An anorexic becomes obsessed with dieting and losing weight and is overwhelmingly afraid of packing on the kilos. He also becomes preoccupied with food.
Ms Geraldine Tan, a psychologist at Centre For Effective Living, said: 'The bottom line is that there is low self-esteem and a lot of insecurities. Anorexics think 'If I just lose a couple of centimetres then I get affirmation'.
It's a vicious cycle.
'Friends will go up to them and ask if they've lost weight. They see it as affirmation and then it becomes an obsession.'
There are two kinds of anorexia - restrictive anorexia and binge/purge anorexia.
Those suffering from the former maintain their low body weight mainly by limiting what they eat while those suffering from the latter restrict their food intake but also regularly binge-eat and engage in purging behaviour like self-induced vomiting or abusing laxatives.
Other symptoms of anorexia include compulsive exercising, absence of periods and a distorted body image.
Anorexia can lead to complications like a smaller and weaker heart, damaged kidneys and loss of bone mass.
The mental disorder is most common in young adults between the ages of 18 and 25.
Ms Tan said: 'Most anorexics are very intelligent. Many are high achievers, like established dancers, yet they feel it's not enough.'
It runs in the family
It is not known what causes anorexia although researchers agree that it is a combination of genetic and environmental factors.
Eating disorders tend to run in families.
The chance of someone developing anorexia is 12 times more likely if a nuclear family member has it.
Treatment for the disorder is multi-disciplinary. If the patient's weight is too low, he has to be admitted to hospital so he can be restored to a healthy weight.
As the problem is both psychological and physiological, the patient will have to undergo cognitive behavioural therapy with a psychologist as well as nutritional counselling with a dietitian. The patient's family and friends may also attend therapy to learn to help him modify his diet and exercise habits.
Ms Tan said: 'We can't totally eradicate the patient's insecurities but he learns strategies to cope with certain thoughts and situations and to build up his self-esteem.'
For more information on anorexia nervosa or to enrol in Singapore General Hospital's Eating Disorders Programme, contact SGH's Life Centre on 6326-6697 or e-mail sgh.lifecentre@sgh.com.sg. You can also call Singapore Association For Mental Health on 1800-283-7019 (9am to 1pm, 2 to 6pm, Mondays to Fridays) or e-mail counselling@samhealth.org.sg.
