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.

Social media and eating disorders…

Social media is part of our every day life.

For some people their work relies upon social media. It has so many roles and uses in today’s society.

Social media can be helpful to us in our recovery, but it can be a minefield. I actually removed myself from most social media accounts early in my recovery. I don’t believe there is a right or wrong solution to this, but I believe an awareness of the impact social media has on you personally and whether it is helpful or detrimental in your recovery is the most important question. Your motives for following particular accounts, whether they serve you, or your eating disorder.

If you look for it, there are tons of recovery orientated social media platforms. But, it’s not always easy early on to identify motives of some and whether they are 100% pro-recovery.

Some platforms, target our vulnerability. Ads, pop ups etc all follow your history and if you are trying to move away from certain paridigms it can be really hard being constantly reminded about the latest fad-diet or exercise programmes etc! You get my point. Equally you can’t control what people post/ talk about. Your friends, family and colleagues may post things that are particularly sensitive for you. So sometimes taking some time away from this can help at least until you are in a stronger place.

Social media can be anxiety provoking, for those in lockdowns, isolation the conflicting and unhelpful messages can impact upon mental health. It’s not surprising around the world the new diagnoses or relapses of eating disorders that have occurred during the pandemic. Social media I believe plays a large part in this. Adding to pressure around health, diet and exercise. As well as the change to routine and access to normal resources. Knowing that not everything on social media is real, or as it appears on there I think can help.

I am glad I didn’t grow up in the ‘Tik-Tok’ era, and facebook/ instagram was only really around when I was late teens. I feel for teens and young people now with the pressures of social media. This really worries me for future of their health.

It’s the time of year where the diet and fitness industry try their hardest to sell their products. So social media is swamped with diet culture and all the shit that goes with it. I am now in a place where I can mostly see this for what it is, selling a product. This industry generally targets a vulnerable population too, people like myself. However I am aware of it, and I’m aware of the impact it can have on me. I will not be deleting my social media accounts this year. Last year I needed to, to escape this onslaught. Instead I am using my social media to promote the ‘fuck it diet attitude’, following positive influences that are pro-recovery. If an ad pops up, I will simply reject it. Friends, family and colleagues dieting that’s up to them, I can choose to ignore this. But if you are in a place where this is going to be damaging to your recovery, a social media holiday can help. I found it quite liberating and realised how reliant upon social media we are. Returning to social media has been a big test in my recovery.

Surviving Christmas diet speak in eating disorder recovery…

I love Christmas. I used to start getting excited for Christmas in September. The air smells different, the trees change and nights get shorter and staying in on a cold winter’s night with a festive movie is magical.

I still love Christmas. But Christmas can be a challenging time for many people especially people with eating disorders or recovering from eating disorders. It can invade every waking second, robbing the joy and replacing it with fear and dread. Let me be clear it is NOT just about food. Eating disorders are not just about food. They are so much more complex than this. People with eating disorders feel so much pressure, and that they cannot share this because it’s not festive or worry about disrupting the joy.

It’s a time of year where celebrations continue for most of the month (covid aside). Even in isolation the social media, the promotions during this time and messages about new beginnings in the new year etc.

Eating socially becomes more prominent. But at the same time people start discussing New Years resolutions, which inevitably involves shitty diet talk. This is so hard for people in the midst of their eating disorder or working hard to recover. Where it’s normally easy to excuse yourself from the bull shit diet speak, or judgement around food it’s harder. Often it can include spending time with people you haven’t seen for a long time (probably not so much this year) but that can be daunting and the fear of comments even when well meaning can be hard! If you are in that situation, try and be kind to yourself and see it as a positive. And the comments such as “you look well” probably are genuine and mean you look well and that you just simply no longer look like you’re dying, it’s not saying you look fat or whatever else your stupid ED tells you.

You are bombarded with conflicting messages, unhelpful quips, comments that even for those of us who are solid in recovery can be really fucking hard. The classic I will have to run this off, I’m going to be so fat, is that all you’re eating, you’re eating so much are all likely. Be ready for them and choose to stay on track. How you respond to the comment is up to you.

I have noticed myself this last couple of weeks, I’ve had to work really hard to check myself as thoughts have slowly crept in about ‘how much I should be eating, moving, what’s not “allowed”’ all bullshit and all because of the time of the year and the inevitable society pressures.

In a way it’s helpful, because although frustrating as it is to be experiencing the thoughts and anxiety return, It highlights there’s still work to be done. Clearly I still have a lot of re-wiring to do. I still clearly have an irrational fear of weight gain, which I thought I was passed. But that’s what it is, an irrational fear. It’s a phobia and it’s ingrained through the years and years of inappropriate reinforcement. It’s not surprising that events ignite these brittle pathways. I have not engaged in behaviours for close to 5 months, but it shows how easily old pathways can be re-ignited by old habits, reminders. Which is why it is so vital to continue to recognize triggers and continue the work.

For me, this means, not allowing myself to compensate for the Christmas period/ holiday (event restricting). Not entering into diet behaviour or allowing myself to be drawn into other people’s diet talk, fears and plans. Not engage in ridiculous exercise regimens because society expects it. I love you Joe Wicks BUT please stop the constant before and after pictures!

Not allowing myself to demonize food because other people are. NO FOOD is bad.

You do not have to compensate for food or inactivity ever. People’s biases around food and exercise, new years resolutions are their business and serve no place in recovery no matter how uncomfortable you feel. Be kind to yourself, ask for support and keep talking. If it helps, set boundaries before the event and if it’s too much to be in control yourself ask a support person with decisions etc.

There are tons of resources online that serve as toolkits/ survival guides for holiday.

The purpose of this blog however is not so much to share tips for how I have managed Christmas or will manage Christmas. Although I appreciated podcasts, vlogs, resources myself to help me. Rather this purpose of the blog is for people in the midst of their eating disorder, or recovering and just a simple understanding. That’s what I have found the most useful. So if you are in this situation, I see you I understand.

If you are a friend or a family member of someone with an ED, my thoughts are it’s tough on you too. Please, think about how you talk about diets, your own fear of weight gain in front of the person. Be their advocate as they may not be able to speak up so divert unhelpful conversations where you can. Maybe ditch the unhelpful comments about calories.

Ask the person (if you are in a position where you talk about the eating disorder) what the eating disorder is telling them. What they are thinking. But be warned you might not like or understand the answer. But if someone does feel comfortable to share this with you, show them support without judging them. No one expects you to get it, we don’t get it most of the time ourselves but feeling supported is huge.

Happy Christmas everyone. Stay strong