It is Eating Disorder Awareness Week (EDAW) here in Canada, February 1st to February 7th, 2019. The National Eating Disorder Information Centre (NEDIC) is running a campaign stating that “1,000,000 Canadians struggle with an eating disorder- we can’t afford to wait”. The concept being that we need to squash the myths and stereotypes that surround eating disorders and get people the help that they need- and deserve! This stat should be concerning on a few different levels. First being- that is a huge number of individuals diagnosed however I suspect that there are many many more that are not being diagnosed because the medical community continues to have biases around body size and shape which means that people are not getting properly diagnosed and treated. This should be so upsetting to the human race yet I am not sure that it is. Our culture has taught us that our body sizes are our faults. That if we are not working to make ourselves smaller then we are not working hard enough. That if we live in larger bodies our bodies are not worth the same amount of care or treatment. There are so many more people walking around this earth with what could be a diagnosable eating disorder if anyone bothered to listen to their stories. And this is my plea. We need to listen. We need to put the body in front of us in context to their lives, not ours. We need to hear the trauma that their body has endured. We need to do all this without making the assumption that we can assess them just by looking at their body.
Deb Burgard once said “ we diagnose in smaller bodies what we prescribe in larger bodies.” Let that sink in. If you have an emaciated body with a list behaviours you could get an eating disorder diagnoses and access to treatment. If you have a larger body with the exact same list of behaviours you will either get a pat on the back if your weight has gone down or be told you need to work harder. Seriously. This is happening all around us. If you do not look like the Hollywood version of an ED it is harder for you to get a diagnosis. If you broke your leg and you went to the doctor for help and the doctor said “You are doing a great job, keep doing what you are doing as it is obviously working…” I am sure most of us would protest and demand to see another doctor. However we have been trained to have so much shame over our bodies that we do not. Diet culture has made us believe that we need to look a certain way to be normal- normal relationship with food be damned! I have sat with larger body clients that were told they needed to lose weight however are eating so few calories a day that they literally look at me and say “ I guess I am not supposed to eat anything because the doctor says I need to lose weight for my health”. But what is health? If the size of the body in front of me at that point were much smaller there would so much concern- a possible hospital admission, a run of blood work, a check of blood pressure and heart rate. But instead they are told to lose weight for health all the while I suspect that they are not believed when they say that they do not eat very much. This is completely unethical health care.
So what am I proposing?? Listening. Not listening to answer and move on. But really truly listening to the story of the body in front of me. Listen to their lived experience. Listen to how they relate to food and movement. Listen. Not to solve or fix. Not to criticize or deem unbelievable. But to be open minded enough to realize that eating disorders do not discriminate between genders, races, socio-economic status, sexual orientation or body size. They can affect any human that is walking this earth right now. We need to listen so that we can be the best health care providers or supporters we can be. We need to listen so that everyone who is struggling with their eating has a safe place to go to seek assistance. And we need to listen so that everyone can get the treatment and support that they all deserve.
If you are interested in following along for EDAW check the hashtag #EDAW2019 or go to nedic.ca for further information or links.
until next time be unapologetically you, while I be unapologetically me RD