When Doctors Don’t Understand Eating Disorders

By Shalini Wickramatilake

doctor.jpgLast week I attended the Eating Disorders Coalition’s (EDC) Advocacy Day on Capitol Hill. Our “ask” for the day was for members of the House of Representatives and Senate to take steps to ensure that more medical professionals get training on how to identify eating disorders and intervene appropriately. It’s safe to say that most doctors, physician assistants, nurse practitioners, and other health professionals don’t understand eating disorders because they usually don’t have an opportunity to learn about EDs during school.

Medical professionals play a critical role in preventing and treating disease. Included in the Hippocratic Oath taken by medical students is the line, “First, do no harm.” Despite the fact that throughout my life I have been cared for by doctors who are compassionate, skilled, and have my best interest in mind, several of them not only ignored my eating disorder, but sometimes made it even worse.

I struggled with an eating disorder for most of my life. During those many years of struggling, my eating disorder was ignored by medical professionals because I didn’t look a certain way. Despite the fact that eating disorders can affect anyone–regardless of shape, size, weight, height, race, ethnicity, gender, sexuality, geographic location, or socioeconomic status–the misguided stereotype that only thin, upper-middle class Caucasian girls are affected by eating disorders persists to this day. I didn’t fit that stereotype, so I went without the specialized treatment that I needed for far too long.

I remember in 2016 when I went in for my annual physical, I was starting to get scared about how out of control my eating disorder behaviors had gotten, and I actually told my doctor about what was going on. She responded by telling me about an eating disorders treatment facility nearby, but quickly added, “That treatment center is for patients who are really sick. I refer people there if they’re really, really thin.

Instead of being referred to specialized treatment at that point, I received a message that I wasn’t “sick enough,” because I wasn’t “thin enough.” Instead of getting help from my doctor, I proceeded to get worse, and I truly internalized that message that I had to look a certain way and physically hit rock bottom in order for my disorder to be legitimate.

In hindsight, I absolutely was sick “enough.” I don’t think that it’s possible to objectively rate mental pain. If you’re struggling, you’re struggling.

If you’re struggling in any way at all, no matter what your body looks like, you’re deserving of help. Hitting rock bottom should not be a prerequisite for getting specialized treatment for an eating disorder. 

Fortunately, over the past year and a half, I have encountered doctors who really do understand how to treat patients with eating disorders. I’m grateful to have found medical professionals who validate my feelings, don’t allow me to see my weight when I step on the scale, coordinate care with my therapist and dietitian, run the right tests to make sure my body continues to grow strong, and really seem to “get” me.

But those doctors–the ones who received adequate training on eating disorders–are rare, and I hope that eventually all medical professionals have opportunities to learn about this important public health issue. If more doctors know how to identify signs, screen, intervene, refer patients to the appropriate treatment, and work collaboratively as part of a patient’s treatment team, the more likely it is that individuals who are struggling will enter into recovery. If more doctors receive training on eating disorders, ultimately, more lives will be saved.    


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