Living with Bulimia in Pakistan

By Sana Ahmed

Content Warning: This blog contains discussions of disordered eating and body-shaming which some readers may find triggering.

I grieve all the minutes, hours and years lost to an eating disorder.

I was only 14 the first time I threw up in a bathroom stall during lunch at school. This activity slowly became my way of escaping the daunting hour that was lunch, where I would wonder whether I had eaten 'too much.' My mind would often compare my appetite to those of my peers. As a coping mechanism, the urge to throw up consumed me. I still remember the act of purging felt violent and shameful, but it immediately brought with it a sense of relief; it made me feel like I had regained control over my body and thoughts.

Looking back at it now, I realize that this was my way of dealing with the culture shock of moving from Lahore to London. For the first time in my life, I felt uncomfortable in my skin and had suddenly become aware of how different I looked to most of my relatively slimmer classmates. Although the initial intent behind my purging was to lose weight and fit into my surroundings, it soon developed into my personal coping mechanism.

I began using it to cope with several complex emotions and anxieties.

With time, I got deeper into a vicious cycle of restricting my diet, bingeing food, and then purging it all out. My body normalized the act of throwing up. Through all this, I was convinced I did not have a clinical eating disorder, mainly because I didn't perceive myself to be severely underweight. Instead, I saw my body fitting into the crowd at school, not realizing at the time, that my brain was comparing my body to individuals who were themselves experiencing some form of disordered eating. (I found out about this years later in a conversation with a group of old school friends)

For the next five years, these thoughts consumed me for hours every single day. I was expelling enormous amounts of energy, worrying about my body, planning my next purge, hiding my actions, and fearing the next meal. Eventually, I shared my experiences with a close friend, and she noticed that I spoke with such conviction about the 'positives' that came about due to disordered eating. I firmly believed that my actions were not unhealthy. It was only after my friend repeated my words back to me, approaching the conversation in a very blunt and straightforward manner, that I began to realize how deep I was into disordered eating. Even after this initial conversation, it took months of me refuting my friend's efforts to give in and seek help finally.

The process of getting help was an intense one. I was assigned to a team of therapists, psychiatrists, and medical consultants who worked with me to help me begin my recovery. Soon, I was formally diagnosed with Bulimia. Although receiving the diagnosis brought a sense of relief, it also meant that I had to face the reality of how much harm I had inflicted on my body. The reports that followed informed me that I had developed multiple stomach ulcers and become anaemic. According to my medical team, my heart was under strain due to the violent purging. My gums suffered damage from the excessive throwing up, and I also began noticing that I was experiencing hair loss.

After spending three years in therapy, I began to unlearn old habits and adopt a healthier mindset. This phase coincided with my family's decision to move back to Lahore, and this was when I began the most challenging part of my recovery. The transition was especially difficult due to the lack of understanding of eating disorders in Pakistan. Women in Pakistan would applaud each other for losing weight quickly, generating more guilt in my brain for not trying to lose weight (or, in my case, not throwing up). "Oh, you look more normal now,"- a very close family member said to me after a relapse left me much thinner. Other family members would question the legitimacy of my struggles on the daily, constantly making remarks downplaying the seriousness of the issues I was dealing with: "Beta, aap ulti kerna chor dou bas, ismay itna mushkil kya hai?" (Why don't you just stop throwing up, what's so hard about that?) As a result of such comments, I shied away from discussing therapy and openly discussing my experiences with ED.

I was made to feel incredibly alone in my journey to complete recovery.

As I began developing healthier eating habits and stopped purging, I experienced a natural weight gain which was met by multiple comments from 'aunties,' “Beta, aapnay itna gain kerliya hai, gym nahi jaa rahi aaj kal?” (You've gained so much weight, aren't you going to the gym nowadays?) These remarks and questions felt like a direct attack on my decision to overcome my struggles. I began to slowly ponder whether my 'recovered' body would ever find acceptance in a society that ran rampant with toxic diet culture.

It was a whole year before a friend openly shared her disordered eating struggles with me. Hearing her experience with an ED in Pakistan gave me the confidence to open up about my struggles. I started setting personal boundaries about my eating habits very vocally, and soon multiple close friends also began sharing their own experiences. It was heartbreaking to see just how many women were struggling, how many of them had to face comments about their weight fluctuations, and the subtle hints to lose weight. I felt so much empathy for all the Pakistani women who are victims of these intrusive and preoccupying thoughts and emotions; limiting all of us and keeping us from achieving everything that we are capable of.

It has now been nine years since I first purged and four since I sought help for it. Through countless hours of therapy and personal growth, I have learned how to manage the ED thoughts and behaviours better than before. But with the world we live in, coupled with toxic diet culture, moving away from disordered eating can be extremely difficult. Most disordered eating is encouraged in Pakistani households. The numerous fad diets, cutting out of entire food groups periodically, celebrating others' weight loss are all just behaviors promoted on a daily basis. Refusing to lose weight and accepting the body that helped me regain my health and happiness seems to be an act of rebellion in a society like Pakistan's.

I write this post with the intent to empower people like me, who have been struggling for so many years, to speak freely and be comfortable in sharing their struggles. Just knowing that you are not alone in your day-to-day, meal-to-meal struggles is very reassuring. Helping others regain their confidence brings me a step closer every day to helping me regain mine.

Don't get me wrong - I still have my daily struggles, lack of self-confidence; on certain days, my insecurities are louder and may win. Still, I keep pushing to make this a better place for the future. One where we can finally accept eating disorders as a legitimate struggle and recognize their complexities to better understand them.

264 views0 comments

Recent Posts

See All

“A boy was born. That hyperactive ball of energy did not sleep for the first 9 days of his life,” tells my mother with a tiresome yet loving smile on her face. That, I would say, was a rock solid hint