Just like you, Senior Principal Physiotherapist Cindy Ng has a part to play in supporting patients with eating disorders.
Dr Cindy Ng, Senior Principal Physiotherapist, once “caught” a patient running around outside the Lifestyle Improvement & Fitness Enhancement (LIFE) Centre as she waited for her turn to see the doctor. In other instances, she has seen patients doing star jumps and burpees around SGH.
As a key member who helped to open the LIFE Centre 10 years ago, her main focus is to help patients with weight management issues. Occasionally, she comes across a patient who shows signs of eating disorder.
“Some overweight patients have binge episodes and may use exercise to compensate for their eating behaviour. Exercise must be done in the right dose. Over exercise may result in injuries such as ankle sprains, inflammation of the joints and, in extreme cases, fractures. In some instances, due to medical reasons, it may cause rhythm disorders of the heart or low glucose episodes,” she explained.
Dr Ng has seen how eating disorders have wreaked havoc on not just patients, but also friendships and family life. Seeing both ends of the spectrum, from the obese to the very thin, Dr Ng’s key aim is to encourage all her patients to have a positive body image of themselves.
However, approaching patients who may have eating disorders can be a challenge, as many of them refuse to see a psychiatrist, thinking that they don’t have a problem.
Dr Ng’s Tips:
Don't be confrontational.
These patients may not even realise they have a problem. They may simply tune out or refuse to see you again for other health issues.
Be sensitive and avoid triggering words.
For example, physiotherapists or dietitians may talk about “burning fat” or “counting calories”, but these are highly triggering. Oftentimes, disordered eating behaviours stem from past teasing. Using triggering words may cause more harm.
It’s a team effort.
Alerting other members of the care team is important. It allows each member to send a consistent message to the patients. Continue to support them until they recognise their problem and are willing to seek help.
Continue to support them.
Patients’ trust in healthcare professionals means they may feel comfortable and willing to share more, even about their bad days. Assure them that seeing a psychiatrist doesn’t mean that they are crazy. It is unlikely their disordered eating habits will be resolved overnight, so continue to support and encourage them!
How do you tell if someone has an eating disorder?
The red flags are usually very low body weight, or weight that rapidly drops over a few weeks. If blood tests are very abnormal, or heart rate is very low, it also warrants urgent treatment such as admission as these imply that the patient is medically unstable. Patients that are psychologically unstable may also warrant more urgent treatment, e.g. those who are suicidal.
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