Eating Disorders

What are eating disorders?

Eating disorders are illnesses that manifest themselves in extreme unhealthy eating patterns. They are mental conditions that affect eating habits but are not necessarily tied to a specific body type; someone with an eating disorder can appear very thin, healthy weighted or above healthy weight. Although symptoms of these disorders emerge primarily in young women, eating disorders can affect anyone from any gender, age, ethnicity and income level.

There are a few main types of eating disorders, highlighted below. An individual with an eating disorder can suffer from more than one of the following types of disorders. The following describes the symptoms and not the causes of eating disorders.

Anorexia Nervosa involves the partial or total abstinence from food (solids or liquids) because she/he believes any amount of food will cause weight gain. An anorexic often perceives herself/himself as ‘fat’ and has an intense fear of gaining weight. This is reflected in an unhealthy preoccupation with food and exercise, and sometimes purging through self-induced vomiting and laxative abuse.

Bulimia Nervosa is often associated with binge-eating disorder as a bulimic is often engaged in a cycle of binging and purging. Bingeing is characterized by the consumption of a large amount of food (in comparison to what the individual normally consumes) in a short period of time and is frequently emotionally-induced. Purging arises from the guilt of overeating and involves self-induced vomiting, laxative abuse, excessive exercising and extreme fasting.

Binge-eating Disorder involves binging excessively with periods of uncontrolled, impulsive and continuous eating to the point of being uncomfortably full, with no compensatory behaviour (purging) after. Bingeing is usually triggered by an emotional event that causes the individual to turn to food as a means of comfort, the aftermath of which often results in guilt and self-loathing.

Orthorexia Nervosa is a relatively lesser-known eating disorder which involves extreme exercise and obsession with eating what is perceived to be ‘healthy’ foods. They reject any food that is perceived as unhealthy such as food with oil, butter, carbohydrates etc. Sometimes orthorexics eliminate such a large number of foods from their diet that they become emaciated, which results in anorexia orthorexia. However, anorexia and orthorexia are different illnesses that arise from different intentions with anorexics usually seeking to lose weight whereas orthorexics typically seek to attain pure, clean and healthy bodies.

What causes eating disorders?

As with any other mental illness, eating disorders are complex, multi-layered disorders that arise from various psychological, mental and emotional issues that vary from individual to individual. However there are a few broad issues that have been observed to lead to eating disorders.

  • Depression
  • Unhealthy perceptions about body image, as promoted by the media as well as peer and parental pressure.
  • Past traumatic experiences such as physical, emotional or sexual abuse.
  • Emotional upheaval such as major changes in an individual’s life (e.g. the loss of a friend or family member, ending of a relationship,, major personal disappointments)
  • Individual’s need for control. Various factors could result in the individual feeling a loss of control over their lives, resulting in the use of their bodies and eating habits as a means of reclaiming control.
  • Obsessive Compulsive Disorder

How can I tell if I, or someone else, have an eating disorder?

They may have:

  • Distorted perception of own weight,
  • Extreme preoccupation with food,
  • Emotional state tied to eating habits,
  • Self-loathing behavior,
  • Reduced concentration and thinking ability,
  • Becoming very secretive about food,
  • Moodiness, shakiness and irritability,
  • Obsessive routines (such as eating only certain foods at certain times),
  • Social withdrawal and isolation and
  • Avoidance of social situations that include food

What should I do when someone I know has an eating disorder?

Support is extremely important for someone experiencing an eating disorder, even if they might act like they do not want your help. Let your friend know that you are there for them by providing a listening ear. You should not exert excessive pressure on them to seek treatment, as this may result in worsening the relationship or ineffective treatment. However if the disorder has reached a life-threatening level, you should inform a trustworthy figure of authority in order to get your friend the urgent help they need.

I/Someone I know has an eating disorder, where can I get help?

Currently, AWARE does not specialise in the treatment and advocacy of eating disorders although we do provide general counseling for women or girls in need of support. Organisations and establishments that do focus or specialise in such disorders are listed below.

Treatment clinics
These listings in no way constitute a recommendation of their services. The links are provided for info only.
Eating Disorders Programme at SGH – +65 6321 4377  |  eatingdisorders@sgh.com.sg.
Mount Elizabeth-Charter: 1-800-6738 9595
Dr. Tommy Tan – Novena Psychiatry Clinic – 6397 2688

Information
Health Promotion Board: Eating DisordersTips on how to prevent eating disorders and methods of treatment.
Not Just Surface DamageA compilation of stories by survivors of eating disorders in Singapore. Wonderfully written and designed.

Support
Singapore Association for Mental Health : 1800-283 7019
Support for Eating Disorders Singapore (SEDS)This is a support group for people who have recovered or are recovering from eating disorders as well as their caregivers.

What can I do to prevent an eating disorder?

As of yet, there has been no scientific proof of ways eating disorders can be prevented, however there are a few ways you can protect yourself from succumbing to an eating disorder.
As an individual:

  • Learn about healthy eating and an active lifestyle from the right sources. The Health Promotion Board (http://www.hpb.gov.sg/healthyliving/default.aspx) offers a useful and comprehensive guide on healthy living .
  • Surround yourself with positive influences and be a positive influence yourself! Friends who are confident in their body image will encourage you to feel the same and vice versa.
  • Be active! Involvement in meaningful activities leave lasting positive impacts on your outlook and mental health.
  • Communicate with your friends and family. By learning how to listen and share your problems with people you love, you’ll be able to sort out the various emotional issues that come your way.

As a parent:

  • Reassure and reaffirm your child constantly. A large percentage of insecurity in individuals arises from a lack of affirmation as a child. The simple act of encouraging them to feel confident in their bodies and selves could be enough to protect them against insecurity-based eating disorders in the future.
  • Teach them about the benefits of healthy eating. Emphasize the importance of living healthily by incorporating balanced meals into their diets, encouraging them to be active in school and outdoors, and teaching them about moderation.
  • Be a positive influence yourself. Don’t encourage body insecurities in front of them by making disparaging remarks about your own or others’ bodies. Instead, teach by example by being confident in your own body.