National Eating Disorders Awareness Week and Its Relevance in Sri Lanka
Written by: Pansiluni Weerawansa
Photo by Getty Images
Eating disorders are relatively complex mental health conditions that seemingly surpass cultural, geographical, and socio-economic boundaries. National Eating Disorders Awareness Week (NEDAW) falls between the 24th of February and the 2nd of March 2025, and serves as a pivotal time to shed light on these often-misunderstood disorders, foster conversations, and provide support for those affected. Although eating disorders have been the focus of extensive studies in Western societies for years, their existence in countries like Sri Lanka is better understood in light of cultural idiosyncrasies, societal pressures, and evolving ways of life, which provide the context where disordered eating behaviour can occur.
Eating disorders are a chain of psychopathological syndromes characterized by abnormal relationships with food, abnormal attitudes towards the body and to self-esteem. The key forms are:
– Anorexia Nervosa: characterised by severe limitation of food intake, grossly excessive fear of gaining weight, and distortion in body image. Individuals perceive themselves as overweight even though they are underweight, leading them to severely restrict their food intake and exercise intensively.
– Bulimia Nervosa: involves recurring cycles of binge-eating and compensatory actions such as self-induced vomiting, excessive exercise, and/or improper use of laxatives. This cycle is driven by the fear of weight gain and is generally accompanied by feelings of guilt and shame.
– Binge Eating Disorder (BED): Marked by repeated occurrences of consuming large quantities of food without control, often resulting in distress and guilt. In contrast to bulimia, individuals with BED do not engage routinely in compensatory behavior.
– Other Specified Feeding or Eating Disorders (OSFED): A diagnosis for atypical presentations of these disorders that are still severe enough to interfere with a person’s health and well-being.
These diseases are not merely about food – they are manifestations of underlying psychological disorders, including low self-esteem, perfectionism, and control. Physical harm can be severe, striking cardiovascular and gastrointestinal systems, often leading to malnutrition.
Sri Lankan culture has a strong influence on attitudes towards body image and eating behaviour. A clear comprehension of these cultural factors is critical in addressing the development of eating disorders in the nation.
1. Traditional Dietary Practices and Modern Shifts
Sri Lankan cuisine is renowned for its variety and flavor, with rice and curry being staple components. Traditional meals are balanced, incorporating vegetables, proteins, and carbohydrates. However, urbanization and globalization have introduced fast food culture, leading to a shift from home-cooked meals to readily available, processed foods. This transition has contributed to a dichotomy where malnutrition and obesity coexist, both of which can be precursors to disordered eating behaviours.
2. Societal Beauty Standards and Media Influence
Historically, Sri Lankan beauty ideals favoured fuller figures, symbolising prosperity and health. However, contemporary influences, particularly from Western media, have shifted these ideals towards slimness. The proliferation of social media platforms like Instagram and Facebook has exacerbated body dissatisfaction among Sri Lankan youth, as they are constantly exposed to curated images that promote unrealistic beauty standards. This exposure can lead to internalisation of these ideals, increasing the risk of developing eating disorders.
3. Gender Roles and Expectations
In Sri Lankan society, traditional gender roles are deeply entrenched. Women are often expected to embody grace and modesty, with physical appearance being a significant aspect of their societal value. This pressure can lead to unhealthy behaviors aimed at achieving the ‘ideal’ body. Men, too, are not immune – the emphasis on muscularity and fitness can drive them towards disordered eating and excessive exercise.
4. Stigma Surrounding Mental Health
Mental health remains a taboo in many South Asian cultures, including Sri Lanka. Eating disorders are often misunderstood or dismissed, leading to underreporting and the lack of treatment. The stigma associated with mental illness can prevent individuals from seeking help, exacerbating the severity of the disorder. Cultural perceptions that prioritize physical health over mental well-being further hinder recognition and intervention.
While public sentiment towards conditions like depression and anxiety has changed in recent times, eating disorders are still grossly misunderstood, misdiagnosed, or dismissed outright. The following is an in-depth critique of the leading hindrances to therapy in the Sri Lankan context.
1. Lack of Awareness
One of the biggest barriers to treatment in Sri Lanka is the overall lack of awareness about eating disorders. This lack of awareness exists at a number of levels:
The majority of Sri Lankans, even those who have eating disorders themselves, do not know what exactly these diseases are. Eating disorders are usually misconstrued with normal dieting, temporary stress-related eating patterns, or even voluntary behavior. A person suffering from anorexia can be envied for their self-restraint in avoiding food, and a person with binge eating disorder is blamed for not having self-control.
The majority of general practitioners and even mental health practitioners in Sri Lanka are not trained to recognize or diagnose eating disorders appropriately. Because eating disorders have physical as well as psychological symptoms, signs such as extreme weight loss, gastrointestinal issues, or fatigue may be treated as standalone medical conditions rather than being recognized as part of an underlying eating disorder. For example, a person with bulimia will see the doctor because they have acid reflux and dental complications caused by constant vomiting, but the true cause— an eating disorder—will be ignored.
Moreover, Sri Lankan school curricula are not highly focused on mental health literacy, and disordered eating is barely touched upon. Without proper education on body image and healthy relationships with food from the start, adolescents are left vulnerable to developing unhealthy habits without ever realizing they are unhealthy.
2. Cultural Perceptions: Normalization of Unhealthy Behaviors
Sri Lankan attitudes about food, the body, and mental illness powerfully shape conceptions of eating disorders as well as their recognition as authentic conditions to be treated.
Being thin is becoming the ideal in modern Sri Lankan living, particularly among women. Most individuals who exercise or diet excessively gain approval instead of being a cause of concern. A person with anorexia may receive feedback like “you’ve lost weight! You look great!” even though their weight loss is severely unhealthy.
On the other hand, the cultural importance assigned to food in Sri Lanka, as the hospitality sector exemplifies, can mask overeating behavior. Social events like eating in groups with large meals included are common happenings, and overeating ensues. A consumer with binge eating disorder might not know that their situation is not healthy, because overeating at festivals, family gatherings, or other events is acceptable and normalized, which renders their condition as unproblematic.
While thinness is complimented, weight gain is met only with stern reproaches. Relatives in Sri Lankan communities can freely pass unsolicited judgement regarding weight by commenting, “you have gained weight! You shouldn’t eat so much more” or “no man would marry you if you continue eating like that”. Societal pressure thus forces individuals to turn to disordered eating habits in order to cope with discontent over their bodies.
3. Limited Mental Health Infrastructure
Sri Lanka does not have a sufficient number of mental health specialists with experience in eating disorders. Psychiatrists and psychologists are primarily dealing with depression, anxiety, and schizophrenia, and eating disorders are given little attention. In the absence of specialists, individuals with such disorders may not receive the specialized interventions they need.
In most other countries, people suffering from severe eating disorders can be treated in inpatient treatment centers that ensure 24-hour care, nutritional support, and psychotherapy. Sri Lanka, however, does not have specialized eating disorder treatment centers, so people have to either travel overseas for treatment (which is not an affordable option for many) or opt for general psychiatric hospitals that may not specialize in the treatment of eating disorders.
To add to this, we are well aware that mental health treatment is expensive, particularly in the private healthcare system. The majority of individuals cannot afford regular therapy sessions or expert medical consultations. Public healthcare centers, although free, have long waiting lists and limited resources to effectively treat eating disorders.
4. Family Dynamics
In Sri Lankan culture, the family is central to both decision-making and one’s own health. Even though close relationships with family are a source of strength, they can also function as barriers to treatment in many ways.
· Many Sri Lankan families don’t embrace mental health issues easily. When a family member develops an eating disorder, the family might deny it as a “phase” or believe that the person simply needs more self-control. Denial of the issue prevents the individuals from seeking help.
· Family reputation is highly valued in Sri Lanka’s collectivistic society. Parents may fear that shame may be brought to the family by being open about their child’s eating disorder. They might be discouraged from seeking professional assistance by keeping this issue a secret.
· In other homes, discipline and hyper regulation of a child’s life can result in eating disorders. A child who must be “smart”, “pretty”, or has to do what everyone else wants them to do can begin to utilize eating disorders as a way of getting life in check. Again, however, parents will resist this reaction with punishment.
5. Generational Gaps in Understanding
Earlier generations in Sri Lanka have different ideas about health and nutrition. For example, a grandparent may encourage a child to eat more rice and oily foods for “strength” and simultaneously complain about their weight gain. These conflicting messages can puzzle young people and create unhealthy relationships with food.
Addressing eating disorders in Sri Lanka requires a multifaceted approach that considers cultural sensitivities and societal structures.
1. Community Education and Awareness
Implementing community-based education programs can demystify eating disorders and promote early recognition. Collaborating with local media to disseminate information can reach a broader audience, challenging misconceptions and reducing stigma.
2. Culturally Sensitive Healthcare Training
Training healthcare professionals to recognize and treat eating disorders within the cultural context of Sri Lanka is vital. Incorporating cultural competence into medical education ensures that practitioners can provide empathetic and effective care.
3. School-Based Programs
Integrating mental health education into school curricula can equip young individuals with the knowledge to identify and seek help for eating disorders. Programs that promote body positivity and media literacy can mitigate the impact of harmful beauty standards.
4. Family Involvement in Treatment
Engaging families in the treatment process acknowledges the collectivist nature of Sri Lankan society. Family-based interventions can provide a support system for the individual, fostering a conducive environment for recovery.
National Eating Disorders Awareness Week serves as a reminder that eating disorders are not confined to specific cultures or regions. In Sri Lanka, where mental health awareness is still evolving, it is crucial to break the silence surrounding these conditions. The rise in disordered eating behaviors fueled by societal expectations, media influence, and shifting lifestyles calls for urgent intervention.
The journey of change begins with education, open conversation, and systemic support. We must fight against the cultural values that perpetuate toxic beauty standards, support mental health infrastructure, and create sanctuaries for those in pain. The fight against eating disorders is not simply a matter of personal recovery—it is one of shifting the way society perceives and accepts its citizens.
This National Eating Disorders Awareness Week, let’s commit to listening without judgment, supporting without hesitation, and advocating for those who may not yet have the strength to speak up. Because no one should have to battle an eating disorder alone.
1. National Eating Disorders Association (NEDA). “Eating Disorders Overview.” [www.nationaleatingdisorders.org](https://www.nationaleatingdisorders.org)
2. World Health Organization (WHO). “Mental Health in South Asia: Public Health Challenges.” [www.who.int](https://www.who.int)
3. Eating Disorders in Asian Populations: A Critique of Current Approaches to the Study of Culture, Ethnicity, and Eating Disorders (Cummins, Lillian & Simmons, Angela & Zane, Nolan (2005)