Image: 123rf

She used to be bullied in school. At 1.4m tall and 50kg, Jamie (not her real name) was deemed “fat” by her peers.

The 12-year-old started on a diet plan that later spiralled out of control. In just a few months, she lost 20kg.

She was later diagnosed with anorexia nervosa.

Eating disorders are becoming more common among adolescents, defined as aged between 10 and 19 years old, like Jamie.

There are four main types of eating disorders: Anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder and binge eating disorder.

At KK Women’s and Children’s Hospital, there has been a steady increase in the number of new referrals for suspected eating disorders.


Last year, the hospital saw more than 70 new cases, up from 12 new cases in 2008.

Dr Lim Boon Leng, from Dr BL Lim Centre For Psychological Wellness, attributed the increase to better mental health literacy and the increased willingness of parents and patients to seek help.

His clinic has seen a slight increase in the number of eating disorder cases too.

Image: StraitsTimes

He told The New Paper: “People now understand that eating disorders are dangerous illnesses that need to be addressed and not neglected.”

The exact cause of eating disorders is unknown and likely to be multifactorial.

Dr Lim said: “There is likely to be a genetic link, as it can run in the family. Neurotransmitters (brain chemicals) such as serotonin have been implicated.

“Many eating disorder patients also have psychological problems, such as low self-esteem, impulsive or perfectionist personalities and troubled relationships.

“Social issues, such as media influences and peer pressure to look thin, also play a part in tipping a person over into eating disorders.”


Common signs of eating disorders in adolescents include:

1. Rapid weight loss or poor weight gain

2. Insufficient food intake for weight gain

3. Secondary amenorrhoea (someone with a normal menstrual cycle who stops getting her periods for six months or longer)

4. Excessive exercise

5. Vomiting or laxative abuse

Image: 123rf

Contrary to popular belief, eating disorders are neither a lifestyle choice nor a phase an adolescent will snap out of.

Despite an increasing number of cases detected over the past few years, Dr Lim thinks there are many adolescents suffering from eating disorders out there but who are still not identified and getting treated.

“We are also not catching them early enough, and they surface only when the adolescent is in a serious stage.

“In fact, even for anorexia, which is the most well recognised eating disorder, patients are often already in a bad physical state when they first see a doctor,” he said.

Adding that there may be a stigma to seeking treatment for psychiatric conditions, Dr Lim pointed out that patients with other eating disorders such as binge eating disorder may not even seek help at all as their behaviour may be seen as mere gluttony.

As eating disorders vary, treatment should be tailored to the type of eating disorder and the patient.

Dr Lim said: “In general, psychotherapy – such as cognitive behavioural therapy, which helps to correct erroneous thoughts on eating and self-image – is necessary.

“Nutritional advice and supervision are important areas to help with recovery from eating disorders.

“Medication can also play a role in helping one normalise their eating habits and negative mood arising from eating disorders.”


Article first published on TheNewPaper