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Eating disorders are an increasing mental health issue in Hong Kong, particularly prevalent amongst teenage females, as statistics reveal. People of all genders and age can be affected. If untreated, disordered eating can damage the physical, mental and emotional health of patients.
Eating disorders are defined by the American Psychological Association as abnormal eating habits that threaten health or even endanger the lives of patients. As a result of disordered eating patterns and distorted attitudes towards body weight and body image, sufferers can harm both their physical and psychological health. Among others, the two most serious types of eating disorders are anorexia nervosa and bulimia nervosa.
Anorexia nervosa is characterized by extreme weight loss, distorted body image, plus irrational fears of gaining weight and becoming obese. It is a common eating disorder, especially, but not exclusively, amongst adolescents. According to National Collaborating Centre for Mental Health, subtypes of anorexia nervosa are:
Bulimia nervosa is characterized by repeated bouts of excessive eating, followed by self-induced vomiting, taking laxatives or diuretics, fasting or vigorous exercise. Symptoms of bulimia nervosa are similar to the binge-eating/purging subtype of anorexia nervosa, with the difference being that bulimia nervosa patients can often maintain a normal weight. However, this makes bulimia nervosa more difficult to diagnose. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), subtypes of bulimia nervosa include:
These are complex and not yet fully understood, but scientists believe eating disorders are caused by biological, cognitive and social factors.
In addition to dramatic weight loss, patients with anorexia nervosa may experience:
Even after recovery, patients may still suffer from complications in the long-term, for example, difficulty in childbearing.
According to the US National Institute of Mental Health, the physical symptoms of bulimia nervosa include:
Aside from physical symptoms, patients with anorexia nervosa also experience profound psychological symptoms.
In general, psychological symptoms of eating disorders concern thought patterns and feelings. Common psychological symptoms include:
The psychological symptoms of bulimia nervosa are similar to those of anorexia nervosa. In essence, common behavioral symptoms of bulimia nervosa include:
Mental health professionals usually employ the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose patients susceptible to eating disorders.
On the authority of the DSM-criteria for eating disorders, individuals who show the following symptoms over the last three months may have eating disorders:
In addition to DSM-5, mental health professionals rely on psychological self-assessment questionnaires for diagnosis. They can also use clinical rating scales, including:
Treatment options for eating disorders include:
Treatment examples:
The Maudsley Method provides guidelines to help adolescents and children with eating disorders by supporting parents to take a central role in diet management. Parents temporarily take control of the patient’s food and activity, e.g. selecting, preparing, serving and supervising meals and snacks, until the patient shows evidence of weight gain. When the adolescent is at or near full weight restoration and self-starvation behaviors have subsided, the treatment may conclude with further support.
Cognitive-behavioral therapy (CBT) targets in-patients and out-patients, aiming to change negative self-statements and basic assumptions anorexic patients maintain. Mental health professionals first identify patients’ cognitive biases, then replace their irrational thoughts with logical ones.
These target in-patients with more severe conditions. This approach focuses on helping the patient to recover from anorexia by changing their behavior. For example, mental health professionals may teach anorexic patients to formulate new eating habits with a goal toy, increase their amount of food consumption.
Prevention interventions of eating disorders may be implemented under clinical, community and school-based settings. Programs that focus on changing the weight-related attitudes of youth and promoting healthy weight-control strategies aim to prevent eating disorders.
One solution to prevent developing eating disorders is to distract yourself from paying too much attention to your weight. It helps to break the habit of checking your body shape and frequently weighing yourself. Consider developing an interest in outdoor activities like hiking and swimming to shift attention away from your physical appearance.
Eating disorder sufferers almost always have low self-worth and negative beliefs that lead to chronic low self-esteem. They often have “other esteem” which means they rely on other people to provide their feelings of value and worth. Until they reduce their reliance on the fickle opinion of others and learn the skill of esteeming themselves from within, recovery can be difficult. Eating disorders can also result from early negative childhood experiences such as loss of a parent or beloved relative, abuse and even sexual abuse, so an assessment by a qualified and experienced clinician is advised to get an accurate diagnosis of the underlying cause. There is often a strong addictive element at work with bulimia nervosa as the act of vomiting is a powerful stress reliever and creates an endorphin response. Endorphins are the body’s natural opiates and in this way vomiting after bingeing becomes a compulsive habit with a payoff. Anorexia nervosa causes starvation and one of the body’s ways of enduring the pain of starvation during times of famine was to induce a sense of euphoria, a natural high. This “high” has been a feature of fasting for religious purposes throughout history. Thus self-induced starvation can also become highly addictive, with anorexics being able to go without food for long periods thanks to this natural payoff.
Therefore it may be helpful to see the complex topic of eating disorders through the lens of an addiction while considering which of the many treatment approaches will work best.
In case you need immediate support, please reach out to mental health professionals. Below is a list of organizations that offer eating disorders counseling:
Hong Kong Eating Disorder Association Limited
Address: Unit 101, 1/F, The Mills, 45 Pak Tin Par Street, Tsuen Wan
Tel: 2850 4448
Email: [email protected]
The Lighthouse Counseling
Address: 15/F, Bonham Centre, 79-85 Bonham Strand, Sheung Wan, Hong Kong
Tel: 6086 7995
Email: [email protected]
MindNLife
Address: Suite 1202, Chinachem Hollywood Centre 1 Hollywood Road, Central, Hong Kong
Tel: 2521 4668
Email: [email protected]
Child Development Team
Address: 10th Floor, One Island South, Suite 1015, 2 Heung Yip Road, Hong Kong
Tel: 2592 9000
Email: [email protected]
ReSource The Counselling Centre Limited
Address: 701, China Hong Kong Tower, 8-12 Hennessy Road, Wan Chai, Hong Kong
Tel: 2523 8979
Email: [email protected]
Eating disorders are characterized by abnormal eating patterns causing physical, mental and emotional distress, typically accompanied by body dysmoephia, a distorted body image. The primary constituent of eating disorders is under or over eating, with or without compulsive bingeing and purging patterns.
It is possible but unusual. Patients may falsely assume their eating habits to be normal and fail to recognize the problems. If you suspect that you may suffer from disordered eating, consult a qualified clinician for a professional diagnosis.
Research suggests females are more likely to develop eating disorders than males, though up to one in ten anorexics are men. In terms of age, adolescents and young adults aged from 14 to 25 are most at risk, but younger children and adults can also be affected.
This article was independently written by Healthy Matters. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.
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