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Conditions
A person may be suffering from an eating disorder, if some or a combination of symptoms persists:
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Rapid loss of weight over a short period of time
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Unusual concerns with body weight
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Intense fear of weight gain
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Excessive exercises
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Improper/frequent use of laxatives and slimming pills/products
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Deny problems relating to eating
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Secretive eating
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Periodic consumption of large amount of food (bingeing)
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Use of bathroom after meals (vomiting) Engages in extreme exercise regime
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Mood swings (irritability) and depression Cessation of menstruation
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Perfectionism
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Use of bulky clothing
If you suspect that you or your loved one may be suffering from eating disorder, please seek professional help early.
Serious Physical, Social and Psychological Consequences
When left untreated, eating disorders can lead to serious and chronic health, social and psychological problems. Some of these problems are:
- Irregular heartbeat, cardiac arrest and/or death
- Severe tooth decay
- Chronic constipation, intestinal obstruction Weak bones and fractures
- Swollen salivary glands; "Chipmunk cheeks" Excess hair on face, arms and body
- Dry blotchy skin
- Guilt and shame
- Anxiety and self-doubt
- Feel out of control and helpless
- Alienated, lonely and isolated
- Low self-esteem
- Depressed and suicidal
Eating disorders are known to have the highest mortality rate amongst the different psychiatric disorders.
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Treatment & Management
A multidisciplinary approach with a combination of treatments to restore healthy eating habits, body weight and psychosocial wellness has shown to be effective. The combination of treatment may include:
- Nutritional counselling and rehabilitation
- Individual or Group Psychotherapy
- Family Therapy
- Medication
What to do when you realize that you maybe suffering from an eating disorder?
Sometimes, in the relentless pursuit of "thinness", you may refuse to acknowledge that you may be very ill. The first thing that you would need to do, and perhaps the hardest, is to come to terms with your eating problem and accept that you have this illness.
It is often difficult for you to seek help as you maybe afraid, anxious and ashamed eating problems that you are having. However, difficult as it is, you need to accept help early so that you can regain control of your health habits and begin to live a meaningful life.
What to do when you loved one is suffering from an eating disorder?
It takes courage for your loved ones to admit that they have an eating problem. It may also be difficult for you to accept that your loved ones have a problem. Sometimes you may be the one who first noticed their eating problem, while your loved one refused to accept that they have an illness. This is because persons suffering from eating disorders do not understand that they are ill and that they need help. Family member may feel scared, angry or helpless as your attempts to help may be met with their anger and hostility
Hence, it is important that you to try to:
Be supportive
Seek professional help early
Participate in the treatment programme active to increase effectiveness and prevent relapse;
Seek or engage in personal/ family counselling when necessary, as helping a person to overcome eating disorder can be a challenging experience.
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What the symptoms of such a clinical condition?
Obesity refers to the condition where there is an abnormal accumulation of fat in the body. Clinically, it is measured by calculating the individual's Body Mass Index (BMI) using the formula below:
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BMI = Body Weight(Kg) / Height2 (m2)
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Table 1: BMI Classification |
Table 2: BMI Classification |
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WHO Classifcation |
Asians
BMI (Kg/m2) |
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Underweight |
<18.5 |
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Normal weight |
18.5 -24.9 |
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Overweight (Pre-obese) |
25.0 - 29.9 |
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Obese |
>30.0 | |
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Risk Classifcation for Asian |
Asians
BMI (Kg/m2) |
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Underweight |
<18.5 |
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Low Risk |
18.5 - 22.9 |
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Moderate Risk |
23.0 - 27.4 |
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High Risk |
27.5 - 32.5 |
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Very High Risk |
> 32.5 | | Obesity can also be measured by measuring the inidivdual's waist circumference.
Table 3: Waist Circumference classfication
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Asian Male |
Asian Female |
| Normal |
<90cm |
<80cm |
| Excessive body fat |
<90cm |
<80cm |
From the tables above, it can be seen that the risk of developing Type II Diabetes Mellitus and cardiovascular diseases is moderately high in Asians with a BMI between 23.0kg/m2 to 27.5kg/m2. The risk of developing the above-mentioned diseases is even higher in Asians with a BMI greater than 27.5kg/m2. Thus, it can be seen that obesity significantly increases the risk of many chronic diseases.
What are other clinical conditions contribute to/or are associated with this ailment?
There are many clinical conditions related to obesity.
Mechanical problems resulting from excessive weight include musculoskeletal disorders such as osteoarthritis of weight-bearing joints (hips / knees / ankles). Obese individuals may also develop spondylosis of the lumbar spine and degeneration of the intervertebral discs, leading to chronic low back pain.
Metabolic disorders such as Type II Diabetes Mellitus and Non-Alcoholic Fatty Liver Disease, cardiovascular diseases such as dyslipidemia (elevated LDL-C, decreased HDL-C), hyperlipidemia (elevated Total Cholesterol, Triglycerides and LDL-C) and Hypertension (High Blood Pressure) are also associated with obesity. Other diseases that are commonly associated with obesity include Polycystic Ovary Syndrome – PCOS and Obstructive Sleep Apnoea (OSA).
When are these condition generally exhibited?
Based on the National Health Survey that was conducted in 2004, the prevalence of obesity amongst Singapore resident aged 18 to 69 was 6.9%. Obesity was most noticeable in the 60 — 69 age group.
However, it should be noted that 25.6% of adult Singaporeans are overweight and are in the moderate risk category. In addition to that, 11.9% of Singaporeans have excessive abdominal fatness. This is again most prevalent in the 60 — 69 age group.
Treatment
What are some of the treatment options available?
Lifestyle modification is the first line of treatment for clinical obesity. This involves medical nutrition therapy to decrease caloric intake, increase in daily physical activity and structured, individualised exercise programme and behavioural modification for a healthier lifestyle.
Drug therapy may be used as an adjunct to lifestyle modification when deemed appropriate by the physician. In cases of morbid obesity, surgical interventions such as gastric banding (eg: Lapbands®) may be performed on certain individuals. |
Where is treatment available?
The Obesity Unit @ SGH LIFE Centre offers comprehensive, multi-disciplinary obesity management programmes of various duration that aims to facilitate patients adopt changes in their lifestyle and in doing so, achieve realistic and meaningful weight loss. These integrated programmes comprise of individual consultations with the physician, dietician and clinical coordinator, group workshops with the psychologist for behavioural modification, group workshops with the dietician and supervised and individualised exercise programmes. In cases of morbid obesity, the physician will also refer to the surgical team for surgical interventions.
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