Recent reports suggest that about 14% of university students in Malaysia are at risk of developing an eating disorder (ED). Yet, EDs are often misunderstood and underreported in our country. For this reason, we at Charisma Movement have decided to shed light on the complexities of EDs by organising a virtual panel session on the 7th of December, titled Empowering Recovery Stories in Eating Disorder Communities, in collaboration with UM MMI Young Medics and Sunway Medical Centre. Experts Ms Celeste Lau Wai Hong and Ms Lim Yong Xin from Sunway Medical Centre provided valuable insights to our participants.
Overview of EDs
For starters, how exactly do we define an ED? According to the American Psychiatric Association, EDs are defined as abnormal eating habits that negatively affect physical or mental health. According to Ms Lim, the most common types of EDs in Malaysia are anorexia nervosa (overly restrictive eating), bulimia nervosa (binging and purging) and binge-eating disorder. These usually stem from genetic predisposition and societal pressure, the latter of which is known to have its roots in the beauty standards portrayed in social media and in many East Asian cultures. The typical victims are youths and women, but it is slowly expanding to other demographics. All in all, EDs are influenced by societal norms, beauty standards, and exacerbated by our country’s stigma around mental health.
Beyond the Plate: The Emotional Landscape
One common myth is that eating disorders are solely about food and weight. In fact, EDs are much more than just struggles with food — they represent deep-seated issues of self-worth and mental health. Such a simplistic view trivialises the complexity of these conditions and can impede early diagnosis and effective treatment. Quite often, one may focus on food or weight as a tangible means of control when other areas of life feel unmanageable. Food behaviour is merely a symptom of deeper issues; you cannot take care of the eating disorder without understanding the underlying emotional triggers, which can be anything from anxiety to perfectionism to trauma. That is why recovery plans focus on psychological therapy hand in hand with nutrition rehabilitation.
Social Influences: The Role of Cultural Expectations
However, these factors become even more difficult to overcome with societal pressures in Malaysia. The pressure to have the 'right' body type— a slim figure, for example— pushes individuals to develop unhealthy eating behaviours as a means of trying to be accepted. Social media exacerbates this struggle, as carefully filtered images and fad diets encourage an unhealthy obsession with one's appearance.
The panel shared that eating disorders can affect any individual regardless of weight, size, or appearance. For example, a person with binge-eating disorder may not conform to the stereotype of being thin, so their illness may be overlooked or minimised. The belief that eating disorders are just "diets gone too far" is also extremely dangerous. It can prevent people from seeking help until their condition is severe. Men and older adults, in particular, face additional barriers to diagnosis because of stereotypes that eating disorders only affect young women. "Stereotypes can delay diagnosis," noted dietitian Lau Wai Hong, “-especially for individuals who do not fit the traditional image of someone with an eating disorder. It is critical to move beyond these biases so everyone feels empowered to seek help.”
Comorbidities: When Disorders Collide
Another critical point mentioned during the session was that people suffering from eating disorders often have comorbidities. People with anorexia, bulimia, and binge-eating disorder usually suffer from anxiety, depression, OCD, or PTSD. These are disorders that make the treatment process and recovery more complex. As is often the case with anorexia nervosa, for example, perfectionist tendencies and obsessive behaviours like rigid calorie counting or compulsive exercise always point to anxiety and OCD. Binge-eating disorder generally accompanies depression and is often deeply rooted in cycles of guilt, shame, and low self-esteem that keep disordered eating patterns in motion. Unless such comorbidities are treated, treatment is not complete. We cannot anticipate a person to come out of an eating disorder if there is anxiety or trauma not taken care of.
Medical and Psychological Treatment: A Combined Approach
Panellists pointed to the dual nature of eating disorders; thus, an integrated method of treatment should include medical as well as psychological treatment. Nutritional rehabilitation and medical monitoring are also imperative in recovering physiological function, particularly in cases suffering complications such as electrolyte imbalances or heart issues. However, these must be reinforced with therapy to tackle deep-seated psychological factors at their roots. Evidence-based treatments, such as cognitive-behavioural therapy (CBT) or dialectical behaviour therapy (DBT), have been quite effective in helping individuals reframe their thoughts and develop healthier coping mechanisms.
Challenges of Recovery
Recovery from eating disorders is often challenging but not impossible, as the panellists underlined. Recovery is not a linear process but one of setbacks, relapses, and moments of self-doubt. This is notably due to the risk of relapse; the triggers that lead to the eating disorder, such as societal pressure, stress, or trauma, often remain well after treatment has started. Many find their disordered behaviours comforting, and changing—even when they know it is necessary for their well-being—is hard to embrace. The physical health-restoring process, like obtaining a normal weight or reversing medical complications, is usually accompanied by intense emotional discomfort, especially in those who struggle with body image. Shame and fear of judgment prevent many from openly discussing their struggles, thus delaying access to support and treatment. It is crucial to realise that some days, you will feel like you are climbing out of a hole, only to slip back into it. Yet, all steps forward matter, no matter how small.
Strategies for Recovery
There are a few effective strategies for dealing with recovery and building on the need for patience and self-compassion. For instance, focusing on small, reachable milestones can make the journey less overwhelming. The goal might be to add one more meal in a day or to practice self-affirming exercises. Also, patients need to discover their motivation. Clearly understanding why recovery matters — be it for physical health, relationships, or personal pursuits — may serve as a powerful motivator. Then, recognition and celebration of minor successes, like overcoming fear of food or going to a social gathering, reinforce the behaviour. Ultimately, seeking help from professionals, such as therapists, dietitians, and psychiatrists, remains the most important strategy as it is crucial for evidence-based support that meets individual needs.
Differences in Treatment Across Age Groups and Conditions
Evidently, treatment strategies need to be differentiated according to age, gender, and the type of eating disorder. Family-based treatment, in which the family actively supports the nutrition and recovery process, is often effective for younger patients. Families should avoid blame and instead offer empathy and practical help, such as preparing meals or encouraging the patient to adhere to a dietitian-prescribed meal plan.
Generally, individual therapy, coupled with nutritional counselling and, in some cases, medication, is the general treatment modality for adults. The challenges faced by men experiencing eating disorders are somewhat unique due to stigma and other societal expectations. Hence, to match these barriers, interventions need to be appropriate.
Whereas a person with anorexia may need initial medical stabilization before therapy can begin, a person with binge-eating disorder, for instance, might respond better to behavioural therapy and group support. Recovery is multi-dimensional, including physical, emotional, and social needs. With a combination of professional guidance, personal resilience, and strong social support, recovery is not only possible but also sustainable. Recovery is not about returning to who you were but becoming who you are meant to be.
The Eating Disorder Virtual Panel Session was a powerful reminder that eating disorders are complex mental health conditions requiring awareness, empathy, and comprehensive treatment. The event brought out some important takeaways, such as early detection, the need for medical and psychological interventions, and the importance of community and social networks to nurture recovery. It busted some myths that had been existing in society, such as "eating disorders are just about food and weight", and paved the way for a better understanding of these conditions.
As individuals and as a society, we have our roles to play in breaking this stigma about eating disorders. Whether through educating ourselves, supporting awareness campaigns, or offering understanding to those affected, every little action counts. If you or someone you know is struggling, do not hesitate to seek help. Together, let us break the stigma and empower recovery stories within our communities, one step at a time.
By
Christabelle Lee,
Journalist,
Charisma Movement 24/25.
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