What do you wish your doctor had done/said to help you with your relationship with food?
This week is National Eating Disorders Awareness Week and the theme for the week is ensuring that all health professionals receive appropriate and complete training on eating disorders. The national eating disorder charity BEAT are campaigning for all UK medical schools to introduce training on eating disorders into their curriculum. I would take this one step further and suggest that all health professionals receive training on disordered eating and not just eating disorders (i.e. where an individual doesn't meet the diagnostic criteria for an eating disorder but still has irregular or erratic eating patterns and their relationship with food has a negative impact on their mental health).
I can appreciate that doctors and other health professionals have very busy schedules and through no fault of their own, they often don't receive any training on eating disorders or disordered eating. However, how a doctor or health professional first interacts with some struggling with their relationship with food, can have a huge impact on whether that individual is able to access appropriate support and make a full recovery. In my experience of working with individuals struggling with there relationship with food, these are ways in which other medical professionals could have helped them or supported them with their eating disorder or disordered eating:
- By knowing how damaging statements around weight can be: Many of my clients struggling with binge-eating disorder or binge-eating report to me how often they have told that they "need to lose weight" by their doctor or another health professional. Whilst this is very well-meaning advice, for someone that is struggling with an eating disorder, this can be extremely harmful and triggering. Often what drives binge-eating is food restriction i.e. an individual will starve themselves and put themselves on a very restrictive diet but then feel very hungry and end up bingeing as a result. Bingeing is a very primitive mechanism, designed to keep us alive in times of famine. In order to treat the binge-eating and break this pattern, it is necessary to free someone from this restrict-binge cycle. However, when an individual is told that they need to lose weight, they can end up putting themselves on yet another diet or restrictive meal plan and their binge-eating can get much worse as a result. Therefore discussion around weight can be very harmful for those struggling with eating disorders or disordered eating.
- By not recommending restrictive diet plans: Many clients tell me that their doctors or other health professionals have recommended that they go on fasts, cut out food groups or join another weight loss programme that eliminates most fats from their diet. Not only can these recommendations make conditions such as binge-eating and bulimia much worse, they can also make individuals scared of entire food groups. I have seen a significant rise lately in "orthorexia" which is a condition where an individual's diet becomes extremely restrictive with their diet in the pursuit of good "health".
- By listening and making them feel seen and heard: One of the saddest things that I hear from my clients is that sometimes they have felt as though their concerns are trivial or that they have been discouraged for seeking out or accessing help as they are a "normal" weight. When someone is struggling with any mental health related issue one of the most valuable things that medical professionals can offer that individual is a space in which they feel seen, heard and validated. It is often only with this feeling of validation that they will then go on to find appropriate help and look to recover.
- By spotting the signs and on-referring them for appropriate help: Receiving training in eating disorders would help medical professionals to spot the signs of an eating disorder or to ask questions to determine whether disordered eating may be an issue. Often the only metric that medical professionals use right now is weight to assess this. However asking questions around an individuals eating habits, how often they think about or worry about food choices, how they feel about themselves and their confidence levels and many other factors can be indicative of disordered eating. More training on spotting the early signs of disordered eating could help individuals to access help much sooner. The sooner an individual struggling with an eating disorder accesses help, the more likely they are to make a complete recovery.
- By knowing that it is never as simple as "JUST" eating "less" or eating "more" : Many of the clients that I have worked with have described stories where they have reported feeling out of control around certain foods to a medical practitioner or dietician, only to be told that they need to just exercise more control and eat less. Individuals struggling with restrictive eating, ARFID or orthorexia have also reported to me, being told that they just need to eat more. Of course, issues around food are NEVER that simple. It can be very patronising for an individual to be told what to do around food. In my experience, most individuals know exactly how they SHOULD eat - what they need help with is understanding WHY they are unable to eat this way.
- By acknowledging that someone with an eating disorder doesn't look a particular way: There is often this assumption that just because someone looks "healthy" or you can't see that they are unwell, that they must have a healthy relationship with food. There is often this perception that eating disorders are only experienced by underweight, young females. However, ANYONE can suffer with an eating disorder. The person suffering could be overweight or have a regular BMI, they could be male or female, they could be over 70 or under 20... there is no specific demographic or "type" of individual that eating disorders will only affect. This is where it is helpful to remember that the state of someone's mental health is invisible and it is important not to assume that just because someone looks "well" or "healthy" that they are psychologically well or health. Many clients that engage in restrictive eating but that don't have a BMI below 18.5, have told me that they have found it very difficult to be taken seriously or access help because they aren't "unwell" enough physically yet to be given support. By helping people BEFORE they become physically unwell, this really improves their chances of full recovery. Also, we shouldn't underestimate the mental torment that someone can experience when struggling with their relationship with food - it can become all consuming and have a negative impact on their relationships, professional life, confidence and sense-of-self.
Medical professionals do so much great work and without appropriate training and education it is not their fault for sometimes taking missteps in this field. However, this is the week that we can all raise awareness and campaign for change. What do you wish your doctors and medical professionals knew about eating disorders and disordered eating?
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