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The Weighing Game
Walk along the street in Singapore and chances are, every other teenager you pass is on some kind of diet.
Dieting has become so common that almost half the teens in Singapore are watching their weight. A study published in the Singapore Medical Journal last year found that 42.5 per cent of Singaporeans aged 11 to 21 are actively dieting.
This figure even exceeds the 30.4 per cent found in a survey of American high school youths in 2000.
How did we come to this?
Dr P Parvathy, consultant at the Institute of Mental Health’s Child Guidance Clinic, believes that as our society became more westernised, we have adopted the western idea that thinner is better.
“Thin means you are disciplined. If you are fat, people think you cannot control your impulses. Thin is also seen as beautiful because models, actresses and singers are all quite thin,” she says.
The relentless assault on media images and messages that glorify slimness has deeply ingrained the thin ideal here. And the resulting widespread preoccupation with weight and prevalence of dieting has made some sensitive teens more susceptible to eating disorders.
A study of anorexia nervosa patients in Singapore between 1994 and 2002 found the most vulnerable group to be 14- to 15-year-old girls, though there was one patient as young as six. The study also found that some 11 per cent of the patients were previously from the Trim and Fit (TAF) club in their schools.
Ironically, in trying to encourage these overweight children to lead a healthier lifestyle, the unwelcome focus on their size may have precipitated their eating disorder.
“I wouldn’t blame the healthy lifestyle programme or the TAF clubs. But if a child already has some inner psychological conflict, this emphasis on their weight could become a trigger,” says Parvathy.
Another irony is that increased awareness of eating disorders may have also helped fuel their rise. Media coverage of the problem could have given some children ideas they might otherwise not have had. “Sometimes it is not good to write too much about this either,” she sighs.
Little miss perfect
Dr Lee Ee Lian, consultant psychiatrist and director of the Eating Disorders Programme at the Singapore General Hospital, thinks that these factors may contribute to the problem: the pressure to excel academically, as well as the limited time and opportunity children here have to develop coping skills and indulge in de-stressing activities.
Often, adds Pavarthy, eating disorder sufferers are the ‘good girls’ – the ones who do well in school. They usually have a perfectionist streak. Says Nichol Ng, 28, a former eating disorder patient who was from a top girls school, “In today’s world, a young person feels the need to excel in every way, including looking good.”
In school, she busied herself with multiple leadership roles on top of her school work. “On hindsight, I was trying to escape from something. Maybe I was trying to prove to everybody that I was better than what I seemed, and I could only do it by controlling my food, and through all these activities.”
The root cause of an eating disorder is psychological. That is why treatment has to include psychiatric help, says Parvathy. But it is usually not easy to get sufferers to seek help.
“They can be so desperate not to lose control that they are as stubborn as mules,” she adds.
Watch your words
But parents sometimes cannot afford not to act. Although death from an eating disorder is not common, it does happen. Often, death occurs because the disruption in the body’s fluids and mineral levels has led to an electrolyte imbalance that causes the heart to stop beating.
To prevent such self-destructive behaviour, parents should try to ensure that their children grow up with a healthy body image. From the time the kids are very young, parents should watch the subtle messages they are sending out about eating and weight.
“Don’t criticise people’s weight and bodies, for example, when watching the Miss Universe contest on telly,” says Lee.
And minimise parent-child battles over food. “I’m not saying you shouldn’t encourage your child to eat healthily, but some parents overdo it,” says Parvathy.
“They won’t die if they occasionally eat a Magnum ice-cream!” says Lee. “All foods have their intrinsic value, whether nutritional or emotional, when taken in the appropriate quantities.”