Q&A: Anorexia and Hoarding Behaviour

Anorexia, a Common Teen Health Issue

Question: My 14-year-old cousin was diagnosed with anorexia six months ago. She was hospitalised, but has since returned home and gone back to school. Her parents and siblings are trying their best to help her, but she seems to be in denial about her condition and still refuses to eat. What can I do to help?

Answer: It is important to first recognise that anorexia nervosa (or anorexia) is an illness, and that your cousin did not choose to have this eating disorder. Her feeling of being overweight feels real to her, although to the people around her, that is not the case.

Commonly associated with mental health complications, including anxiety, depression, and suicide, anorexia affects one to four per cent of women and 0.3 to 0.5 per cent of men worldwide. In Singapore, there appears to be an upward trend — a local study showed that from 2003 to 2010, the number of new anorexia cases increased by 115 per cent.

Related: Loving and Accepting Yourself

As mentioned, a person with anorexia often believes that he/she is overweight, despite clearly being not. These individuals will restrict their food intake, induce vomit after meals, or take laxatives to cause diarrhoea. Some may also exercise excessively. Such extreme measures can make a person unwell, and the consequences can be fatal.

Offer support to your cousin without supporting her distorted belief. You can do this by listening without judgment, learning more about eating disorders, and sharing your concern for her when the opportunity arises. Sometimes, it also helps to be there for the people who are caring for her — they are probably very worried and not looking after themselves well.

Dr Goh Kah Hong
Head & Consultant
Psychological Medicine
Khoo Teck Puat Hospital

Hoarding, a Common Senior Health Issue

 

Question: My 70-year-old mother is reluctant to throw away things, which are starting to pile up in the house. This is a surprise because, previously, she would keep the house tidy and dispose of any unused items. Am I overreacting? Or is hoarding common among the elderly?

Answer: Hoarding disorder is a pattern of behaviour where a person excessively collects personal possessions and has difficulty with discarding things, some of which they may not need. This results in a severely-cluttered living space.

Hoarding affects between two to 4 per cent of our population. The severity of hoarding tends to increase with age — about six per cent of hoarders are over 55 years old. Hoarding can also be a symptom of other mental health conditions, such as obsessive-compulsive disorder, dementia and schizophrenia.

Related: Dementia Role Reversal: Who Is the Caregiver Now

Hoarders are often not affected by their habit and may attribute it to being simply disorganised, having a small living space, or thinking that the items may be required in future.

Hoarding may also be a reflection of a person’s impairment in judgement, attention and working memory. It is important to check for cognitive dysfunction or dementia in seniors who hoard. For others, hoarding can be an anxiety-reducing behaviour, especially in the face of major life events or stressors. Bring your mother to a doctor who can help address the underlying psychological issues.

Dr Marcus Tan
Consultant
Department of Geriatric Psychiatry
Institute of Mental Health

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