January 18, 2019

“Are you nervous?” Lishan Lim asks, in the elevator. “Actually, I’m more curious than anything,” I reply coolly, a thousand ideas sprinting across my mind about what I’ll see and who I’ll meet. The doors open to the 11th floor of Novena Medical Centre. We make our way into a small, brightly lit clinic, and through the doors of another tinier room. It’s 6:55pm, and we are relatively early. The chairs are arranged in an intimate circle—Lishan settles into the couch, while I pick the adjacent armchair. One of the facilitators greets me gleefully and hands me a newcomer’s pack, an envelope containing a handful of informational brochures. At 7pm, the room suddenly fills up, and I realise I’m surrounded by a cluster of some of the most beautiful women I’ve ever met. Tall, lean and attractive like supermodels. This isn’t what I’d expected at all.

I’m at my first Overeaters Anonymous (OA) meeting. There are about nine of us, mostly Caucasian ladies in their 20s. I’m shadowing Lishan, a yogi and occasional model-actress, to see what it’s like. I assumed that she would be the exception, that most overeaters are overweight, but au contraire. The first lesson I learn hits me hard: Looks are deceiving.

Founded in 1960 in Los Angeles, OA isn’t just for compulsive overeaters. It welcomes anyone battling an eating disorder and the symptoms of it, including undereating, anorexia, bulimia and excessive exercising. The session starts with a serenity prayer that the group recites out loud: “God grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.” Despite OA’s insistence that it isn’t a religious group, its overt spiritual overtones are hard to ignore.

After the newbies are introduced, the lead facilitator for the day reads through the guidelines, the dos and don’ts, and the mission of OA. Everyone is then given a laminated sheet of paper that details the recovery process, including the 12-step programme, adapted from Alcoholics Anonymous (AA). Each person reads one or two paragraphs until the end. The group also goes through two books with daily meditations, which remind me of daily devotionals for Christians. This might seem cult-ish to an outsider—reading from a script in a robotic tone—but it is a genuine source of comfort and catharsis for its members. Nowhere is this more apparent than during the individual sharings.

Sometimes, the attendees follow a sequence and share in a circle. Today, anyone is free to jump in at any point. It takes a while before the tension breaks and the veneers of strength and cool-headedness disappear. Stories, feelings and vulnerabilities are shared, and tears roll down the cheeks of more than one participant. Witnessing the brokenness of these strangers, I feel myself on the precipice of reacting the same way.

What’s different between these meetings and an average conversation is that at OA, “feedback, cross-talk and advice giving are discouraged”. You’re meant to address the entire group when you share, instead of responding directly to another person’s sharing. Like in AA, the speaker always starts with, “Hi, I’m so-and-so, and I have an eating disorder.” When the sharing is over, everyone collectively thanks the individual. At the end of the hour, the group stands up, holds hands and reads a final declaration together before departing.

“It’s effective because you feel less alone in your struggle. If you talk to a normal person, they might say something unhealthy,” Lishan shares after the session. It is the 25-year-old’s second time at OA, which is a more affordable option than her therapy sessions that can cost up to $200 for an hour. “In therapy, it’s more like a conversation, but the therapist has to be a little detached.”

A graduate of Wee Kim Wee School of Communication and Information, the svelte, eloquent yoga instructor has been struggling with bulimia for about decade. “It is an addiction,” she says, explaining why OA works like AA. “Food is my friend when I’m bored. I use it to numb myself from feeling lonely and everything.” Going through endless cycles of binge eating and purging, Lishan uses food to soothe herself, but ends up feeling guilty about the calories and proceeds to vomit her meals to undo her “mistakes”. It’s also a way for her to stay slim. Having gained weight in the past, she was bullied for it, suffering a hit to her self-esteem and body image. Coupled with the stress of school, she turned to purging.

It didn’t help that she also had type one bipolar disorder with psychotic features, and depression, which she developed at the age of 11. “I knew I had depression since I was very young,” she says, only seeking professional help later in life. Even then, mental health treatments were still in their infancy, and Lishan was misdiagnosed with chronic depression, instead of bipolar disorder. “Many people with bipolar get misdiagnosed with schizophrenia or personality disorders. It’s quite common,” she says. It led to taking the wrong prescriptions, which “worsened my mania”.

For many with eating disorders, it’s common to be suffering from mental health ailments concurrently. Bulimia and bipolar disorder, in particular, are closely linked. The emotional extremes you oscillate between with bipolar, mimics the rollercoaster ride of overeating and emptying yourself, being bloated and starving. For Lishan, her eating disorder is one of the ways she copes with her bipolar, depressive and suicidal thoughts.

If I made a typo in this article, all it takes is just a few clicks to make it right. If I accidentally botched a picture in Photoshop, CTRL+Z will solve everything. The appeal of purging is like having a real-life backwards button. “You feel like you un-did something wrong. It’s like a magic wand,” she says. You didn’t really consume those bags of potato chips, or that entire chocolate cake. It seemed like the perfect remedy. You could eat to feel better, and purge to remain skinny. But Lishan eventually realised its dangers: “My face got bloated, my eyes were bloodshot and I had heart palpitations.”

Others may stay away from purging, but torment themselves mentally, dragging an entire week down because of a moment of weakness. At times, the degree to which they overeat may be slight, but having an eating disorder distorts the way your mind perceives things.

The solution to your pain becomes the source of it.

Beyond academic stress and childhood bullying, there seem to be larger issues at play in Lishan’s life. Her childhood, for one, was “chaotic”. Between the ages of 3 and 6, she was hopping from house to house, staying with her grandparents during weekdays and her parents on the weekends. “I’ve stayed in six places,” she explains. “We were shuffling around different relatives’ homes because my grandparents didn’t have their own home, and my parents needed to work.” Lishan attributes her unstable childhood to her parents’ workaholic nature—after all, they weren’t balancing multiple jobs or dealing with financial issues. But whether that’s the real reason for her irregular living arrangement, she’s still unsure. What she’s certain of is the toll it took on her. “I remember crying once on my own after coming back to my parents’ place. It was like I could never form bonds and find a stable place. Once I felt settled somewhere, I had to move again.”

It’s no surprise to learn that Lishan doesn’t share a close relationship with her parents. She admits, “We live together, but hardly see each other. I just keep to myself. I think that’s the issue with modern-day living. It’s worse for Asian families because we don’t talk about our feelings. My parents don’t like to show emotions, so it makes me feel like I have nowhere to express myself safely.”

Besides the issue of masking emotions, sensitive conversations surrounding mental illness and eating disorders are generally disregarded in Asian culture. “They think I’m cured, but that’s not true,” she says of her parents. That’s perhaps why six of nine of the attendees at the OA meeting were either white or Eurasian.

“My circle of friends always changes too. Everything is very fleeting. People are, to me, the worst to rely on. You can’t control what another entity wants to think and do,” she adds. “What about your grandparents?” I ask. “No. I wasn’t close to anyone,” she responds. The one thing she does every day as a healthy form of coping is yoga, which she discovered five years ago when she started her university studies. “It’s a good distraction. I loved how holistic it was from the first class,” she says. “Before, I didn’t have a purpose. Yoga made things better for me and made me more self-aware.”

Still, it isn’t a permanent solution. “When I’m teaching, I’m engaged. But sometimes, after classes, I go back to feeling bad very quickly.” Lishan also takes mood stabilisers for her bipolar disorder—a remedy that at times leaves her with side effects like tremors and restlessness that interfere with her recovery. One of them, Seroquel, even aggravated her bulimia. On the flipside, the antidepressants that treat her bulimia triggers her mania. To date, she has tried five different types of medications.

“I got a little worried when you asked me out to dinner,” Lishan admits, as we dig into our paleo-friendly plates at Caveman Food an hour before the OA session. In preparation for this get-together, she had to be strict with herself, planning in advance exactly what she was going to have for breakfast, lunch and dinner. More than the physical act of eating well, it was also a psychological battle. “I told myself I won’t purge after my meals today,” she says. And she didn’t. In spite of that momentary victory, Lishan’s struggles are a daily affair. A good day can be followed by a disastrous week. “I feel vulnerable all the time,” she says. “I must be conscious with myself at every moment.”

Being conscious means that you have to be awake to the issues and tune in to yourself, but sometimes it takes an eternal nudge. Before I was given the green light to shadow Lishan at the OA meeting, I was asked if I’d any experiences with eating disorders. Though my first instinct was to say no, I realised I had indulged in starving myself in the past out of sheer laziness to cook myself a meal. Yet, I’d never thought of it as a symptom of a disorder. The danger of these diseases is that it’s possible to fall into them unwittingly. We need to engage in conversations that spark awareness and reflection, not just for ourselves, but also for society at large to dismantle the stigma that keeps those who suffer from seeking help.