Understanding Anorexia


Hello hello!

Sir Post-A-Lot here once again! Hope the week has been treating you well! This time round we have a fantastic offering from our very own Sping Lim who writes about Anorexia!

I've been told that Anorexia is a difficulty that is very hard to spot, owing much to our society's incredible appetite for thinness as a beauty standard. It's scary to think that many times, someone who is sick and is facing so much difficulties, are described as 'beautiful' or encouraged to keep it up. As an analogy, it's almost like encouraging someone who passed his exams because he cheated, to keep on doing it.

Our Health Psychologist Sping Lim writes to tell us a little about what Anorexia is, and how it can be a silent, but potentially deadly problem to live with. Sping also writes about how family members and friends can potentially help as well as how to spot individuals who are suffering from Anorexia.

Anorexia is something that can be very debilitating, but if spotted early and appropriate help given, it doesn't have to be a life sentence.

So keep on a scrolling and have a look at what Sping has to say!

That's it from Sir Post-A-Lot this week! Cheerio!


Understanding Eating Disorder - Anorexia

“All she wants is just to be good looking.”

Oftentimes, it's not just about wanting to look good. Individuals suffering from anorexia often have thoughts which revolves around unpleasant emotions and feelings such as anxiety, fear, guilt as well as helplessness. These are generally overlooked and can result in added pressure to individuals suffering from anorexia.

Anorexia (aka anorexia nervosa) is one of the most common eating disorders today. Simply put, it is a mental health condition in which people are obsessively concerned about their body image and keep the body weight as low as possible by restricting the amount of food consumed, as well as purging food consumed or exercising excessively.

A “Western” condition? Not anymore.

Eating disorders were once known as a “Western” condition as it was more commonly diagnosed in Western cultures. This is possibly due to cultural factors including exposure to research and intervention. In the United State, a recent study shows that 20 million women and 10 million men suffer from eating disorders including anorexia at some point in their lives, with numbers continuing to grow (Wade, Keski-Rahkonen & Hudson, 2011). In Asian countries the numbers of individuals suffering from eating disorders are significantly increasing. Despite these increases however, the lack of awareness and resources of treatment in Asia are worrying.

What causes eating disorders?

Psychological factors

People with anorexia often fear gaining weight because their body image causes them significant anxiety. This is generally derived from the distorted perception that their body image plays a significant role in deciding or directing their achievements in life. Individuals with anorexia may have distorted thoughts as below,

“My life is bitter because I am fat, I just need to be more skinny then things will be alright.”

“I look terribly big, no wonder my friends stay away from me.”

“I can only be successful if only I were as skinny as…”

You may find these strange, unfortunately these are very real thoughts that are experienced by individuals who suffer from anorexia. The distorted thinking patterns constantly trigger feelings of guilt, which often develop into unhealthy behaviours. For example, they would reject normal food consumption and would overly exercise to keep body weight as low as possible.

Environmental factors

Puberty, culture, society, life event and stress may contribute to anorexia.

Puberty is the stage when significant bodily changes occur. This combination of hormonal changes, self-esteem issues, anxiety and stress, makes teenagers prone to develop distorted perceptions about body image during.This makes a perfect storm of sorts that would predispose someone to suffering from anorexia.

Culture and society also play significant roles in contributing to body image perceptions. We are often exposed to the idea that being thin is beautiful. Celebrities for example are often harshly criticized for their slight imperfections, creating an almost impossible ideal to strive for. These are individuals with an army of nutritionists and personal trainers whose job is to look good. If our beloved celebrities go through so much to keep their gorgeous figures, one can only imagine what we would have to go through to reach such ideals.

Stressful life events can also play a significant role in triggering the onset of anorexia. Divorce and bereavement in older adults, or bullying at school, particularly teasing about weight and body shape are some factors that contribute to the development of anorexia. People who have difficulties coping with dramatic life changes may lead to false belief that by having an ‘ideal’ body image could have improved the situation and relieve them from the bitter part of life. Distorted cognitions are often developed once one starts to believe that body image plays a significant role in defining their lives.

Biological factors

Eating disorders are often biologically inherited and tend to run in families. Individuals with a family history of eating disorder are prone to onset of anorexia. Recent studies found that inherited biological and genetic factors contribute approximately 50% of the risk for developing an eating disorder. This indicates that individuals with a family member who suffered from anorexia are at higher risk of developing anorexia as compared to those without a family history of eating disorders.

A wealth of research also suggests that the changes of brain structure or activity may contribute to the onset of anorexia, particularly the hypothalamus, which is the brain structure responsible for regulation eating behaviors. However, the biological factors of eating disorders are not very well understood. This may due to the majority of studies are conducted during the acute of recovery stages of an eating disorder. At this time, there are physiological changes occurring in the person as a result of their eating disorder behaviors which can affect the findings of the studies.

How serious anorexia can be? 

Anorexia can be a life-threatening chronic condition, which is often described as “eating a person from the inside out”. For example, individuals suffering from anorexia may also develop secondary depression, which puts them at high risk for suicide. Or, they may suffer from malnutrition or other physical dysfunctions such as organ failure, poor immune system and other major medical conditions. Therefore, it is vital to seek professional help before it gets too severe!

Should anorexia be treated medically or psychologically?

This is the million dollar question. The answer is oftentimes both. Medical treatment and psychotherapy are vital steps in treating individuals with anorexia. As mentioned earlier, anorexia is a mental health condition where distorted thinking patterns play a major part in manifesting the condition. Psychotherapy helps individuals overcome the cognitive distortions, as well as to manage behaviours to improve eating habits and manage weight loss.

Meanwhile, medical treatments are used to manage vital signs, hydration level, electrolytes, and provide treatments such as the use of tube feedings in severe cases. Medication is also used to treat associated psychological problems such as depression, obsessive compulsive disorder (OCD) as well as anxiety.

As a family or friend, how can I help?

Understand what anorexia is. The lack of awareness is one common reason why help is often delayed which leads to unwanted results. People tend to overlook the signs and symptoms when individuals suffer from anorexia cry out for help. It’s amazing what can be done if only the most basic signs and symptoms of anorexia are known. Here are some warning signs of anorexia that can be detected such as dramatic weight loss, refuse to eat certain foods to avoid gaining weight, frequent comments about feeling “fat”, anxiety about body image and excessively exercise.

Be receptive, stop judging. Let’s face it, we belong to a judgmental society. It is impossible to not judge. However, people should learn how impactful a simple word or expression can be. People with anorexia need help and support from people around them. They generally feel helpless or even depressed about their condition, thus comments and criticisms that make them feel even smaller. If you don’t know what to say, perhaps just being there for your loved ones is all that’s needed. Always remember that staying silent is sometimes better than voicing something hurtful.

Seek help and advice from the expert. Action speaks louder than words. People with anorexia may stop themselves from seeking help due to fear, avoidance, anxiety or any other factors. As family or friends, encouraging them to seek professional help is often the best thing you can get them to do. It may be challenging to convince them to comply, but it’s better than having our loved ones suffer alone.

In a nutshell, anorexia is no longer only a mental health condition when it comes to the stage where physical health is severely impacted. The complication requires a variety of resources to help the patients to recover. Therefore, seek help before it is too late! Enjoy reading.

Wade, T. D., Keski-Rahkonen A., & Hudson J. (2011).Epidemiology of eating disorders. In M. Tsuang and M. Tohen (Eds.), Textbook inPsychiatric Epidemiology (3rd ed.) (pp. 343-360). New York: Wiley.


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