29 Sep 2020

You don’t have to be a certain weight to experience an eating disorder


Raja opens up about the difficulties she faced when trying to access help from professionals, and we would like to encourage you to reach out to our Helpline to get referrals from specialist ed practitioners, should you experience the same challenges.

You don’t have to be a certain weight to experience an eating disorder – Weight Stigma Awareness Week

The reason why I wanted to write a blog for Weight Stigma Awareness Week, is because I think weight stigma is an immediate barrier in itself. According to Obesity Action, weight stigma is:
‘Weight stigma or bias generally refers to negative weight-related attitudes toward an individual with excess weight or obesity.’[1]

Early this year I was diagnosed with an Eating Disorder. To begin with, I did not even realise I had one. This was partly to do with the stigma around body size.  It was not until I was asked about my feelings and how that relates to behaviours that I was engaging in, that I realised there was something going on.  This has been uncharted territory for me, I haven’t struggled with body-related issues since I was in my early teens.

At the start of the COVID lockdown, I noticed I was extremely stressed and anxious and I was starting to feel it physically, the biggest impact was on my appetite.  It didn’t bother me at first but then I started to notice the intrusive thoughts I was having about my body and its appearance. I felt like everything was spiralling out of control and food happened to be the only thing I had control over.

ED’s are not about body size, I repeat they are NOT about body size. For most people, it’s about your relationship with your body, feelings, food etc…

This is one of the reoccurring barriers to help-seeking I came up against, I didn’t believe I was sick enough and the medical professionals I saw, kept getting hung up on my body size.

I have found, when you look at the medical guidelines for diagnosis and admissions, majority of the time it does not provide an avenue of help-seeking for folks with a bigger body size.  The invalidation that comes along with not being considered as a person with a life-impacting ED is dehumanising.

Having an ED has been all consuming, it impacts on every single aspect of my life. Having to justify to a Dr that I actually do have an ED is exhausting, especially when it happens every. single. time.

Being an obviously Aboriginal person, I already face enough bias, stigma and discrimination, based solely on my physical presentation. I already feel as though I have to justify my existence and justify equal treatment as a human. Combine this with the bias, stigma and discrimination I have faced due to my weight. The denial of the reality of my ED and the impact it has on my life makes me feel less than a human.

I remember a doctor at the hospital diagnosing me with ‘a mild eating disorder.’ What does a mild eating disorder even mean? To me, that was their way of saying, this condition isn’t actually impacting me negatively and I’m being a bit dramatic in my presentation. I couldn’t help but feel that I was dismissed so easily just because of my body size. Which is why I also want to take this opportunity to discuss what I think another barrier is – BMI (Body Mass Index).

To me, BMI is an invalid way to measure a person’s health. I have always sat at a BMI that is considered ‘overweight/obese’. I felt like the only reason I was able to access inpatient treatment was because I had a clear medical compromise, not because I live with an ED.even though it has a large impact on my life. In my opinion, BMI doesn’t take into consideration that because I am Aboriginal, my body is inherently going to be different from the rest of the community. Therefore, a BMI measurement is not actually going to reflect anything of importance to my health nor tell you if I am living with an ED.

The general lack of concerns from medical professionals about my health and wellbeing was a big deterrent for me to seeking help. The off-handed comments from medical professionals such as, ‘If I lost that weight, I would be happy, I don’t know why you are here.’ ‘You just got to eat healthily’ ‘You can keep losing weight’ which made me feel like my ED was not real. It was invalidating and feed the little voice in my head that tells me I’m not actually sick.

To me this sent a very clear message: Because I was ‘overweight’ there was nothing actually wrong with me, ie I couldn’t possibly be experiencing an eating disorder. I often wonder, if health professionals would be more proactive with treatment options if my BMI was considered ‘healthy/underweight’.

Medical guidelines should not be weight-based, it’s a mental health condition, and therefore not primarily medical. Eating Disorders can affect anyone in any size body, it’s not about body size, it’s about what is going on in someone’s brain. When people think of health, most of the time they think of a person who has a small body size. Changing the dialogue around what health really looks like and that health is not to be correlated with body size, is one step in the right direction.

Thankfully now I have a really good treatment team and their primary concern is my health and wellbeing, not my body size and getting it to a ‘society friendly body size’ or a ‘healthy BMI size’.

The way I was able to get a good treatment team was through word of mouth, I spoke to friends that had dealt with ED’s and asked if they had recommendations for services, GP’s, dietitians etc…

This also allowed me to talk to my friends about what has been going on for me. It is important to be talking about weight stigma because people are being denied help and not seeking help because of this stigma.

[1] https://www.obesityaction.org/community/article-library/weight-discrimination-a-socially-acceptable-injustice/#:~:text=Other%20examples%20include%20being%20denied,home%20because%20of%20one%27s%20weight.