PETALING JAYA: When it comes to children and adolescents dealing with eating disorders, Hospital Tunku Azizah (HTA) serves as a referral centre for the country.
HTA has a multi-disciplinary approach and team with paediatric/adolescent paediatric, psychiatry/child psychiatry, clinical psychologist, therapist and dietician expertise.
Consultant child and adolescent psychiatrist Dr Anita Codati said the hospital receives, on average, 10 to 15 referrals per month, with patients ranging from as young as 11 and up to 18 years old.
In the post-pandemic era, Dr Anita said HTA saw a threefold increase in cases, compared with three to five cases a month previously.
However, as the end of 2024 approaches, the hospital is seeing the numbers coming down.
“This is in line with the global trend whereby initially during the post-pandemic (stage), cases were higher. A lot of those with eating disorders are evolving because they could be on the way to recovery or partially while continuing to struggle with other issues such as depression or anxiety.
“Many of those with eating disorders also have neurodiversity issues – no two brains function alike,” she told The Star recently.
Asked why people end up with eating disorders, she said many people, especially teenagers, have issues with body dysmorphia or abnormal relationships with food, or have dysfunctional family dynamics. She said the pandemic forced many families to be isolated, thus changing the dynamics for a lot of people, with disruptions to structure and routines, and pressure on connections.
This contributed to the rise in cases and now it is going back to normal while people are adapting again, she added.
“Teenagers go through a lot of body changes, and only a subset of them are susceptible to eating disorders or at risk.
“The blueprint of how teenagers interact at home is how they are going to be in school with peer connections. Those who are vulnerable usually lack connections or deep meaningful connections with parents and siblings.
“There are also other factors like school bullying, peer opinions and social media influence, which play a large part especially for teenagers,” she said.
On the influence of social media and trends, Dr Anita said it allows a lot of young people to look at content that may not be suitable for them, like a 12-year-old boy getting influenced by a 20-year-old bodybuilder on protein shakes and restrictive food, or young girls trying to emulate K-pop stars.
“What I have also noticed is that among the younger anorexia patients, those under 14 and also apparent among kindergarteners, they often talk about what is good food and what is bad food.
“When there are labels, it might put certain kids who are already vulnerable at higher risk.
“For example, potatoes or even nasi lemak is not unhealthy per se, but more about how much we consume. The same goes for butter – there was a period it was considered bad because of cardiac disease, but now margarine is considered the bad one.
“So, our understanding of what is good or bad keeps changing,” Dr Anita said.
Children having such disorders is also an indicator of high levels of anxiety and sense of perfectionism, thus teachers and parents should be attuned enough to notice their condition, she added.
In addressing any eating disorder, she said early intervention is key as the biological impact is great, including the brain breaking down.
“The brain is made up of 60% of fat – when there is zero per cent body fat, the brain starts breaking down. Scans of anorexic children show that their brains shrink. Still, the best part of humans and children is resilience, our strength for survival. So even if something happens, there is hope for recovery,” she said.
