Recognizing the Warning Signs of an Eating Disorder

Eating disorders are serious mental health conditions that can have devastating consequences if left untreated. They are characterized by an unhealthy relationship with food and body image, often leading to severe disturbances in eating habits and behaviours. In Singapore, the pressure to conform to societal beauty standards and the competitive academic environment can contribute to the development of eating disorders.  

 

Understanding Eating Disorders  

Eating disorders encompass a range of conditions, including anorexia nervosa, bulimia nervosa, binge eating disorder, and avoidant/restrictive food intake disorder (ARFID). These disorders can manifest in various ways, but they all involve a distorted perception of body image, an intense fear of gaining weight, and unhealthy eating patterns. They can affect people of all ages, genders, and backgrounds.    

 

Causes and Contributing Factors  

Eating disorders are complex conditions with multiple contributing factors. While the exact causes are not fully understood, research suggests a combination of genetic, psychological, sociocultural, and environmental factors play a role. 

  • Genetic predisposition: Family history of eating disorders or mental health conditions can increase the risk. 
  • Psychological factors: Low self-esteem, perfectionism, anxiety, depression, and trauma can contribute to the development of eating disorders.    
  • Sociocultural influences: Media portrayals of idealized body images, societal pressure to be thin, and cultural norms around food and appearance can influence body image and eating habits. 
  • Environmental factors: Stressful life events, family dynamics, and peer pressure can trigger or exacerbate eating disorders. 

 

5 Warning Signs and Expert Advice  

Recognizing the warning signs of an eating disorder is crucial for early intervention. Here are five key signs you shouldn’t ignore: 

  1. Dramatic weight loss or fluctuations: Significant and rapid changes in weight, often accompanied by obsessive calorie counting or restrictive dieting. 
  2. Preoccupation with food and body image: Constant thoughts about food, weight, and body shape, often leading to obsessive behaviours like checking weight frequently or avoiding social situations involving food. 
  3. Distorted body image: Seeing oneself as overweight even when underweight or at a healthy weight. 
  4. Changes in eating habits: Skipping meals, avoiding certain food groups, eating in secret, or engaging in binge eating followed by purging behaviours like self-induced vomiting or excessive exercise. 
  5. Physical and emotional changes: Experiencing fatigue, dizziness, hair loss, digestive problems, mood swings, anxiety, depression, or social withdrawal. 

 

Doctor Recommends: 

“It’s important to remember that eating disorders are not about vanity or a lack of willpower. They are serious mental health conditions that require professional help. If you notice these warning signs in yourself or someone you care about, don’t hesitate to seek support,” says Dr. Jacob Rajesh a leading psychiatrist at Promises Healthcare. 

 

Taking the First Step Towards Recovery 

Recovery from an eating disorder is a journey that requires professional guidance and support. At Promises Healthcare, our dedicated team of psychiatrists, therapists, and nutritionists understands the complexities of eating disorders and provides personalized care to help you heal. 

 

If you or someone you know is struggling with an eating disorder, taking the first step towards recovery is crucial. Seeking expert advice and support is essential for overcoming these challenges and achieving lasting well-being. Don’t hesitate to reach out to Promises; we are here to help you every step of the way. 

Understanding Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD), in simple terms, is a condition involving an obsessive focus on one or more perceived flaws or defects in appearance. While the perceived flaw may be minor and inconspicuous, individuals struggling with this disorder are inclined to spend a large proportion of their waking hours worrying and finding means to fix these flaws. This includes seeking dermatological or cosmetic procedures and exercising excessively to fix their appearance. Depending on its severity, BDD can be disabling – the emotional distress it causes can affect one’s functioning at social events, work and in the public eye.

BDD is estimated to affect approximately 2 percent of the adolescent and adult population worldwide, and preliminary studies in Singapore have also noted a similar proportion. This figure is, however, likely to be underreported due to the nature of the disorder, where affected individuals are unable to recognise the symptoms of the disorder. Coupled with the lack of awareness of BDD, people associate these BDD symptoms with the “physical flaw” itself.

While there is no definitive cause, there are risk factors that can contribute to the onset of BDD. These can include bullying or abuse, perfectionism, constant competition with others, genetics, and other mental health conditions such as depression, anxiety or obsessive-compulsive disorder (OCD). With the prevalence of social media, this condition is further exacerbated as it perpetuates body image comparison and the image of an “idealised body”. This can trigger such compulsive behaviour in vulnerable individuals, especially if they struggle with low self-esteem. Chemical imbalances can also trigger the onset of BDD in the brain or the use of certain drugs such as ecstasy in susceptible people.

What is the diagnostic criteria for BDD?

For a BDD diagnosis, there is a set of criteria that the individual must meet. According to the Diagnostic Statistical Manual of Mental Disorders (DSM V), they are:

  1. Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
  2. At some point during the course of the disorder, the individual has performed repetitive behaviours (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g., comparing his or her appearance with that of others) in response to the appearance concerns.
  3. The preoccupation causes clinically significant distress or impairment in social, occupational or other areas of functioning.
  4. The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.

In addition, the individual would need to be assessed on their degree of insight regarding body dysmorphic disorder beliefs. In other words, how convinced are they that their bodies look “deformed” or “ugly”? A person with good or fair insight recognises that these beliefs are definitely or probably false. A person with poor insight would think that these beliefs are probably true. In the worst-case scenario, a person with absent insight or delusional beliefs would be completely convinced that their body dysmorphic beliefs are true.

What forms of treatment are available for BDD?

A combination of psychotherapy and pharmacotherapy is often implemented in the treatment plan for BDD. Cognitive Behavioural Therapy (CBT) is a psychotherapeutic method which aims to help one recognise maladaptive thought and behaviour patterns, and teach self-help coping strategies that can improve one’s quality of life. CBT has been proven to be an essential form of treatment for other mental health conditions as well, including depression and anxiety disorders. CBT for body dysmorphia would focus on helping the patient build self-esteem, and learn to tolerate the distress of “exposing” their perceived defects to others. It helps them manage their concerns with healthier coping mechanisms instead of taking extreme measures to fix their appearance. This includes training them to cope with symptoms of anxiety.

Medication is sometimes used in combination with CBT for maximum efficacy. One common medication used to relieve BDD symptoms include antidepressant medications. Selective Serotonin Inhibitors (SSRIs) in particular, can ease and reduce compulsivity, as well as overwhelming symptoms of anxiety or depression.

You may wonder why we don’t proceed with cosmetic or surgical procedures to correct their perceived flaws, especially if they seek such measures. As mentioned, BDD often involves flawed beliefs surrounding an inconspicuous or minor flaw in appearance. We must acknowledge that any medical or surgical procedure carries health risks, regardless of the extent of the surgery. Any unnecessary alterations or body modifications may not only lead to undesirable health effects but may also lead to dissatisfaction with the results. Should the surgical procedure not turn out as expected, this could worsen the patient’s BDD.

If you believe a loved one may be showing signs of BDD, do encourage them to consult one of our mental health professionals at Promises Healthcare. 


References:

  1. https://www.channelnewsasia.com/commentary/body-dysmorphia-vanity-obsession-mental-health-treatment-1883421 (Accessed 25/07/2022)
  2. https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t19/ (Accessed 25/07/2022)
  3. https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/causes/ (Accessed 25/07/2022)