She developed eating disorder to cope with woes

Ms Lee Yue Er's most striking childhood memory was that of her parents shouting and fighting while she sat on the floor crying.

- Lee Li Ying

As an only child, she had no one to turn to for help. She was in lower primary school then. A sense of abandonment and confusion plagued her childhood, said Ms Lee, now a 21-year-old nursing student, in an interview with The Straits Times.

At the age of 11, her emotional turmoil churned into a more destructive force. A self-professed "shy kid", she faced friendship problems in school.

She began starving herself because food was the only thing she felt she could control.

"Hunger was a source of comfort. When my weight dropped, I felt satisfaction," said Ms Lee, who was diagnosed with anorexia nervosa when she was 14.

The mental health condition is characterized by an abnormally low body weight and an intense fear of gaining weight. Another common eating disorder is bulimia nervosa, which involves binge eating, then purging.

Stressors such as family conflicts, academic stress, bullying and low self-esteem can contribute to the development of an eating disorder, said Dr Courtney Davis from the adolescent medicine service at KK Women's and Children's Hospital (KKH).

Other factors that put one at risk of developing an eating disorder include being female, having other psychiatric conditions like mood disorders and being a perfectionist, she added.

Although eating disorders can affect people at any age, they commonly develop in adolescence.

In Singapore, anorexia nervosa and bulimia nervosa begin at 14 years old on average.

One of the main contributing factors is puberty, said Dr Ng Kah Wee, director of the eating disorder programme at Singapore General Hospital (SGH).

"There's more awareness of a person's body as it changes, like body size, shape and image which are the main domains that patients have struggles with in eating disorders," she said.