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Sufferers often high achievers

People with eating disorders are quite often high achievers, said Ms Frances Yeo, the principal psychologist at Thomson Paediatric Centre.

"They set high expectations on themselves, but it may not always be realistic. Coupled with a distorted body image, they will try to gain control of their lives by dieting or exercising excessively," she said.

To complicate matters, high achievers are usually more determined than most people and can follow an excessive dieting and exercising regime. 

Ms Yeo said: "Depression can set in when they eat a little bit more than usual and feel guilty."

She recommended that patients go back to school after the medical aspects of the eating disorder have stabilised.

"It is important for these children to go back to their usual routine once their medical condition is stable."  

Treatment for eating disorders takes time and family support is important so that they can get through this period.

"Working with the child, the therapist will help the child understand her difficulties, alter body image issues and set achievable goals for her," said Ms Yeo.

Ms Selena See, a trained counsellor at City College, said that it took a while before Miku Seko opened up about her problems.

"I consistently asked her how she was doing and assured her that it was okay to share her emotions," said Ms See, who was also Miku's chemistry teacher and mentor.

"Beyond academics and grades, kids need to be reminded that they have their own strengths and are better than they think they are," she said.