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Anorexia nervosa among female secondary school students in Ghana

  • Dinah Bennett (a1), Michael Sharpe (a2), Chris Freeman (a3) and Alan Carson (a4)
Abstract
Background

We set out to determine whether anorexia nervosa exists in a culture where the pressure to be thin is less pervasive.

Aims

To determine whether there were any cases of anorexia nervosa in female students attending two secondary schools in the north-east region of Ghana.

Method

The body mass index (BMI) of consenting students was calculated after measuring their height and weight. Those with a BMI ⩽19 kg/m2 underwent a structured clinical assessment including mental state, physical examination and completion of the Eating Attitudes Test and the Bulimic Investigatory Test, Edinburgh. Participants nominated a best friend to serve as a comparison group, and these young women underwent the same assessments.

Results

Of the 668 students who were screened for BMI, 10 with a BMI <175 kg/m2 appeared to have self-starvation as the only cause of their low weight. All 10 viewed their food restriction positively and in religious terms. The beliefs of these individuals included ideas of self-control and denial of hunger, without the typical anorexic concerns about weight or shape.

Conclusions

Morbid self-starvation may be the core feature of anorexia nervosa, with the attribution for the self-starvation behaviour varying between cultures.

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Copyright
Corresponding author
Dr Dinah Bennett, Specialist Registrar in Psychiatry, Department of Psychiatry, St John's Hospital, Howden Road West, Livingston, Edinburgh EH54 6PP, UK. E-mail: Dinah.Bennett@lpct.scot.nhs.uk
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Declaration of interest

None.

Footnotes
References
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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). Washington, DC: APA.
Banks, C. G. (1997) The imaginative use of religious symbols in subjective experiences of anorexia nervosa. Psychoanalytic Review, 84, 227236.
Becker, A. E., Burwell, R. A., Herzog, D. B., et al (2002) Eating behaviours and attitudes following prolonged exposure to television among ethnic Fijian adolescent girls. British Journal of Psychiatry, 180, 509514.
Bemporad, J. (1996) Self-starvation through the ages: reflexions on the pre-history of anorexia nervosa. International Journal of Eating Disorders, 19, 217237.
Bhadrinath, E. R. (1990) Anorexia nervosa in adolescents of Asian extraction. British Journal of Psychiatry, 156, 565568.
Blair, C., Freeman, C. & Cull, A. (1995) The families of anorexia nervosa and cystic fibrosis patients. Psychological Medicine, 25, 985993.
British Medical Association & Board of Science and Education (2000) Eating Disorders, Body Image and the Media. London: BMJ Books.
Garfinkel, P. E., Lin, E., Goering, P., et al (1996) Should amenorrhoea be necessary for the diagnosis of anorexia nervosa? Evidence from a Canadian community sample. British Journal of Psychiatry, 168, 500506.
Garner, D. M. & Garfinkel, P. E. (1979) The Eating Attitudes Test, an index of symptoms of anorexia nervosa. Psychological Medicine, 9, 273279.
Henderson, M. & Freeman, C. P. (1987) A self-rating scale for bulimia: the ‘BITE'. British Journal of Psychiatry, 150, 1824.
Khandelwal, S. & Saxena, S. (1990) Anorexia nervosa in people of Asian extraction. British Journal of Psychiatry, 157, 783784.
Lee, S. (1996) Reconsidering the status of anorexia nervosa as a western culture-bound syndrome. Social Science and Medicine, 42, 2134.
Lee, S., Ho, T. & Hsu, L. (1993) Fat phobic and non-fat phobic anorexia nervosa: a comparative study of 70 Chinese patients in Hong Kong. Psychological Medicine, 23, 9991017.
Le Grange, D., Telch, C. & Tibbs, J. (1998) Eating attitudes and behaviours in 1435 South African Caucasian and Non-Caucasian college students. American Journal of Psychiatry, 155, 250254.
Morgan, J., Marsden, P. & Lacey, H. (2000) ‘Spiritual Starvation?’ A case series concerning Christianity and eating disorders. International Journal of Eating Disorders, 28, 476480.
National AIDS/SDI Control Programme, Disease Control Unit (2001) Estimating national HIV prevalence in Ghana using sentinel surveillance data. Accra: Ministry of Health. http://www.policyproject.com/pubs/countryreports/GhanaNatEst2000.pdf
Onis, M. & Habicht, J. (1996) Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. American Journal of Clinical Nutrition, 64, 650658.
Oyewumi, L. K. & Kazarian, S. S. (1992a) Abnormal eating attitudes among a group of Nigerian youths: I. Bulimic behaviour. East African Medical Journal, 69, 663666.
Oyewumi, L. K. & Kazarian, S. S. (1992b) Abnormal eating attitudes among a group of Nigerian youths: II. Anorexic behaviour. East African Medical Journal, 69, 667669.
Park, R. J., Lawrie, S. M. & Freeman, C. P. (1995) Post-viral onset of anorexia nervosa. British Journal of Psychiatry, 166, 386389.
Patton, G. C., Selzer, R., Coffey, C., et al (1990) Abnormal eating attitudes in London schoolgirls – a prospective epidemiological study: outcome at twelve month follow-up. Psychological Medicine, 20, 383394.
Rampling, D. (1985) Ascetic ideals and anorexia nervosa. Journal of Psychiatric Research, 19, 8994.
Spitzer, R. L., Williams, J. B. & Kroenke, K. (1994) Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 Study. JAMA, 272, 17491756.
Szabo, C. (1998) Tuberculosis and anorexia nervosa. South African Medical Journal, 3, 274276.
Szabo, C. & Hollands, C. (1997) Abnormal eating attitudes in secondary-school girls in South Africa – a preliminary study. South African Medical Journal, 87, 524530.
Trusswell, S. (1999) ABC of Nutrition. London: BMJ Books.
Wassenaar, D., le Grange, D., Winship, J., et al (2000) The prevalence of eating disorder pathology in a cross-ethnic population of female students in South Africa. European Eating Disorders Review, 8, 225236.
World Health Organization (1992) Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD-10). Geneva: WHO.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
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Anorexia nervosa among female secondary school students in Ghana

  • Dinah Bennett (a1), Michael Sharpe (a2), Chris Freeman (a3) and Alan Carson (a4)
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