The Quest for a Healthier Life

LAU specialists weigh in on diet trends and the impact on mental and physical health of body image dissatisfaction and disordered eating in Lebanon.

By Hanan Nasser

The ultimate advice to modify one’s weight and sustain it is to make changes that can be maintained through behavioral modification.

With the beach and wedding season in full swing, it is not uncommon to find friends and family resorting to quick-fix fad diets, indifferent to their health hazards and the fact that they are impossible to sustain as a healthy lifestyle.

Such trends exploded in Lebanon with the boom of social media and the growing impact of influencers, especially on the younger generation.

“Many bloggers and influencers give diet advice and are paid to showcase certain products and diets. The younger generation is very inclined to believe and follow them,” said Associate Professor of Nutrition at LAU Nadine Zeeni.

Indeed, LAU specialists have shown that social media use – among other factors – can have negative effects on the physical and mental health of both men and women.

A collaborative study published in 2018 by Dr. Zeeni, Associate Professor of Psychology Maria Jose Sanchez Ruiz and Associate Professor of Nursing Rita Doumit found a correlation between the use of mobile phone multimedia and unhealthy eating habits and stress.

The study concluded that “social media use was associated with body image dissatisfaction (BID), eating disorders (EDs) risk, and the self-control construct of trait emotional intelligence (TEI).”

The Fad Diet Myth

While fad diets are not necessarily a reflection of an eating disorder, they could be an indicator of BID, which in turn could be a predictor of disordered eating (DE) and eating disorders. DE includes eating restraint, emotional eating, and skipping meals, which is the case in intermittent fasting. 

“Disordered eating in general is associated with clinical eating disorders, but it doesn’t necessarily mean that if you follow those fads you will develop an eating disorder. But it is a mediator,” explained Dr. Zeeni, who is also the coordinator of the Nutrition Program.

Addressing two recent diet fads – the keto diet and intermittent fasting – Dr. Zeeni rejected both as a means for sustainable weight adjustment, even going as far as warning of the former’s harmful effects on health.

“The keto is not nutritionally adequate. It is high in salt, fat and saturated fat, which is bad for the cardiovascular system, and it is low in some important vitamins and minerals. Moreover, you are preventing your body from getting enough carbohydrates, which are the quickest and easiest source of energy, and needed by the brain,” she said. 

Although intermittent fasting does not have the same adverse effects on health, it is often incompatible with social life, and equally unsustainable. When lunches and dinner parties make it impossible to skip meals, “a lot of people end up compensating in the hours that they are allowed to eat,” she said.

One thing is for certain, popular diets “promote fast weight loss, and are sometimes extremely unhealthy and lead to very fast weight regain,” she cautioned.

Studies have also shown that the Mediterranean diet is one of the healthiest diets and even plays an active role in preventing dementia and Alzheimer’s.

The ultimate advice to modify one’s weight and sustain it is to make changes that a person can maintain through behavioral modification. The key, Dr. Zeeni said, is to not feel constantly deprived or stressed.

BID Does not Discriminate

More alarming is the link between social media and BID in pregnant women in Lebanon, according to research conducted by Dr. Zeeni and her students, which concluded that social media use, and more specifically image-posting, “may increase body image dissatisfaction and appearance comparison during pregnancy, leading to restrictive dietary behavior and poor weight gain.” The study is still under review for publication.

A recent study conducted on female undergraduate students in Lebanon (ages 18-25), Dr. Sanchez Ruiz pointed out, had found that “21.2 percent of those surveyed were at risk of developing an eating disorder, and 11.4 percent had been diagnosed with anorexia nervosa, bulimia, or binge eating disorder.”

While literature on the issue of BID and DE has focused mainly on females, another collaborative study published in 2017 by Dr. Sanchez Ruiz, Dr. Zeeni and Dr. Doumit examined predictors of disordered eating in males, which remains an under-examined topic.

The study revealed that “media influence and strategies to decrease body weight had direct effects on depressive symptomatology, which in turn predicted emotional eating” among males as well.

Dr. Doumit said that “people tend to think that men do not struggle with BID like women, only because they are understudied. But all the literature that is coming out now is actually showing that they do.”

Such topics have also attracted the attention of students at LAU such as psychology alumna Stephanie Farah (BA’ 19). In her capstone project, Farah found that at least 50 percent of respondents in her sample “engaged in restrictive eating behaviors and scored high on emotional eating.”

What Can Be Done

To counter BID and DE in college students, Dr. Sanchez Ruiz called for public health and psychological interventions.

“The university environment provides an ideal setting for the prevention of body-image related problems due to ease of access to students for screening and diagnosis and the possibility of incorporating programs targeting these issues into the academic curriculum and various other college activities,” Dr. Sanchez Ruiz said.  

She also recommended implementing an early detection system through school-based screening as a preemptive measure. 

“Our research has shown that emotional intelligence components are related to BID and disordered eating, in line with international research findings,” she said. As such, prevention programs would greatly benefit from incorporating an emotional education component.

Dr. Sanchez Ruiz has designed an evidence-based training program on emotional intelligence focused on promoting skills among Lebanon’s youth to perceive, understand, and regulate their emotions. This approach will help counter the “unrealistic ideals portrayed in social media,” among other challenges faced by this population.

Similarly, Dr. Doumit is in the process of developing remedial and preventive educational programs based on cognitive behavior therapy to help the youth build coping skills to deal with anxiety, depression, obesity, and improve their self-esteem and resilience. All of which play a key role as predictors for BID.

“The concept is very complex because there are many factors that can trigger BID, but that can also be an outcome of BID,” she said.

The popularity of fad diets and the need to counter BID have also prompted Dr. Zeeni to give sessions in her major and elective classes about the effects of social media and such diets to set the record straight and raise awareness.

“Nutrition is one of the fields where you have the most misinformation. It is a constant struggle for everyone in my field to fight this,” she said.