For some ‘eating disorder warriors’, social media is part of the recovery journey

SINGAPORE – Colourful snapshots of hearty meals and snacks adorn their Instagram feeds, with "superfoods" like avocado, chia seeds and brown rice making frequent appearances.

The posts are often peppered with hashtags such as #edwarrior, #realrecovery, #healthynotskinny, #edfamily, and #edfighter.

The individuals behind these cheery and vibrant social media accounts, however, are rarely unveiled – a suggestion, perhaps, that there is more than meets the eye.

They are not the typical fitness enthusiast but, rather, people recovering from eating disorders like anorexia and bulimia. In documenting their recovery online, some have found a community of like-minded "ED (eating disorder) warriors" across the world through these hashtags.

The number of people in Singapore seeking help for eating disorders has reportedly increased in recent years, and women make up the bulk of cases.

While experts have flagged the role of social media in fuelling the desire to be thin and the spread of unhealthy fads, some individuals recovering from eating disorders have turned to it as part of efforts to get better.

It is not known how many from Singapore are in these virtual social circles, but almost 8,000 posts on Instagram have been tagged #sgedw, or Singapore eating disorder warriors.

An 18-year-old who wanted only to be known as Katie said she felt encouraged by others openly sharing the ups and downs of their recovery journeys.

"I think the Instagram community does help support and encourage, not only (through) getting to know other successful ED warriors’ stories,” said the junior college student. “(It) reminds me of how far I have come and what I have accomplished in my recovery journey.”

Diagnosed with anorexia in 2014, Katie started two Instagram accounts a year later to "post pictures of my meal to track my progress". She updates @moitummy and @moibread almost every week and now has close to 4,000 followers in total.

"At the start, those accounts acted like ‘proof’ to myself of how far I have come. I got to know about the community later on. We share with each other about our recovery journey and some struggles we still face today, and give advice to each other. I know a few of them have recovered completely from eating disorders. When I am at a loss and need support, fellow ED warriors will offer encouragement with positive comments," she said.

Those she has established a rapport with include a young woman from Taiwan.

“She was suffering from an eating disorder and I tried to give her some advice, show concern and help her whenever possible. She's doing great now, married and expecting her first child!”

Katie added: "It was also through Instagram that I made many new friends and (we) occasionally still meet up to enjoy good food together. When we go for good meals, we talk about our lives, not only focusing on eating disorders, but in general."

Grace, a fellow 18-year-old who befriended Katie online, uses Instagram and the blogging app Dayre to track her journey towards recovery.

The polytechnic student said virtual platforms help those who are recovering to forge strong friendships, which makes the process less isolating.

But there are risks. Grace said social media can drag users into the comparison trap and hinder recovery.

“I feel that Instagram has lots of triggers for someone with an eating disorder. There are many hashtags that may cause comparisons, food diaries, and even pro-eating disorder accounts. Some girls or guys may post depressing quotes or pictures of their bodies, or say they are ‘fat’ when they are not really,” she said. “People recovering are in a very vulnerable position, this is why so many suffer relapses.”

She limits the time she spends on these platforms to prevent the negative effects from setting in.

HANDLE WITH CAUTION

Nutritionists and public health experts had mixed views and said the jury is out on whether social media is more of a help or hindrance for people recovering from eating disorders and other health conditions.

The use of social media is an evolution from online forums, which is common not only for eating disorders but other health issues such as diabetes and depression, said Ms Goh Yih Shian, a dietitian and nutritionist at Better Life psychological medicine clinic.

“As with all tools, there are pros and cons. Some clients have said they met people with encouraging progress and that has bolstered their confidence. On the other hand, triggers abound online and it does not take much for clients to slip back,” she said.

“For instance, Instagram can be quite toxic especially when many are so concerned about the number of ‘likes’ (they get). It then becomes a numbers game and (about) having to outdo yourself constantly.”

Psychiatrist Lim Boon Leng from BL Lim Centre For Psychological Wellness said healthcare providers often tap social media platforms to share positive health stories, but individuals afflicted with mental illnesses – including eating disorders – typically find it harder to talk about their experiences for fear of discrimination.

The visual nature of platforms like Instagram and Dayre makes them good aids for those recovering from eating disorders, he added.

“Images are a really good initial way to expose a person with anorexia to food. It helps them desensitise themselves to the anxiety around food. What this group of recoverers are doing is heartening. Their accounts of their recovery are extremely powerful for existing patients," said Dr Lim.

Mr Daniel Koh, a psychologist at Insights Mind Centre, said such use of social media platforms should be complemented with professional help. Social media can emphasise that “one is not alone” but getting help from a professional offers a check and balance, he said.

“Someone needs to make sure people in the group feel safe, secure and comfortable," he said.

Dr Jessie Chua, senior clinical psychologist at The Resilienz Clinic, said she would not recommend using social media as a platform for support for any mental or medical condition. “Without a trained professional, (those with various conditions) are vulnerable to misinformation of their symptoms and the appropriate coping strategies. The inadvertent sharing of ‘advice’ may be detrimental to some of these individuals,” she said.

“In my opinion, it is important to see a mental health professional for proper diagnosis and evaluation. Thereafter, one can consider attending specialised group therapy programs conducted by trained professionals to receive proper guidance and treatment of one's issues.”