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Indonesia may consider itself up-to-date with regard to global fashion trends, but when it comes to awareness of the disorder widely associated with the industry, the country is only beginning to catch up.

“I remember 10 years ago, when people first began hearing the term ‘eating disorder,’ they thought it was very strange,” said Gregorius Pandu Setiawan, chairman of Indonesian Mental Health Network. “They knew about mental disorders, but when they heard the term, they said ‘Huh? Disorders about eating habits?’ ”

Anorexia nervosa and its close relative, bulimia nervosa, began receiving widespread Western media attention decades ago with high-profile incidents such as the self-starvation death of singer Karen Carpenter in 1983.

But Setiawan said the term “eating disorder” has only been in widespread use in Indonesia for about a decade, and the number afflicted by them has escalated over that time, though he could not cite exact figures.

He said the increase in number of patients diagnosed was due in part to higher awareness of the disorders, but also because of the increasing pressure to be thin brought about by greater access to media, such as fashion magazines that present unreasonable notions of ideal body image.

In 2006, tabloid media intensively covered the death of two young female models, bringing another wave of awareness about the disorders across the globe, including Indonesia.

Uruguayan Luisel Ramos, who was 22 years old, died of a heart attack after starving herself for months, subsisting only on lettuce and soda. A few months later, Brazilian model Ana Carolina Reston died at the age of 21 due to multiple infections. She reportedly ate only tomatoes and apples for weeks. Ramos and Reston both died with their weight far below the normal body mass index. Experts in Indonesia say the incidents were an important wake-up call for women here who idolized thin bodies.

Such obsessive “dieting,” fasting or excessive exercise have long been known to be symptoms of anorexia nervosa, usually shortened to “anorexia” in popular media though the latter is more broadly applied by heath care professionals to mean any lack of appetite among patients.

“Women are more concerned about body image and people’s opinion of them compared to men, and unfortunately many people believe that beauty means a skinny body,” Setiawan said, adding that more than 90 percent of those who suffer eating disorders are women.

“The strong demand to have a perfect figure combined with low self-esteem could trigger eating disorders that could literally kill people, mostly women in these cases,” Samuel Oentoro, a clinical nutritionist, told the Jakarta Globe on Tuesday.

Researchers say anorexia can stem from psychological causes like an unreasonable fear of gaining weight or a displaced need for control. Bulimia, in which people may eat normally or overeat and then purge afterward by stimulating the vomit reflex, is also said to be a symptom of deeper psychological problems.

“Anorexic people don’t want to eat or only eat a little but bulimic people often stick their fingers in their throats to induce vomiting and erase their guilt after eating,” Oentoro said.

He said the two disorders presented dire health threats. “Anorexic people don’t get sufficient nutrition and their body weight will continue to decline, while bulimic people lose their bodies’ electrolytes and minerals due to the vomiting, which causes imbalance in the body,” he said.

Most people diagnosed with anorexia or bulimia, he said, suffer unusual insecurity about their body image. “They will always think they are too fat and need to lose some weight no matter how skinny they are,” he said.

Oentoro said most anorexic people were underweight, while bulimic people do not necessarily lose their weight quickly, yet they remain emotionally vulnerable due to fits of guilt after eating.