Eating disorders: What are the warning signs?

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An unhealthy attitude to food, body weight and body shape can lead to an eating disorder, a serious condition that can be life-threatening. Eating disorders typically affect mostly female teenagers and young women.

The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.

In Singapore, such conditions have been found to be most common among adolescents and young adults, with the average age being 20 years.

“We have seen around 180 newly-diagnosed cases per year from 2013 to 2015,” says Dr Ng Kah Wee, Director, Eating Disorders Programme and Consultant in the Department of Psychiatry at Singapore General Hospital.

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Different eating disorders and what causes them

Anorexia is characterised by an abnormally low body weight, an intense fear of gaining weight, and a distorted perception of one’s weight or shape. Sufferers may excessively limit calorie intake, and vomit after eating or exercise excessively to lose weight.

Bulimia involves episodes of bingeing and purging. You may eat a large amount of food in a short time, and then vomit – or use other methods such as laxatives – to eliminate the calories consumed.

In binge-eating disorder, you may regularly eat too much food and feel intense guilt or shame about it. But instead of purging it, you may eat alone and keep your bingeing a secret.

Like most psychiatric conditions, there is never one causative factor for eating disorders, says Dr Ng.

Causative factors include:

  • Family history of eating disorders
  • Body image dissatisfaction
  • Low self-esteem due to bullying/teasing
  • Examination stress
  • Peer influence, need to fit in and be popular
  • Psychosocial stressors, e.g. family stress, frequent quarrels between parents, sibling rivalry

“Social media can also be a contributing factor, with its emphasis on physical appearance, pursuit of thinness, and glorification of the slim and lean,” says Dr Ng.

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7 warning signs of an eating disorder

  • Skipping meals and avoiding eating
  • Avoiding eating with others
  • Obsessing about losing weight
  • Dramatic weight loss
  • Wearing baggy clothes to hide weight loss
  • Excessive visits to the bathroom during or after meals
  • Excessive exercising

How are eating disorders diagnosed and treated?

Eating disorders are diagnosed with the help of a physical and psychological evaluation and they are treated with medication as well as psychotherapy. A multidisciplinary team also provides patients with dietary guidance, physiotherapy, occupational therapy and art therapy to help them recover and resume their normal lives.

Family therapy, which enables family members to support the patient, is also an integral part of the treatment process. Hospitalisation may be required in cases of severe malnutrition.

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