Anorexia nervosa among female secondary school students in Ghana

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

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

The body mass index (BMI) of consenting students was calculated after measuring their height and weight. Those with a BMI

Of the 668 students who were screened for BMI, 10 with a BMI <17.5 kg/m(2) 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.

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