only to contestants weighing at least 176 pounds.

“We have found that real African women have big bums,” said Prince Tshabalala, 24, a former model and choreographer, who started the competition in 1999 to foster appreciation for heavy women. “Big women symbolize African beauty.”

“I wanted to show the world that we fuller-figured women preserve the features of the African woman,” said Mmamakgadi Masilela, 24, who entered the contest last month, weighing in at more than 300 pounds. “I’m not ashamed of myself. Whatever a skinny woman can do, I can do better. I have confidence in myself.”

Many young women here believe that large women have a harder time attracting men.

Black South African men might indeed admire a woman with a slender physique--but they would probably opt to marry one who is larger, said Tshabalala, the beauty pageant promoter and a man with a petite frame.

This is especially true among the older generation, said Marion Goldspink, an international technical consultant for Sofn’Free hair and beauty products in Johannesburg.

“It appears that when they are mature, they like their women to be built like real women--childbearing hips, fuller figures,” Goldspink said. “They would class the model-like woman as a career woman. But when a woman has [a fuller] body, they think she is going to be loving and more caring and she is going to take care of their needs.”

Psychiatrists here say one of the keys to physical and mental well-being is learning how to appreciate what you have.

After a rocky start at the hospital, Gcina feels that she is on the right track. Her food intake has more than doubled to about 2,000 calories a day, and she now weighs more than 90 pounds. She feels happier and already more confident.

“I have learned how to love myself,” Gcina said. “Beauty is not about being thin. You are never beautiful when you are too thin. It creates problems. We should accept ourselves the way we are.”