Beating anorexia: what causes the eating disorder – and how to support someone battling it

I was not designed to be a skinny kid. I was a round one. I don’t know why I succumbed to anorexia nervosa. Maybe it was because I was a perfectionist? Because my mother got sick with depression? Because I found the speed at which I was growing up alarming and wanted to rein it all in?

Anorexia nervosa means “loss of appetite”, which is a misnomer. I never lost my appetite. I ignored it – even though it complained loudly from the pit of an increasingly shrunken stomach.

It is an illness characterised by a distorted body image and subsequent abnormal eating patterns. After nearly four years, at the age of 17, I was exhausted by the lack of food and my strict, self-imposed eating regimen. I realised I wanted to be well more than I wanted to be thin. If that meant being 51kg and not 38kg, I’d take the risk. Even when you don’t eat, you still grow up.

Gabrielle Tuscher, a Hong Kong child and adolescent psychologist and eating-disorder specialist, says anorexia is a complex mental health disorder driven by a number of factors including genetics, environmental influences and personality traits. “What drives one person’s illness does not necessarily drive another’s,” she says.

Perfectionism and the need for control are usual symptoms in most anorexia sufferers, Tuscher says. “Where other aspects of their lives and self are out of control or emotionally overpowering, the body and food become a space for the sufferer to have structure and a false sense of safety and control.