Miss Ho is an anorexia patient who is so underweight and in critical danger that she has been hospitalized involuntarily.
Her mother is skeptical about the diagnosis, noting that her daughter does not hate food at all.
In fact, she said, she has often caught her daughter sneaking into the kitchen and gobbling her favorite food. Miss Ho also enjoys grocery shopping and cooking a feast for her friends and family.
People often equate anorexia with loss of appetite, but the opposite is actually true. They think of food constantly and crave it.
The problem is, they fixate on the belief that they are overweight, and this disgusts and horrifies them. This self-hatred and fear drive them towards strict diets and other extreme ways of staying slim.
They may deliberately throw up after meals, exercise excessively or take medications like anorexiant, laxative or diuretic.
Anorexia patients avoid eating in front of people, and often lie about the portions of food they have eaten. While they overstate the amount of food they have had, they are also busy cooking and pushing others to eat more.
Some of them may not be able to resist the temptation and start gorging themselves on food. The guilt and shame that they feel afterwards, along with their fear of calories building up in their body, will prompt them to throw up deliberately. However, vomiting only makes them feel worse.
The vicious cycle is a living hell for many of them.
Anorexia patients experience weight loss due to low energy intake. While the normal BMI (Body Mass Index) for Asian adults is between 18.5 and 23, that for anorexics is lower than 17.5.
Apart from continuing weight loss, the strength of their muscles and bones decrease. The hormonal imbalance in female patients can disrupt their menstrual cycle. Men, on the other hand, may lose their sex drive or face erectile problems.
Anorexic patients suffer from constant self-loathing and terror. Because of the shame that they feel, they do not want to share their struggles, much less seek professional help. Most of the time they just pretend to be fine.
Friends and families should listen to their confessions and show empathy to encourage them to receive medical help.
Involuntary treatment is not the ideal way of handling the problem, but when the patient’s life is threatened, forced treatment will be the only option.
This article appeared in the Hong Kong Economic Journal on Jan 10
Translation by John Chui
[Chinese version 中文版]
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