Families in Pakistan often notice something is off before they have words for it. A teenager who used to love biryani now picks at her plate. A university student in Lahore starts skipping sehri during Ramadan even when he is not fasting. A young woman weighs herself three times a day and still insists she is overweight. These are not just phases or fads. They may be early signs of an eating disorder.
Eating disorders are serious mental health conditions that affect how a person thinks, feels, and behaves around food, body weight, and body image. They are not a lifestyle choice or a sign of weakness. According to a 2024 study published in PMC examining Pakistani undergraduate students, roughly 19.5% showed signs of disordered eating, with binge eating episodes being the most commonly reported behaviour. A separate 2025 systematic review in Research Square, analysing 21 studies on Pakistani youth, found a strong association between heavy social media use and disordered eating, with Instagram and TikTok named as key drivers of body dissatisfaction.
Spotting the signs early matters. Most people with eating disorders do not look visibly unwell, and the behaviours often develop quietly over months. Knowing what to look for, whether in yourself or someone you care about, can make a real difference.
کھانے کی خرابی: اہم نکات
کھانے کی خرابی (eating disorder) ایک سنگین ذہنی صحت کا مسئلہ ہے جو پاکستان میں نوجوانوں، خاص طور پر طالب علموں میں بڑھتا جا رہا ہے۔ اس میں کھانے سے انکار، بہت زیادہ کھانا، یا کھانے کے بعد الٹی کرنا شامل ہو سکتا ہے۔ سوشل میڈیا پر غیر حقیقی جسمانی تصاویر دیکھنے سے جسمانی بے اطمینانی بڑھتی ہے۔ اگر آپ یا آپ کا کوئی قریبی ان علامات میں سے کسی کا شکار ہو تو فوری طور پر کسی ماہر ڈاکٹر سے رجوع کریں۔
What Is an Eating Disorder?
An eating disorder is a psychological illness involving persistent, harmful patterns around food and eating that cause significant distress or physical harm. The main types recognised by clinical guidelines (DSM-5) are:
| Type | Core Pattern | Key Feature |
|---|---|---|
| Anorexia Nervosa | Severe food restriction | Intense fear of weight gain, distorted body image |
| Bulimia Nervosa | Binge eating followed by purging | Self-induced vomiting, laxative use, or over-exercise |
| Binge Eating Disorder (BED) | Repeated uncontrolled overeating | No purging; followed by shame or distress |
| ARFID | Avoidance of foods by texture, smell, or taste | Not driven by body image concerns |
A common misconception in Pakistan is that eating disorders only affect thin girls. Research shows most people with eating disorders are not underweight, and the conditions affect boys and men too. The 2024 PMC study on Pakistani undergraduates noted a changing trend in eating disorder presentation among male students, a group that is rarely screened.
Physical Warning Signs of an Eating Disorder
Physical signs can appear gradually and are sometimes mistaken for other health problems. They include:
- Noticeable, unexplained weight loss or frequent weight fluctuations
- Feeling cold all the time, even in Karachi’s summer heat
- Hair thinning or hair loss
- Dry skin, brittle nails, or poor wound healing
- Frequent dizziness or fainting, especially when standing up quickly
- Swollen jaw or cheeks (a sign of repeated purging in bulimia)
- Dental erosion or tooth sensitivity (from stomach acid during vomiting)
- Irregular or absent periods in women and girls
- Persistent bloating, constipation, or stomach pain
- Fatigue that does not improve with rest
Not every person will show all of these. Some people with eating disorders have no visible physical signs at all, particularly in the early stages. You cannot tell whether someone has an eating disorder by looking at their weight.
Behavioural Signs of an Eating Disorder
Behaviour around food is often the clearest early signal. Watch for patterns that persist over weeks rather than a single incident.
- Skipping meals regularly or making excuses to avoid eating with the family
- Eating in secret, hiding food, or hoarding large amounts of food
- Cutting out whole food groups without a medical reason (all carbs, all fats, all sugar)
- Going to the bathroom immediately and consistently after every meal
- Obsessively counting calories or checking food labels at every meal
- Rigid food rituals, such as eating only certain foods in a specific order
- Exercising compulsively, even when unwell or injured, to “burn off” what was eaten
- Wearing loose, baggy clothes to hide the body, even in Lahore’s summer months
- Throwing food away or rearranging it on the plate to appear to have eaten
In Pakistani households, skipping family meals, refusing chai with snacks, or refusing to eat at dawats (family gatherings) can be early visible signs that something has changed.
Emotional and Psychological Signs of an Eating Disorder
These signs are often the most overlooked, partly because they overlap with anxiety and depression, which are also common in Pakistani youth.
- An intense, constant preoccupation with food, calories, weight, or body shape
- Believing oneself to be fat or overweight despite being a healthy weight
- Extreme anxiety or irritability around mealtimes
- Low self-esteem tied almost entirely to body weight or appearance
- Withdrawal from friends and family, especially around food-related social events
- Feelings of shame, guilt, or disgust after eating
- Perfectionism and a need for rigid control, often extending beyond food
- Mood swings that seem linked to eating or not eating
According to the National Eating Disorders Association (NEDA), a person does not need to show all of these signs at once. Even a cluster of two or three persistent patterns is worth taking seriously.
Why Pakistani Teenagers and Young Adults Are at Higher Risk
Eating disorders can affect anyone, but certain factors raise the risk. For young Pakistanis specifically, two stand out.
First, social media exposure. A 2025 systematic review analysing studies on Pakistani youth found that platforms like Instagram and TikTok amplify unrealistic beauty standards and fuel body dissatisfaction, with young women and urban populations being most affected. Students in Islamabad, Lahore, and Karachi who spend several hours daily on these platforms are particularly exposed to appearance-based comparisons.
Second, cultural weight commentary. In many Pakistani families, remarks about a person’s weight, whether “you’ve gotten fat” or “you look too thin,” are common and considered normal. Research suggests this kind of repeated commentary can contribute to body dissatisfaction and disordered eating, especially in adolescents who are already sensitive to social pressure. Combining family weight remarks with social media body ideals creates a difficult environment for a young person’s relationship with food.
If you are concerned about a young person’s relationship with food, the sugar addiction signs and effects guide on Marham also covers how compulsive eating patterns develop and overlap with disordered eating.
How to Talk to Someone You Are Worried About
Approaching someone about a possible eating disorder takes care. Confronting them about their weight or food intake directly tends to increase shame and defensiveness.
- Choose a calm, private moment, not during or after a meal.
- Focus on what you have noticed, not on weight. Say “I’ve noticed you seem anxious at mealtimes” rather than “you’re not eating enough.”
- Listen without judgment. Don’t offer quick fixes or tell them to “just eat normally.”
- Avoid commenting on their body or comparing them to others.
- Offer to help them find support, not to fix the problem yourself.
- Be patient. A person may not be ready to accept help the first time.
- Seek guidance from a mental health professional if you are unsure how to proceed.
In Pakistan, where mental health conversations carry stigma, framing the concern around physical health (fatigue, hair loss, dizziness) can sometimes make it easier for a person to accept help without feeling judged.
Get Expert Support Through Marham
If you recognise several of these signs in yourself or someone close to you, it is worth speaking to a professional. Eating disorders are treatable, and earlier support generally leads to better outcomes. A psychiatrist or clinical psychologist can assess what is happening and guide the next steps, which may include nutritional support, therapy, or both.
Marham connects you with verified psychiatrists in Pakistan who consult online from anywhere in the country. You don’t need to travel to a major hospital or wait weeks for an appointment. A short online consultation can help clarify whether what you or your loved one is experiencing needs clinical attention or a structured support plan.
For nutritional guidance alongside mental health support, Marham also works with qualified nutritionists in Pakistan who understand the Pakistani diet and can help rebuild a healthy, sustainable relationship with food.
Frequently Asked Questions
Is an eating disorder a mental illness?
Yes, eating disorders are classified as serious mental health conditions. They involve psychological distress around food, body image, and weight that causes significant harm to a person’s physical and emotional wellbeing.
Can men and boys get eating disorders in Pakistan?
Yes. Eating disorders affect people of all genders. A 2024 study on Pakistani undergraduate students noted an increasing trend of eating disorder symptoms among male students, a group that is rarely screened or treated.
What are the early signs of anorexia nervosa?
Early signs of anorexia include persistent food restriction, an intense fear of weight gain, and seeing oneself as overweight despite being at a healthy or low weight. Fatigue and skipping family meals are often the first things family members notice.
How do I know if I have an eating disorder or am just dieting?
Dieting is time-limited and flexible. An eating disorder involves persistent, rigid patterns that cause distress, interfere with daily life, and are hard to control or stop. If thoughts about food dominate your day or eating causes significant anxiety, consult a doctor for a proper assessment.
When should you see a doctor for an eating disorder?
See a doctor if the signs have persisted for more than a few weeks, if physical symptoms like dizziness, hair loss, or missed periods appear, or if the person seems distressed around food. Early professional evaluation leads to better outcomes.
Can eating disorders be treated?
Yes, eating disorders respond to treatment. Approaches typically include psychotherapy (such as cognitive behavioural therapy), nutritional counselling, and sometimes medication. Recovery takes time, but it is possible with the right professional support.
Does Ramadan fasting cause eating disorders?
Ramadan fasting itself does not cause eating disorders. However, for someone already struggling with disordered eating, the fasting cycle can intensify restrictive or binge-purge patterns. If eating behaviour becomes significantly more distressed during or after Ramadan, it is worth discussing with a healthcare provider.
Conclusion
Eating disorders are more common among Pakistani youth than most families realise, and the signs are easy to miss or explain away. Physical changes, shifts in behaviour around food, and emotional distress tied to body image are the three areas worth watching. Spotting a pattern early and approaching it with care, rather than judgment, gives the person the best chance of getting support that works.
