The silent crisis on our plates

In the quietest hours of Haley’s day, an invisible battle quickly consumes her. Late in the night, Haley rummages through the kitchen — breaking the silence in her house. Her eyes search the shelves for yesterday’s rice, a half-empty drink or anything to chew on. It doesn’t matter if the food is stale, greasy or barely a meal as long as it momentarily fills her stomach and lets her sleep. But it never really does. “It just mattered to me that I was eating and I was full,” Haley, an incoming third year student at the University of Santo Tomas, told Rappler. Haley used to struggle with a binge eating disorder (BED), recognized as a severe, life-threatening condition by the American Psychiatric Association. It is defined by frequent episodes of consuming large quantities of food accompanied by a profound sense of losing control. She was 9 when it began, triggered by a childhood trauma she prefers not to disclose but described only as a “hollow she didn’t know how to fill.” “It doesn’t matter kung may carb man or fat lang siya, ’yung calories. (It doesn't matter if the calories come from carb or fat). It didn’t matter. I was always hungry,” she recalled. She said she often found herself thinking, “Bakit ko pang need gawin ’to? (Why do I even need to do this?) Why not just let me die?” Haley is fighting a systemic crisis. Despite carrying one of the highest mortality rates among psychiatric illnesses, eating disorders remain a healthcare blind spot — dismissed by families and entirely overlooked in a country that needs to prioritize involuntary hunger. The Department of Health (DOH) does not routinely track cases of eating disorders, making it difficult to measure the true scale of those affected, according to a representative who directed these reporters to other agencies. The DOH also disclosed the same lack of tracking in a freedom of information request on the government’s eFOI website. Despite this, several sectors still recognized the need for structured interventions, warning about the fatal consequences of unchecked suffering from eating disorders. “There’s not much research on binge eating,” said Dr. Alyssa Dar Juan, an Eating Disorder Treatment specialist. BED differs from bulimia nervosa in that there is no purging or compensatory behavior, and weight is not a diagnostic factor, Dar Juan explained. Because it lacks the compensatory purging or excessive exercise that characterizes bulimia nervosa, the binge cycle often leaves individuals overwhelmed by deep guilt and psychological distress. For Haley, this clinical reality translated into a condition that slowly turned cravings into habits, and habits into an inescapable reflex that haunted her from groggy mornings to late nights alone with her thoughts. Dar Juan added that “the main distinction is the uncontrollable feeling of wanting to eat and not being able to stop,” noting that this often comes with marked distress and is frequently tied to shame, especially when individuals feel overwhelmed by the amount of food they consume. At times, when Haley would eat so much, she would retch as she forcefully stuffed food into her mouth. “Alam mo ’yung mga moth sa mga flame? (You know how moths are drawn to flames?) They can’t resist it, pero they know it’s harmful for them,” Haley said. Self-loathing drove her to try purging. Fingers in the throat. Laxatives. Anything just she could think of to undo her act of eating. But nothing worked. I The culture that kills Haley’s struggle was not only the urge to eat, but the burden of explaining a disorder that few understood. To save face, she began disappearing during recess and isolating herself from friends in school. “Sobrang embarrassed ko kasi na ipakita ’yung ganong klaseng behavior ko (I was so embarassed to show that kind of behavior). I would eat alone,” she said. Eventually, she took time off from school and stayed home. In many households across the Philippines, a gathering is not complete without food. Yet alongside the warmth of shared meals come familiar, unsolicited remarks about a person's appearance and appetite. “Ano ba ’yan? Kailangan mong pumasok. Sayang naman ’yung tuition na binabayaran ng nanay mo (What is this? You need to go to class. You’re wasting the tuition your mom is paying),” they would tell her, urging her to simply "eat properly" and "stop overthinking." Dr. JN Paat, a psychologist at Gray Matters Psychological Center Philippines, said these comments are common in Filipino families and they affect how young people view themselves. “For the teenager or the young adult, it seems offensive — a direct blow to the ego,” he said, explaining that such comments can influence how individuals perceive their bodies. Paat added that cultural stigmas equating therapy with "serious mental illness" prevent many from seeking help, leaving struggles with body image hidden. Lawmakers have long recognized the threat of eating disorders, but a lack of localized data has consistently stalled legislation. For two decades, proposed measures have languished at the committee level, with most if not all failing to secure a single hearing. The legislative push began as early as 2005. The late Senator Miriam Defensor Santiago — who took a medical leave in 2006 to seek treatment for anorexia — championed Senate Bill No. 1989. The measure proposed the country’s first formal study on the prevalence of eating disorders among students to serve as a baseline for public policy. However, it gathered dust in the committee and when the 13th Congress adjourned, the measure lapsed. Santiago reintroduced an expanded version in 2008 (SB 2705), mandating the Department of Education to roll out awareness programs, train educators, and conduct nationwide research. She refiled the measure in the 15th Congress in 2010 (SB 1656) and the 16th Congress in 2013 (SB 1108). Across four successive Congresses, Santiago’s proposals carried the same core mandate: establish prevalence, assess the impact on students, and shape policy. Yet, every single iteration was left pending at the committee level, based on both chambers’ digital records and documents obtained by Rappler. Similar efforts surfaced years later. In 2021, during the 18th Congress, Camarines Sur Representative Luis “LRay” Villafuerte Jr. filed House Bill No. 9104, pushing for a multi-sectoral approach involving the Department of Health and the Commission on Higher Education. The bill tasked these agencies with improving early detection, training school personnel on response methods and launching parent-learner awareness campaigns. Crucially, it legally defined anorexia nervosa, bulimia nervosa and binge-eating disorder as serious disturbances in mental health and eating behavior. Parallel measures followed. Senator Ramon “Bong” Revilla Jr. filed SB 2179, mirroring the call for multi-agency coordination and school-based interventions, while then-Representative Joy Myra Tambunting filed HB 9186 to reinforce public education and skills training among guardians and educators. The legislative cycle repeated itself in the 19th Congress. Bills filed by Revilla (SB 515), Villafuerte (HB 8739), and then-Representative Gus Tambunting (HB 4318) retained the same structural goals as their predecessors. Yet, much like Santiago's initial push 20 years ago, not a single measure made it out of the committee, leaving the country's eating disorder crisis without a legislative cure. Rappler had sought interviews with Revilla’s former legislative chief but they declined. Santiago’s former staffers, Villafuerte, and the Tambunting couple never responded to official queries. A 2002 study by Lorenzo et al. noted signs of disordered eating among Filipino adolescents, but its scope was too limited to establish a national prevalence rate. This creates a legislative deadlock: without quantified data to prove the severity of the crisis, lawmakers lack the incidence rates needed to justify urgent action. Yet, unless these bills advance, government agencies remain unmandated to conduct the very studies required to gather that data. The DOH declined an interview request regarding its awareness and outreach programs for the illness, which is globally recognized as one of the most fatal psychiatric disorders. On the education front, the response is similarly stalled. In a statement sent to Rappler, the Department of Education (DepEd) noted that while the Basic Education Mental Health and Wellbeing Promotion Act mandates a School-Based Mental Health Program (SMHP), the agency's Learner Wellness Office has yet to release the actual implementation guidelines. “While the Bureau of Learner Support Services – Learner Wellness Office (BLSS-LWO) is set to release a policy on the implementation of SMHP in schools, field implementers have been guided by various interim issuances,” the department said. Finding professional help presents another massive hurdle: the clinical infrastructure for eating disorders is practically non-existent. “Hard to pinpoint how many ED clinicians are in practice because since psychologists are already less than the bare minimum met for all disorders, most ‘try’ to help practice but formally trained siguro (maybe) less than five that I know of,” Dar Juan said. Furthermore, treatments are billed as standard therapy sessions ranging from P2,000 to P3,500 per visit. For a condition that requires long-term intervention, the financial toll is crippling for an average household — a reality that kept victims like Haley away from the clinic. Paat also pointed out that cultural beliefs can prevent individuals from seeking professional help as some Filipinos associate consulting psychologists with negative connotations. The shame of admitting that something is wrong often keeps struggles with food and body image hidden, carried quietly by people like Haley. Anonymous spaces like Reddit and online support groups, offer spaces where people can speak without the shame that suppresses them. In these communities, people both clinically diagnosed and self-diagnosed share their coping strategies, recommended clinics, and comfort from lived experience. This trend extends beyond forums and into local spaces like Eating Disorder Awareness Philippines and Ako PH on Facebook, where they created online platforms for individuals struggling from eating disorders. The former is no longer active as of 2023 and the last time Ako PH was active was 2021. While they carry severe and life-threatening risks, Dar Juan explained that Philippine policymakers inevitably prioritize systemic poverty and involuntary starvation due to the economic realities of the country. Because millions of Filipinos lack access to basic meals, psychiatric conditions involving food are easily dismissed by the government, severely stunting local research and support for patients. Systemic deadlock and cultural stigma keep eating disorders invisible, but Haley’s mother refused to look away. When the single overseas worker learned of Haley's condition, she immediately flew home. Paralyzed by the potential hospital bills and her own despair, Haley initially resisted, until a bitter argument left her mother in tears. Recovery The way back to the table “Oh s***, I have to live for my mom,” Haley realized. Treatment began brutally. With doctors restricting her food exposure and prescribing appetite suppressants, Haley rebelled against the tightly monitoring nurses, shouting: “Aba, di ’nyo ko papakainin, p******* ’nyo! (So you won't let me eat, f**k you!)” Recovery required unpacking her triggers and treating her co-occurring depression and anxiety. She started with the basics: forcing herself to eat slowly and process every bite, even if meals took hours. This time, however, she had an impenetrable anchor. With her mother constantly by her side, backed by encouraging friends and a dedicated medical team, she was no longer fighting alone. Today, when the house falls silent at night, the quiet is no longer a trigger. Instead of rummaging in the dark, she has found peace in a simple dish. “I love this question,” she laughs, asked about her favorite food. “It’s carbonara.” Her specialists recommended finding a meal completely untouched by the guilt of her past. Carbonara became that clean slate — something she enjoys without the crushing weight of her disorder. For Haley, recovery didn't mean forgetting the past. It meant learning how to simply enjoy eating again. — With contributed reporting from Phillip Perez If you or someone you know is living with an eating disorder or disordered eating, you are not alone. Reaching out to a licensed mental health professional, a doctor, or a trusted person is a first step toward support. The authors are sophomore students from the University of Santo Tomas (UST) Journalism Department. This story was produced for their Feature Writing class and managed by the UST Journalism Lab — a university-based news bureau designed to bridge classroom instruction with professional industry standards. This piece was produced exclusively for Rappler.