Cissy Li on recognising and dealing with anorexia and bulimia
Eating disorders such as anorexia and bulimia have been sensationalised and trivialised in the media as occurring to teenage girls who are vain and care about their looks. From experience, I can say that both ladies and young men who experience an eating disorder are diverse; they are bright, ambitious, perfectionists, stubborn, impulsive, depressive and anxious. They are strong and resilient — but ultimately vulnerable. Vain is not a word I would typically use to describe them.
By the time a person realises they need help, the obsession with weight, food, or body image has already consumed them. Those in treatment tell me they would not wish an eating disorder upon their worst enemy. People fail to understand that no young person, whether vain or not, would ever choose to ostracise friends and family in favour of starving themselves to death.
A fatal problem
The truth is, people experiencing an eating disorder have the highest mortality rates of any mental health problem due to both physical and psychological risk. With anorexia, young people may have such weak heart rates that when they go to sleep, they fear not waking up in the morning. Those with bulimia can stress their bodies so much through purging that the electrolytes required for heart functioning fall out of balance and they suffer a heart attack. They may stick their toothbrush too far down their throat one night and purge blood.
Psychologically, low weight and semi-starvation leads to a greater degree of obsessive-compulsive traits, anxiety and low mood. They may have rapid mood swings, or feel incredibly distressed and guilty over what they eat.
Eating disorders are a disorder of "secrets". They are like the ballerina inside a dancing ballerina jewellery box: perfect, forever dancing, but stuck, unable to move freely and pursue what they want in life. Eating disorders may have started as dieting, stress, low mood, food poisoning or gastric problems. It may have started around a stressful event such as moving cities, changing schools, or being subject to bullying. From there, an eating disorder can bubble up insidiously and preference changes can be attributed to time. An eating disorder does not "go away", and can last for years or a lifetime.
Recognising the signs
So what do we look for? Someone close to you may have changed their eating habits (who they eat with, where they eat, what they eat, the way they eat) and are "not hungry", ever. They may have lost a lot of weight but are unhappy with their current weight (it is possible they want to gain weight but "can't"). They may not feel secure about their appearance and this can be in the form of negative comments about themselves.
Do not decide whether someone has an eating disorder based on how they dress (girls and boys are still able to look glamorous and/or wear revealing clothes). Otherwise, they might eat more than a normal person before restricting their diet, going to the gym, or purging. You might see a pack of laxatives, or the unpleasant sound or smell of vomit coming from the shower or toilet.
Here's how you can help your friend or yourself
1. Seek help from a psychiatrist or psychologist, or seek out a eating disorder clinic. Try to find someone with previous experience in this area as eating disorder treatment is different from other mental health disorders. Your health care provider will be able to provide you with more information on the best way to support you, your friend or family member.
2. Focus on your relationship with this person. Create a warm, loving atmosphere. They may value your company more than you would think.
3. If they want to, talk to them about what is happening. Avoid any stressors in their lives. Listen to them, empathise with them, and don't offer to solve their problems. People are sometimes fearful of sharing private information as they worry they will be judged, or told their predicament is their own fault. Don't fall into the trap.
Coping with an eating disorder is not easy, and can require more patience and empathy than what we imagine we possess. However, at the end of the day, it is important for you or your loved one to know that your health professional and support network wouldn't have it any other way. You are there for the good and the bad, and that help offered comes from a place of love — not obligation.
About Cissy Li Originally from New Zealand, Cissy is a fan of thinking outside the box. She firmly believes that people can achieve greater fulfillment in their lives by being open and living authentically. When she's not busy living life, writing for Buro 24/7 Singapore, or engaging in volunteer work, Cissy enjoys her day job as a registered clinical psychologist.