Content warning: eating disorder and intrusive thoughts.
I’m going to start by saying how grateful and happy I am to have found the online ED recovery community. I have learned so much from being a part of it, and have been at times overwhelmed by the welcome and support I have received.
However, there have been just a couple of times when I have felt uneasy, and not quite able to pinpoint why. The last couple of days have clarified where those feelings came from.
Yesterday evening I listened to the first #TheBigEDChat, organised by some of my favourites on Twitter. The subject was Diet Culture and Weight. I’m not going to lie. The first 20 minutes were difficult and triggering, and I know I wasn’t the only one to feel that way.
Later on, I came across the #BeatWeightStigma campaign, highlighting the weight stigma in the UK’s biggest eating disorder charity. Horrified at their stance on o***y, I joined the cause.
But this was all fine. I’m used to comments from people, often well meaning, who do not understand the experience of those in bigger bodies, and I don’t let it get me down any more. I’m used to weight stigma in the medical community. I’m 7 or 8 years into my recovery journey now. And after all, I will never understand thin people’s experience fully either, because I haven’t lived it.
Then this morning I awoke to World O***y Day, and the second I looked at my phone, I saw an article from an ED charity about the similarities between eating disorders and o***y. It was all downhill from there. I had hit my tolerance limit. Here are my feelings, thoughts and actions from that point.
Disappointment and anger. I posted a couple of tweets. Then regretted them because I didn’t want to upset anyone. I stopped myself from deleting them, because I am entitled to my feelings. And because how I was feeling showed that weight stigma causes harm.
Today was my day off, but I had plans to meet my work colleagues for lunch. Without thinking about it, I skipped breakfast, falling back into old habits of “compensating” for food later on.
I went upstairs and showered. I looked in the mirror, hating what I saw. Body checking, I turned sideways to see how big my stomach looked. Of course it looked enormous. I wanted to slice it off; I’ve hated it my whole life.
I chose oversized clothes to hide that stomach from view. It was the only way I’d be able to leave the house when all I wanted to do was hide until I can lose some weight, make my body palatable to all those people pathologising it online. I don’t feel safe, I feel vulnerable. I want to cancel, but that would be letting them win.
I finish getting ready and start driving to the office. I notice intrusive thoughts I haven’t had in a long time (they always popped up when I was driving – the ones that told me to turn the steering wheel the wrong way).
I got stuck in some roadworks for ages. I am simultaneously furious and relieved. Because I am going to be very late, and because that means I will miss the food.
I arrive after everyone has eaten. I have a good time and enjoy chatting to everyone, mostly distracted from the thoughts I had earlier. I accept a slice of cake. I check social media a couple of times, relieved that no-one is upset about the tweets. I take some leftovers when I leave to have for dinner.
The entire journey home I am bombarded by thoughts about stopping to buy binge foods. I actually need a couple of things, but decide to shop tomorrow. It’s not safe to go into a supermarket today.
I get home and realise I am dehydrated. In my ED days, I used to avoid drinking sometimes so my stomach would look smaller. I hadn’t even noticed I had done it today.
So I’ve drunk a couple of glasses of water, had those leftovers, written this blog post, and chatted to a couple of friends. I’m finally feeling more like myself and less like old, ED me.
Because these were the thoughts of old ED me. Less powerful, and not acted on. But they are still there, lurking in the dark corners of my mind, waiting for those triggers so they can try to take hold again. And yet society, and even eating disorder charities want me to invite those triggers through intentional weight loss.
If my set point were lower, if I had recovered into a smaller body, I would receive nothing but praise for what I have accomplished. But it isn’t, and I haven’t. I am fat, so I have to accept that I will have to face weight stigma for the rest of my life.
Even so, I will not let the ED thoughts, diet culture or weight stigma win. I deserve recovery, just as everyone with an ED does.
Sending love and strength to everyone affected by today’s anti-fat rhetoric.
Why eating disorder training for doctors is so important: a patient’s perspective
As I type this, Eating Disorder Awareness Week has not even started. Yet there are already arguments on social media about this year’s campaign, which aims to increase training on eating disorders in medical schools.
It is not my intention here to contribute to the arguments or criticise medical professionals. But I want to raise awareness of the impact training can have on patients with diagnosed or undiagnosed eating disorders, both positive and negative.
These are some of my personal experiences of medical appointments as an ob**e adult female with Binge Eating Disorder.
GP appointment, mid noughties. I told him that I was struggling with eating. I couldn’t seem to stop, I felt out of control, and my weight was increasing. He gave me a diet/healthy eating leaflet, and recommended I join a gym. I tried to explain that I had dieted before and knew what to eat – I had even studied nutrition at school. He told me to try again and cut out sugary snacks.
Impact: I avoided the doctor and didn’t raise the issue again for years.
GP appointment, 2014. I spoke about how I had struggled with food for a long time, and couldn’t stop once I started eating sometimes. I told him how much weight I had lost on anti-depressants. He asked me questions and told me he thought I had Binge Eating Disorder. He referred me to the local Eating Disorders Service.
Impact: I received 2 years of specialist treatment, which started my recovery process.
Rheumatology appointment, 2019. The nurse took me into a room and told me to sit down so she can take my blood pressure. I didn’t realise that I was being asked to sit on a scale, and the nurse did not ask for my consent to weigh me. She asked me if I wanted to know my weight. I disclosed my eating disorder and asked not to be informed of my weight as this could be harmful. She noted this on my chart.
A few weeks later I received a letter from the consultant. It included my weight, and I realised that I had gained more than I realised. It also indirectly blamed my joint issues on that weight.
Impact: a relapse, with regular binges, which lasted for several months.
Follow up appointment, 2019. I let the nurse know what happened and declined to be weighed. She apologised and said she had not realised it would be in the letter. The rheumatologist made multiple comments indicating I should lose weight. I disclosed my eating disorder again. He made no comment.
I left the hospital in tears. I called the department to complain and requested a different consultant. I was told my case would be transferred.
Impact: I spent a further two years without treatment and in pain. My bingeing continued, although I continued to work towards recovery.
Telephone GP appointment, 2021, because I hadn’t heard from the hospital. I explained the story to the GP. She offered to refer me to another hospital, and took the time to ask how I was managing my eating disorder symptoms due to the pandemic, because this was a difficult time emotionally. We discussed my coping and support mechanisms and she told me to call if my symptoms worsened.
Impact: I felt heard, supported, and able to trust the GP.
Nurse appointment, 2021. A few months later I discovered I was eligible for the vaccine due to my BMI, so I called my GP Practice. I was told I needed to be weighed. I went in to see the nurse. I disclosed my eating disorder and she made sure that I couldn’t see my weight. She took the time to check I was managing and tell me how well I was doing during lockdown. When I asked what my BMI is, she didn’t tell, me, saying she would work out what it was after I left.
Impact: I felt supported and reassured that I would not be judged if I relapse, or for my body size.
Hospital appointment with a new rheumatologist, 2021. I was not weighed and treated in a weight neutral way. He offered me pain medication. The tests he referred me for showed that the previous rheumatologist had diagnosed me incorrectly.
Impact: no relapse and reduced pain due to the medication.
You may have noticed that I disclosed my eating disorder, or eating disorder behaviours, at every one of these appointments. Over the years, I have learned to make a point of disclosing. It is the quickest way for me to find out if I am in a safe space. And by this, I mean that it tells me whether the medical professional has received training in ED. Because that training ensures that my health, and not my size, becomes the primary focus. Because weight stigma is real, and it can trigger a relapse.
You will also see that the majority of experiences I have had were positive. There are many, many understanding healthcare professionals out there. But those two or three negative experiences had far-reaching and long-lasting impacts on my overall health. And they have left me feeling the need to protect myself and my mental health every time I visit a new healthcare professional.
This is why I stand behind BEAT’s campaign this Eating Disorders Awareness Week. Because if one more person is diagnosed before their ED becomes chronic, if one less person relapses because of a doctor’s thoughtless comments, I will consider it a success.
I waited over 30 years for a diagnosis. Recovery has taken 8 years. I don’t want anyone else to have to endure that. Increased training in medical school will help ensure that no-one will.
So please consider supporting this year’s campaign. Go to BEAT’s website and sign the petition. Follow the campaign on social media. Let’s make every medical appointment positive for people with ED.