An Introduction: When Doctors Develop Eating Disorders
The silent epidemic of eating disorders in the medical profession.
Posted Jul 21, 2020
Eating disorders can affect anyone. While a stereotype of a young, middle-class, white girl often prevails, these horrible and debilitating illnesses afflict men and women of all ages, from all socio-economic backgrounds, in any line of work.
I am a doctor specialising in pediatric oncology. I first developed anorexia when I was 12 years old. Although I have always remained functional and am now in recovery, my illness has followed a relapsing and remitting course with periods of health interspersed with episodes of decline.
Doctors are not superhuman. We suffer from the same physical and mental illnesses as the patients we treat, and we need to be able to recognize this and ask for help so we can continue to help others. But when it comes to eating disorders, my profession may have a blind spot.
I recently wrote a pair of articles for Psychology Today about my experience of anorexia in pregnancy and as a parent. I was not, however, ready to write about or explore the relationship between my eating disorder and my medical career. I published under my married name rather than the name I use professionally. Why? Mainly because I was concerned I would be judged negatively by colleagues if knowledge of my illness was made public.
When I finally summoned the courage to discuss my anorexia more openly, I was overwhelmed by a huge response from doctors and other medical professionals. A number wrote to confide in me about their own eating problems, and several asked me to signpost them to resources or therapists to help themselves or their children who are developing signs of anorexia.
I was also privileged to speak to the father of Dr. Melanie Spooner—a young pediatrician who tragically died from anorexia in 2011—whose story brought home how devastating the consequences of these illnesses can be if not managed appropriately. The shame, secrecy, and lack of understanding and self-compassion was palpable in the messages I received. Eating disorders in the medical profession seem to be a silent epidemic—and the feeling of shame incurred is one with which I strongly identify.
It is important to discuss the issue of eating disorders in the medical profession—both for the doctors who are suffering and to address the fat-phobia inherent to the profession which has an adverse impact on patient care. There is very little in the literature about anorexia among doctors, despite a fair bit of anecdotal discussion in pastoral groups for medical students and qualified physicians.
Personally, it has taken me a long time to reach a point where I am ready to talk about this. But realizing that my journey is far from unique has shown me how important it is to bring this issue out of the shadows and attend to the modifiable perpetuating factors.
I love my job and can’t think of anything I’d rather do. I am privileged to be part of an incredible team of doctors and nurses caring for the most inspiring children imaginable. But life in the National Health Service has its challenges, and I expect these are mirrored in healthcare systems around the world. Medicine involves working long hours in a highly stressful environment. It can be difficult to take a bathroom break on a 13-hour shift—let alone a lunch break—and the job regularly involves staying late followed by studying long into the evenings. The emotional burden is enormous, and doctors are exposed to death and suffering on a daily basis.
My friends and colleagues in the medical profession are competent, kind, compassionate, altruistic, dedicated, self-disciplined, hardworking, passionate, focused, and interesting. But many exhibit signs of disordered eating or full-blown eating disorders. Others struggle with mental health issues such as anxiety or depression or rely heavily on exercise or alcohol to manage their stress.
Despite these serious health concerns, these doctors continue to put their own needs to the bottom of the pile and provide outstanding care to their patients, often at considerable personal cost. Doctors are often high achievers who have unrealistic self-expectations and hold themselves to impossible standards; as such, they tend to hide their struggles for fear of appearing weak or unable to cope. It’s indeed possible that I have a distorted perception of the prevalence of these problems due to selection bias of my friendship group, but evidence suggests that my experience is more representative than I’d like to believe.
This blog will explore the effects of eating disorders on doctors and their patients, using information derived from my experience as a doctor in recovery from anorexia, published evidence, and expert opinion. It will include posts discussing the precipitating and perpetuating factors that contribute to the development and maintenance of disordered eating in doctors and explore the deficiencies in medical education and aspects of medical culture that can lead to a lack of understanding and empathy.
Going forward, this blog is intended to be a resource for doctors affected by eating disorders themselves, and for those who recognize the symptoms and signs in their colleagues, family members, and patients. Having said that, many issues discussed will also be applicable to other professions and patient groups. It is intended to help fill the gap in medical education that leaves medics feeling ill-equipped to manage these devastating and life-threatening conditions—even when they are the patients themselves.
Being forced to confront and manage my own anorexia in the context of my medical career has taught me a great deal; ideally, sharing this knowledge can help other doctors take better care of themselves, their colleagues, and their patients. At the very least, I hope to encourage readers to view those affected by these conditions with a little more kindness, understanding, and compassion.