[Photo: Alvina Suhardjo on Unsplash]
By Shannon Ling
With the glorious backdrop of local dishes and international cuisines, Singapore is often dubbed a food paradise. Ironically, while our city shines with its myriad of food, there has also been a worrying increase in cases of eating disorders in Singapore. Yet, eating disorders remain as some of the more misunderstood health conditions, often wrongly assumed to only affect women and typically brushed off as ‘female-teen-just-wanting-to-look-skinny’.
The American Psychological Association defines eating disorders as disorders “characterized primarily by a pathological disturbance of attitudes and behaviors related to food”. When thinking of eating disorders, anorexia nervosa and bulimia nervosa often come to mind. However, the perils of eating disorders go beyond these two devils; many suffer from orthorexia nervosa, an “extreme exercise and obsession with eating what is perceived to be ‘healthy’ foods”, or rumination, an “obsessional thinking involving excessive, repetitive thoughts or themes”, among numerous other conditions.
In our conservative nation, there is less diagnosis and awareness of these disorders, which are traditionally viewed as Western culture-bound, translating into damaging stereotypes and hurtful comments.
One of the most destructive misconceptions about eating disorders is the common belief that only females (specifically those underweight) can suffer from eating disorders. As such, males who have troubled relationships with food are almost normalised, and anyone, regardless of gender, without a protruding rib cage is disregarded. Would a male individual who meticulously measures out every single calorie he consumes in his restrictive diet, or spends hours on end in the gym, be considered as someone who is suffering from an eating disorder, or just being health-conscious?
That being said, disordered thoughts should not be confined to a single archetype; they can affect anyone’s thoughts and emotions. There is insufficient gender disparity in studies of eating disorders in Asia to assume dissimilar prevalence of these disorders among different genders. Also, we cannot forget that both genders are equally susceptible to harmful beauty standards that affect their body image — from picture perfect(ly edited) magazine images to the promotion of harmful diets and slimming products, which are frequently found on online shopping sites and even in men’s magazines.
Think about the times when you’re watching a television show and a weight management advertisement pops up: These advertisements often equate terms like ‘healthy’, ‘beauty’ and ‘confidence’ to the process of slimming down — perpetuating this unhealthy association and encouraging unhealthy relationships with food. For every gender, these unrealistic body standards are placed on the pedestal, often seen as the normal or healthy standard.
It is these beauty standards, and the rising importance of one’s believed physical attractiveness, that studies have attributed to disordered attitudes towards food. So, if everyone faces the same issues with unattainable standards, we are all susceptible to these disorders. Hence, they ought to have more attention in Singapore.
With the lack of understanding of EDs and the stereotypes around them, these misconceptions have problematic implications. In particular, declaring that someone “looks anorexic” is seemingly-harmless but in fact damaging.
During family gatherings on special occasions, many are subjected to the nosy comments from relatives (who often believe they are commenting out of good will) — if you’re too skinny, you “look anorexic” and need to eat more; if you’re slightly chubby, you “need to lose weight” else you become unattractive to potential partners. These deep rooted associations with self worth, health and physical image turns seemingly ‘harmless’ comments into deep wounds.
Even if the comments come from a place of concern, attributing mental disorders, especially those associated with body image, to one’s appearance propels notions that one can “look anorexic”, and in turn “not look anorexic”. Such comments perpetuate the idea that one must look a certain way — in this case, skinny enough — to be considered a sufferer of the illness.
This provokes both patients and non-patients to aspire towards an “idealistic” body type that, even if seemingly attained, rarely satisfies the disorder. That way, a sufferer of anorexia, upon hearing such comments, could spiral and worsen their obsessive and compensatory behaviours in order to fit into the “standard” of looking anorexic.
With eating disorders often driving obsessive eating habits and compensatory behaviors, anorexia, in particular, is associated with the abstinence of food and looking emaciated. However, these physical effects are not universal, and all eating disorders have varying effects on sufferers’ bodies. These disorders are categorised by their effects on one’s relationship with food, and not by their weight; a person’s body does not demarcate their diagnosis.
Supporting the road to recovery
For starters, it is not advisable to comment on someone’s appearance or perceived weight (especially with such loaded terms) in general. However, if you genuinely believe someone might be suffering and wish to help, there are many ways you can provide support, such as guiding them through the different stages of change provided by the National Eating Disorders Collaboration, from precontemplation to termination.
In early stages such as precontemplation, warning signs of eating disorders can include becoming secretive about food and social withdrawal. More of such identifiers can be found on websites such as AWARE or the National Eating Disorders Association. In the later stages such as maintenance, actions such as working together to identify triggers or putting fixed systems in place are also useful in avoiding potential relapse.
Additionally, mass media exposure (such as the messages perpetuated through advertisements or even the ideas we consume through scrolling Instagram) is directly linked to body image and disordered eating; it shapes our attitudes and relationship with food. While these effects hinge largely on the user, their escalation with Covid-19 “lockdowns” (from the increased screen-time and social isolation) may adversely impact eating habits and perceptions of one’s body.
As such, caring for someone can be as simple as introducing them to social media accounts such as @edrecoverymarie on Instagram, that purposefully make use of social media’s visibility to encourage recovery. At the same time, accounts such as @bodybravecanada are also useful in learning more about eating disorders and representation. Exposing them to influencers that shine light on positive representation can help them feel more represented and validated, encouraging people to feel better in their own bodies. Additionally, the posts that educate on eating disorders can help sufferers understand the distortion of their thoughts and, hopefully, resolve the conflicts between what their brain tells them and the truth.
Just like other mental illnesses, eating disorders are very real and can lead to subjugation of bodies and health problems. There is no shame in taking the step to learn more (especially with all the available resources online today) in order to support those on the road to recovery.
Should you feel distressed, please know that there are hotlines and resources available to help you:
Samaritans of Singapore
1800-221 444 (24 hours)
Institute of Mental Health
6389-2222 (24 hours)
Singapore Association for Mental Health
1800 283-7019 (Mon to Fri, 9am to 6pm)
1800 377-2252 (Mon to Fri, 9am to 6pm)
Brahm Centre Assistline
6655-0000 (Mon to Fri, 9am to 6pm)
8823-0000 (WhatsApp available)
- Chua, S. N., Fitzsimmons-Craft, E. E., Austin, S. B., Wilfley, D. E., & Taylor, C. B. (2021). Estimated prevalence of eating disorders in Singapore. International Journal of Eating Disorders, 54, 7-18. doi: 10.1002/eat.23440
- Lee, H. Y., & Hoodbhoy, Z. (2013). You are worth more than what you weigh: Preventing eating disorders. Annals Academy of Medicine, 42, 64–65.
- Mitchison, D., Hay, P., Slewa-Younan, S., & Mond, J. (2014). The changing demographic profile of eating disorder behaviors in the community. BMC Public Health, 14(1), 943. https://doi.org/10.1186/1471-2458-14-943
- Thomas, J. J., Lee, S., & Becker, A. E. (2016). Updates in the epidemiology of eating disorders in Asia and the Pacific. Current Opinion in Psychiatry, 29(6), 354–362. doi: 10.1097/YCO.0000000000000288
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- Spettigue, W, & Henderson, K, A. (2004). Eating disorders and the role of the media. Can Child Adolesc Psychiatr Rev. 13(1):16-19