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Sixteen-year-old Nina Ahmad from Shah Alam, Selangor knows too well the agony of an eating disorder. At 152cm tall, the petite, outgoing girl was doing well at school until the disorder took a toll on her well-being and studies.
"Most of my friends would go on a diet if their boyfriends told them they looked fat. However, I went on a crash diet after my parents repeatedly commented on my weight. They said I had chubby cheeks and the fattest among my six siblings," she says.
She felt depressed because of the negative remarks and started skipping meals to shed some kilos.
"I avoided greasy foods and fast food, and opted for soupy meals such as tom yam - I drank the soup, but did not eat the ingredients.
"I stopped eating eventually, and drank only plain water for several weeks. I thought I'd slimmed down, and I was frustrated when my parents didn't think so," she says.
Her teachers and friends noticed her behavioural changes due to extreme dieting. "I was lucky because I didn't fall sick, but I was weak and I experienced constant mood swings.
"I was always sleepy in class and unable to focus or give full attention. And that was when my teachers and friends realised that something was wrong and I needed help," she says.
SIZE ZERO IS KING
The "size-zero" or "thin is beautiful" trend is on the rise in the region, including Malaysia, particularly among adolescent girls, even as young as 10 years old. The pressure to slim down to look attractive (not to be healthy) has forced girls like Nina to refrain from eating.
The trend is prevalent among celebrities. It seems having talent alone is not enough.
Consider the waif-like figures of top Korean pop group Girls' Generation. The girls are famous for practising a spartan diet and rigorous workout regimes as they are under enormous pressure to stay thin, which seems to be an ideal of beauty in the Korean entertainment industry.
Kelly Osbourne, Jennifer Hudson and Adele are among the hundreds of celebrities who have become targets of weight bias, no thanks to critics or fans who label them "too fat" or "too big" in an industry where image appears to be everything.
Kelly, the daughter of Ozzy Osbourne (vocalist of British rock band Black Sabbath) who stars in the reality show The Osbournes, ended up in rehabilitation centres several times after being called "fat and ugly" by the press several years ago.
A music producer told Hudson that her full-figured body was "too big", while Adele was recently scrutinised for being a "little too fat" by the creative director of Chanel.
However, unlike these celebrities, some Malaysian girls are up against more familiar critics - those who criticise their plus-sized bodies are their own parents.
Skipping rice
SKIPPING RICE
Mia Suhaimi from Ampang, Selangor is an active, extrovert 10-year-old.
Mia, a school prefect, is among her school's top students, and loves taekwondo, netball, cycling and running. At 144cm tall and weighing 44kg, Mia felt that she was overweight and started to do without rice in her meals, particularly after her parents and relatives, who mainly have slim figures, made negative remarks about her size.
"I didn't mind my friends calling me a fatso or buncit (bulging tummy), but I just couldn't stand it if the remarks came from my parents or relatives. And that's the main reason I went on a diet. I want to be thin because I think thin is pretty," she says.
Mia seldom enjoys shopping for clothes with her mother because she knows that it is difficult to find nice children's clothes to fit her.
"My mother will get irritated if I can't fit into any pants because of my bulging tummy. Usually I end up buying pants meant for 15-year-olds," she says.
Mia's mother, Laila Abdullah, 40, says Mia is "slightly chubbier" compared with the rest of the family members. Her family members, especially from her husband's side, have slender figures.
"Mia used to be thin during her kindergarten and early primary school years, but started putting on weight last year. We sometimes jokingly tease her, especially when we shop for her clothes. I am aware that she skips rice or dinner because she thinks she is fat. I will make noise if she doesn't eat at all in a day.
"Anyway, I'm not that worried. Mia is still her usual self. She is active in sports and doing well at school," she said.
Mia, the second of three siblings, says her mother tried to get her to eat healthy foods such as wholemeal bread or salads, but she refused.
"The food is not delicious at all. I just don't eat rice or skip a few meals."
TREND AMONG AFFLUENT URBANITES
Counselling psychologist Shankar Thiruchelvam says the trend of young girls like Nina and Mia trying to get thin to look pretty is especially predominant among affluent families in urban areas such as Kuala Lumpur.
"The trend is more prevalent among girls aged between 15 and 25 than among boys. It is important for us to understand why it is happening and how social class plays a large role in the problem.
"There is a greater tendency for girls from affluent families with high purchasing power to fall victim to the trend because they are exposed to many alternatives or options to look good," he says.
One in 10 young girls is prone to various eating disorders such as anorexia nervosa or bulimia nervosa.
The problem tends to be less prevalent in low-income families where putting food on the table outweighs the need to go for facials, buying make-up or going to the gymnasium.
Shankar says the media, peer pressure and family upbringing are the main factors which contribute to the situation.
The media sets the standard or shapes the perception of beauty in society through constant subtle messages.
"Messages such as 'you're not good enough' and 'you need to use this product to look attractive or slimmer' will be reinforced in a person's mind every time he or she is exposed to advertisements, print or online beauty magazines, newspapers, television or radio commercials, as well as the Internet."
Fitness a trend
FIT A TREND
"The growing number of gymnasiums and slimming centres in Kuala Lumpur in recent years has also been sending messages to city dwellers that being slim is important and trendy," he says.
The trend is also driven by the entertainment industry where celebrities define beauty in terms of well-toned bodies or glowing skin, pretty outfits and fancy hairdos.
"Music videos, for instance, give the impression that you need to look as good as celebrities to be accepted in society."
The need to fit in, or to belong to a peer group at schools or colleges, is another contributing factor to the disturbing trend.
Shankar says individuals who look better or thinner are usually easily accepted by their peers, with the rest as so-called "outcasts". "The outcasts struggle to fit in, and become easily susceptible to crash dieting or eating disorders."
Family upbringing is another significant factor that contributes to the increasing trend.
"And what is more worrying is the trend of disintegrated families is increasing among affluent families in urban areas. This scenario will leave a 'vacuum' in the family, resulting in children doing anything to be accepted or endorsed by other people or peer groups." Girls brought up by critical or authoritative parents, or within a society that equates beauty with good fortune or luck, are also likely to be affected by the trend.
"By telling their children what they should look like, parents are sending subtle messages on 'ideal beauty' to them. And to achieve the perceived image, the affluent families are those who can afford the means."
POSITIVE PARENTING IS KEY
Eating disorders among young girls are the manifestations of a bigger issue, which is low self-esteem or low self-confidence.
"If a girl has love and affection at home, she will feel secure and confident, and is less likely to be influenced by the media or peers in projecting her self-image. And to achieve this, strengthening family ties and emotional bonding is crucial. Positive parenting is also key," says Shankar.
Positive parenting includes respecting children's needs, abilities and opinions.
"It is challenging for a family to spend quality time together and strengthen emotional bonding, especially in our fast-paced city life. However, it can be done, but it requires time, persistence and patience.
"Parents have to show their children that they care. If their daughters have shown signs that they are prone to eating disorders, don't delay. Get professional help."