Medical education needs to change. Weight stigma is taught.

Healthcare professionals are not infallible and have their own biases

Apologies in advance for probably a relatively ranty post.

I am not considered overweight, I have been at the complete opposite end of the spectrum and have been often rewarded by health care professionals for being “healthy” when I was slowly killing myself.

When I was considered emaciated this positive reinforcement shifted, I met a lot of stigma from healthcare professionals.

Today I have just experienced horrific weight bias whilst at a medical appointment. A nurse who had my medical record on screen, open in front of us displaying my history: Anorexia nervosa.

Whilst I sat there she began to discuss how next week brings the onslaught of patients booking in for weight maintenance, counselling after “over indulging in the holidays”. She was clearly ignoring this history. She continued with her opinions and judgements regarding patients eating “bad foods” and expecting to lose weight.

My response was somewhat blunt, probably rude. I wish I was brave enough to point out my history but instead I shared my very anti-diet views. Explaining I do not believe in the multi million dollar industry that promotes dieting. I explained if there was a diet that genuinely worked the industry would not be in business. If people successfully reach their goals and stayed there there would be no diet industry. But I explained that simply doesn’t happen and leads to obesity. She went on to demonise foods. To me.

She started talking about a group of people who exercise every day “and aren’t overweight” and do not lose weight. She stated it’s because they aren’t dieting with it. “You can’t do one and not the other” if you cut out rubbish you will easily lose weight she went on to express. She told me how cutting out “unhealthy food, sugar” it’s easy to lose weight.

At this point I was like, are you fucking serious. You’re sat telling a patient in recovery from anorexia about losing weight and demonising foods and promoting the idea that weight gain is to be feared by anyone.

Again, I wish I had felt stronger to call her out. But there’s still a part of me that can’t quite do this in an non anonymous setting. I will get there.

It got me thinking and really feeling for patients. If someone with a history of anorexia, not that long in recovery and not overweight can be subjected to this. Then people who are considered “over weight” according to a BULLSHIT MEDICAL INDEX scale, aka BMI then this is horrendous. We are terrible in the health industry and really under educated in this area. This is one of the reasons I started this blog. To educate and reduce biases in health, society and reduce stigma.

Stigma does occur in very low weight too. When I was very unwell, doctors told me I was irresponsible, like it was a choice. I was marched across busy waiting rooms and made to step on the scales in front of audiences and then condemned publically if I’d lost weight or not gained. I remember one occasion being made to walk up and down a corridor (waiting area) by a GP to make sure my heart wasn’t failing, and saying aloud if you don’t put on weight by the next review you will be forced to be admitted. This is fucking awful when I think about it now.

Scales can be terrifying to someone with an eating disorder ( or no eating disorder)

If you are a healthcare professional: keep your own biases and fear of weight gain to yourself.

If you are knowingly looking after someone with an eating disorder it is highly inappropriate to make them step on scales with an audience, if you must weigh someone keep it neutral without judgment. Scales are one of the scariest things you can ever imagine for someone with an eating disorder, underweight or overweight. In my opinion scales in a hospital or doctors should not be in a public area.

If you have ever experienced stigma, judgement by a healthcare professional I am truly sorry. One day I hope we can shift the narrative. If you feel brave enough and you find yourself in a similar situation to that of mine today, please speak up. I promise I will try to myself next time.

Food is more than just food.

Best biscuit ever……

Yesterday, I had a strange realisation. It’s taken me almost 30 years to get to it, but yesterday I realised food is not just fuel. Food has no rules, no moral value and no foods can be ‘good’ or ‘bad’.

Whilst reflecting about my relationship with food, I craved a chocolate Hobnob. I heard ‘HH’ stipulate, ‘but you’re not hungry’. It was this thought, I rewound and re-framed my life-time’s thinking. Food, although important for fuel and nutrition is also part of connection and ENJOYMENT. It’s always blown my mind that people have just been able to easily eat something, just because. But yesterday, I understood food can be eaten whenever. Whether we are hungry or not. If we want to eat something we can, without judgement, without compensating, because it’s just food.

I was feeling particularly reflective yesterday, because I felt really fucking sad. The fact the I felt sad, set off a whole chain of thoughts. But what made me grateful amongst it all, the fact I could acknowledge and identify that emotion. For years I have numbed my emotions, to the extent when I started to feel again, it took me a while to recognise what I felt. That’s pretty common I think amongst us who have eating disorders. I no longer associate with the nickname I have had for years and use to value, ‘the ice queen’. This is not me now. Nor do I want it to be. The fact it became at one with my identity is quite disturbing to me now, as I am a compassionate person. But in the depths of ‘HH’s grips I was an emotional void. I’d get angry, anxious & irritable if my routine was disturbed, or challenged but these were pretty much the extent of my emotions. Instead of returning to my old behaviours yesterday, exercising to the point of exhaustion, pain or restricting to the point of false euphoria, to numb out the events. Instead I went for a walk out in nature listening to a podcast and then had a cup of tea with a Hobnob.

I felt grateful. Grateful I have reached a point of mental freedom to enable me to feel. Being numb is not living. I was grateful I could feel sadness and sit with it. Feelings pass and are not permanent. But eating disorders are. Recovery although hard, is also temporary.

The next thing I’m working hard to reach, is body neutrality. There is so much talk about ‘body positivity’ at present. I believe the premise of this is great, but I also feel it’s a double edged sword. It’s general concept to love and accept your body, sure. Promoting acceptance by society of shape, size, gender or race is the main aim. But, I feel there’s pressure with ‘body positivity’ as a concept. It over values of the body image itself, rather than appreciation of the body’s functions. For me, I don’t know if I’ll ever ‘love my body’ but I love the things my body enables me to do. I think very few people eating disorder or no eating disorder love their bodies. So for me, getting to a point where I do not care, or have any value from my appearance will be sufficient, beyond that a bonus. But I feel it’s healthier to see our bodies as a vessel, a vessel that allows us to do what we desire. It does not matter what that vessel looks like. That’s what I believe the social media message should be, that’s what body positivity should be.

Interestingly my ‘negative body image’ didn’t truly start until I was in the depths of my eating disorder. Sure there were things I had insecurities with, but I think most people on this planet do have hang ups. But I can say, the negative body image spiralled and it took so much value. This value is incongruent with my own true values, i’m not a shallow person, I couldn’t give a rat’s arse what someone looks like if they are a good human being. But the world becomes so small, consuming and out of alignment with our own beliefs. I really struggle with this aspect of my eating disorder, because on a bad ‘body image’ day it still has far too much space. Space that’s not relevant or part of me. However this is part of the divorce from diet culture and unlearning so many untruths that are so engrained in society. Most days now fortunately I am neutral towards my body, but i’m not where I want to be yet. I’m not where I want the whole of society to be, where body image is as relevant as yesterday’s weather. But rejecting diet culture and accepting ourselves is a start towards remodelling society’s beliefs . Ultimately change starts with yourself.