How Guidelines Will Help Healthcare Staff Support People In Larger Bodies With Eating Disorders

“Doctors in particular should not express surprise when somebody says, 'I think I might have an eating disorder' when they're in a larger body.”

eating disorders guideline

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New medical guidelines have been released to better support people in larger bodies with eating disorders.

— Content warning: This article discusses experiences of eating disorders. —

The stereotypical image of an eating disorder patient is usually a thin, white, wealthy woman — however, this is far from reality.  It’s not just Anorexia Nervosa, either, with Binge Eating Disorder, Bulimia Nervosa, and other specified feeding and eating disorders (OSFED) forming some of the most common types of eating disorders experienced in Australia.

The pervasiveness of this mainstream perception is leading people who don’t fit the description to fall through the cracks when it comes to seeking help, as some health professionals aren’t even considering eating disorders as a diagnosis when screening them for assessment and treatment.

A new set of medical guidelines, developed by a mix of eating disorder experts, researchers, clinicians, and people with lived experience, have been released to assist clinical professionals in their patient treatment.

Outside The Box

What makes the guidelines so unique is that they also advocate promoting physical activity for the physical and mental health benefits, rather than for weight loss, and minimising language that reinforces poor-self worth, or that could worsen eating disorder behaviours.

“I think they’re really wonderful and really important as someone living in a larger body who has had to go through the process of seeking medical treatment,” said Jane Sullivan, who has experienced restrictive eating disorder and atypical anorexia.

“I was really conscious at that time of not feeling like anyone was very confident in treating my case, or had that strong foundation to go off and treat someone,” she told Junkee. “I am just so thrilled that this has come out.”

Approximately one million Australians — or four percent of the population — are living with an eating disorder in any given year, according to Mindframe.

Meanwhile, the Butterfly Foundation says that less than a quarter of that figure receive treatment or support.

“Eating disorders can affect people of any weight, of any gender, of any age,” explained Associate Professor at La Trobe University, and co-author of the guidelines, Leah Brennon. “It’s really important as a community that we are aware of that so that everybody has access to treatment.”

Brennon told Junkee it was important to include people with lived experience in the development of the guidelines so that they could help ensure treatment approaches actually meet their needs, and that it became apparent during the research process just how common weight stigma is for people with eating disorders.

“That stigma is experienced unfortunately in the healthcare system — as much as it is in other settings — which is not new information, but it is really sad every time you come across that,” she said.

Lack Of Understanding

Sam Ikin, who has experienced Binge Eating Disorder, says he still comes across GPs who have no idea how to deal with eating disorders, and in a recent experience requesting an eating disorder plan for himself, was instead recommended a regular mental health plan instead.

“I think people — and doctors in particular — should not express surprise when somebody says, ‘I think I might have an eating disorder’ when they’re in a larger body,” he told Junkee, noting how damaging shame and judgement can be when people are going out of their way to seek support.

“Comments like that, it comes from a lack of understanding,” Sam continued. “I don’t expect that every doctor is going to be across all this kind of stuff, so having these guidelines in place certainly helps everybody to get a better level of care when they need it.”

Sullivan agreed, reflecting on how she’s presented to the doctor for separate concerns, like tonsillitis, only to be told to lose weight instead.

“At that time I did have an active eating disorder,” she said. “So those focuses on weight as if it’s the most important indicator of health, where in an individual, it’s an extremely unreliable indicator of health is really dangerous, and not doing anyone any favours.”

A Network Of Care

Sullivan said it’s comforting to know that these new guidelines will help the medical community better support people in larger bodies living with eating disorders, especially for patients going through the public health system.

“It’s so important that this kind of advocacy, especially towards the medical community, which sometimes lags behind on understanding those patient experiences of what it’s really like to be the person living with this illness,” she said. “That knowledge is super important and I think sometimes it’s lacking, and so I hope that medical professionals really engage with these new guidelines.”

Ikin said while it can be draining to constantly assert himself and rebut against any pushback or minimisation from healthcare professionals, he reiterated the importance of always prioritising your own wellness and speaking with a mental health professional as part of your treatment plan as well.

“If you’ve got any doubts or questions at all, please do reach out to someone…”

“I think that is one of the best supports that you can have — a good shrink who knows what they’re talking about. If you don’t have one across eating disorders, the Butterfly Foundation has a database of professionals in every state. They’ll be able to hook you up with one in person or via Telehealth,” he said. “They give you the confidence to be able to go into a GP and say, ‘this is a thing that I do have, this is an issue that you need to take notice of’.”

“I’m encouraging anybody who does have concerns about eating or about their weight and shape to reach out for support and treatment,” reiterated Brennon. “There are very effective treatments available, that in a relatively short time can make a very big difference to somebody’s wellbeing and health.

“So please, if you’ve got any doubts or questions at all, please do reach out to someone. GPs are a really good starting point, and if you feel like you’ve not been given the support you were hoping for — especially if it’s because of your weight — approach another health professional, and really do look out for the help that you’re after.”

If you or someone you know is experiencing an eating disorder, you can contact the following support services or resources.

Photo Credit: Unsplash