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Eating Disorders

Understanding Mental Health

What is Mental Illness

Eating Disorders

What are Eating Disorders?
An eating disorder is a severe disturbance in one’s eating behaviour and everyday diet. It may involve overeating or a drastic reduction in food intake. The person may try to lose weight through extreme measures, such as purging or excessive exercise. All these take place while the person is besieged by distorted beliefs in his body shape and weight.

Eating disorders are detrimental to the person’s physical and mental health. In severe cases, it may become life-threatening. There are many contributing causes to eating disorders. In most cases, they are triggered by a combination of complex emotional and social issues.

Eating disorders affect both men and women. They occur more frequently during adolescence or early adulthood. The person may also suffer from depression, substance abuse and anxiety disorders

Common types of eating disorders include:

  • Anorexia nervosa
  • Bulimia nervosa
  • Binge-eating disorders
  • Eating disorders not otherwise specified (EDNOS)
Anorexia Nervosa

Persons with anorexia nervosa often consider themselves fat or overweight. This causes them to restrict their diet to the point of self-starvation.

But in reality, many of them are evidently underweight and malnourished. The fear of gaining weight leads them to try and maintain an abnormally low weight. Wrecked with emotional turmoil, they struggle with a distorted body image and self-esteem.

For persons with anorexia nervosa, a thin body is a representation of their self-worth.

Persons with anorexia nervosa often exhibit these characteristics:

  • Obsessive fear of gaining weight
  • Refusal to maintain a normal, healthy body weight
  • Extreme preoccupation with their bodies
  • Distorted and unrealistic perception of body image and body weight
  • Denial of low body weight
  • Being extremely thin and emancipated
  • Lack of menstruation in girls and women
  • Restricted food intake or self-starvation
  • Excessive exercising
  • Constant weighing of themselves

Other physical symptoms may include:

  • Low blood pressure
  • Fatigue
  • Thinning or brittle hair
  • Bloated stomach
  • Abnormal heart rhythms
  • Brittle nails
  • Dry skin
  • Anaemia
  • Low tolerance to cold temperatures
  • Constipation
  • Osteoporosis
Bulimia Nervosa

Persons with bulimia nervosa feel an overwhelming compulsion to binge on food. This is followed by purging to avoid gaining the extra weight or calories.

It becomes a repetitive cycle of binge-eating and purging. Common purging attempts include self-induced vomiting, consuming laxatives, fasting and excessive exercising.

These frantic, self-harming efforts are often accompanied by feelings of shame and distress. The person may also judge himself harshly based on self-perceived body flaws.

Unlike anorexia nervosa, persons with bulimia usually have healthy or normal body weight. They can thus keeping their condition a secret for a longer period of time.

Persons with bulimia may exhibit these outward symptoms:

  • Excessive exercising
  • Damaged tooth enamel and discoloured teeth, due to exposure to stomach acid
  • Dehydration
  • Sore and inflamed throat, or sores in the mouth
  • Fluctuating body weight
  • Swollen cheeks
  • Acid reflux (heartburn)
  • Loss of menstruation
  • Calluses or scars on their knuckles, due to forcing fingers down their throats to induce vomiting
  • Feeling out of control with eating behaviour
  • Inability to stop eating to the point of physical discomfort
  • Eating in privacy or secrecy
  • Frequent visits to bathrooms during mealtimes
  • Feelings of guilt or ashamed or depressed after eating
Binge-Eating Disorder

Binge-eating refers to recurrent episodes of overeating large amounts of food. Persons who binge often feel compelled to eat a lot even when they are not hungry. Bingeing on food has become their way of coping with emotions or stress.

Deep down, the person may feel embarrassed about not being able to resist the urge to binge. This leads him to often binge in secret. Due to the sense of disgust or guilt involved, bingeing may lead to depression. Other health risks include obesity, diabetes and heart conditions.

Persons with binge-eating disorder may not show obvious physical symptoms or weight issues. They may, however, display outward symptoms such as:

  • Eating extremely large amounts of food
  • Consuming food even when full
  • Eating rapidly
  • Eating until it creates a discomfort
  • Feeling out of control with eating behaviour
  • Constant feelings of depression, ashamed and disgust or guilt about eating behaviour
  • Anxiety
  • Eating in privacy or secrecy
  • Difficulty talking about their emotions or feelings
  • Frequent dieting, with or without weight loss
  • Fluctuating weight

Eating disorders are treatable. Treatment should address both the eating disorder itself, and the underlying psychological issues.

Professional help should be sought as early as possible. Early diagnosis and treatment are the key to a successful recovery.

  • Medication
    The use of antidepressants and anti-anxiety drugs to treat any co-occuring mental illness
  • Psychotherapy
    Includes talk therapy and behavioural therapy
How You Can Help a Person with an Eating Disorder
  • Learn about eating disorders and their recovery process
  • Offer emotional support, understanding, patience, and encouragement
  • Listen without judging
  • Encourage the person to seek professional help
  • Be aware of your comments towards food, as well as body size, shape and weight
  • Emphasise what is inside (e.g. kindness) is more important than what is outside (e.g. looks)

Encourage the person to join a self-help or support group, such as Support for Eating Disorders Singapore (SEDS).

SEDS is a support group for survivors of eating disorders and their supporters. The group meets once a month to share problems, experiences and support for one another. Persons recovering from eating disorders benefit greatly from being in a supportive environment.

Contact the SAMH Insight Centre at 1800–283 7019 for more information on the support group.


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