This National Eating Disorder Awareness Week, MINES & Associates is taking the time to shine a light on eating disorders, how they manifest in the workplace, and how you can support colleagues and employees who have eating disorders – and who may be suffering in silence.

What is an eating disorder, and how do they present in the workplace?

Eating disorders are a complex category of mental illness characterized by an unhealthy relationship with food and – usually, although there are some exceptions – body image. There is a wide variety of eating disorder types, and they each have different symptoms. Some eating disorders cause people to severely restrict caloric intake, while others cause people to go through binge-eating episodes.

Generally, eating disorders are some of the most deadly mental illnesses that exist – anorexia nervosa, in particular, has the highest mortality rate of any psychiatric disorder. Eating disorders are not just “extreme dieting” – they are severely harmful to physical and mental health. We need to take them seriously.

With so many Americans living with an eating disorder today, it’s likely that at least one person in your workplace is facing this. However, because of the stigma and misunderstandings surrounding eating disorders, you may not be able to recognize the signs if you’re not aware of how eating disorders present.

Some signs that someone in your workplace may have an eating disorder include:

• Talking a lot about body shape and appearance
• Avoiding work gatherings where food is involved
• Having low energy or appearing lethargic
• Frequent trips to the bathroom, especially after eating
• Changes in appearance, like significant weight loss or gain, or looking pale
• Wearing baggier clothes to hide weight changes
• Constantly checking one’s appearance in mirrors
• Eating in isolation or being overly secretive about food and meals
• Decreased productivity and lack of concentration
• Expressing constant dissatisfaction with one’s body
• Preparing elaborate meals for others, but not eating the meals themselves

Keep in mind that although some eating disorders, like anorexia, can cause significant weight loss for some, most people with eating disorders aren’t underweight. You cannot spot an eating disorder just by looking at someone’s weight or appearance.

People who live with eating disorders can also be very high-functioning in the workplace, so don’t make the mistake of only looking at employees whose performance is faltering.

Perfectionism is a personality trait that’s highly linked with eating disorders in the literature. This perfectionism could lead someone with an eating disorder to reach for the highest achievements and accolades at work. However, over the long term, an eating disorder can negatively affect productivity and focus.

How to support someone with an eating disorder

If someone you work with is living with an eating disorder, they’re likely suffering alone. Eating disorders are often very isolating disorders that cause feelings of deep shame and guilt. People with eating disorders need treatment, but it may take time for them to be ready to come face-to-face with this fact. However, there are ways to support someone with an eating disorder even if they aren’t ready for treatment.

Here are some tips to support an employee or colleague who you suspect has an eating disorder.

Watch how you talk about your own body

Even if you don’t have an eating disorder, many of us have unhealthy views about food and our bodies. Talking negatively about your own body can be triggering for your colleagues with eating disorders.

For example, you might nonchalantly comment about skipping lunch because you overate last night, or make remarks about how a sweater makes you “look fat.” Although you may not live with an eating disorder, these off-hand comments can be triggering for people who do.

Watch the way you talk about your body and eating. You don’t need to express over-the-top positive feelings about your body – this might be triggering as well – but try to stay body-neutral, or avoid talking about your body altogether.

If you express concern, don’t focus on weight

You may have suspicions that someone has an eating disorder, and decide to express your concern. Whether or not you choose to approach the person is up to you and depends greatly on the relationship you have with them. But if you do decide to express concern, don’t focus on their weight – express concern about their overall mental health instead.

For example, let’s say you’ve noticed a colleague rapidly losing weight, although they’ve started wearing baggier clothes to try to hide it. They never seem to eat lunch, saying they had a big breakfast. You notice that they often come into work looking exhausted, and they’re calling out sick much more often than usual.

You may have concerns about an eating disorder, but it’s important not to make assumptions – many health conditions can cause these symptoms. If you choose to express concern, don’t talk about their body or weight. Instead of saying, “You’re looking too skinny lately. Are you eating enough?” say something like, “I’m concerned about you. You seem to be really tired all the time and you’re getting sick a lot. You just don’t seem like yourself. Is everything okay? I’m here to talk if you need to.”

If they share, listen

If a colleague shares with you that they live with an eating disorder, listen with empathy. Understand that telling you about their struggles is a sign of great trust, and respect the conversation as such.

Avoid all judgment; eating disorders are mental health conditions, just like depression or anxiety. The person is not “choosing” to have the relationship that they have with food, so avoid comments like, ‘Why would you starve yourself like that?”.

You may feel the desire to help the person in some way, but it’s best to avoid unsolicited advice. Listen to them openly, and ask how you can support them.

Provide flexible working arrangements

Eating disorders are included in the American Disabilities Act, which means that any employee who discloses that they live with an eating disorder has the right to reasonable accommodations to be able to perform their job duties. Providing flexible working arrangements can help employees with eating disorders continue to succeed in their jobs while recovering.

Examples of workplace accommodations for eating disorders could include:

• Flexible working hours to allow for treatment appointments
• A private eating space during breaks (many people with eating disorders are uncomfortable eating in front of others)
• Leaves of absence for residential treatment, if necessary
• Access to support and resources, like an employee mental health program

Encourage professional treatment

Lastly, eating disorders don’t go away on their own. If your colleague is open to it, encourage professional treatment. Offer to help them look for resources – the difference between, “You should really get therapy,” and “I know it can be overwhelming to look for resources. I can help you call providers on our insurance plan,” can be life-changing.

The MINES & Associates Employee Assistance Program is a great place to start eating disorder support. We offer 24/7 confidential counseling to all of our members, and can refer to more specialized eating disorder resources as necessary. Call 1-800-873-7138 for support now.

To Your Wellbeing,

The MINES Team

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This week is NEDA Week, a.k.a. National Eating Disorder Awareness Week, and every year I make it a priority to openly discuss this deadly disease that is often left in the dark. Unfortunately, it seems that unless a celebrity addresses the topic, or an extremely severe case finds its way to the media, eating disorders are rarely talked about. This makes them more stigmatized, underfunded, and a seemingly ‘less important’ mental health issue.  Also, the lack of discussion and education about eating disorders can make it much more difficult for those struggling to seek help.

The Facts

• Anorexia nervosa has the highest overall mortality rate and the highest suicide rate of any psychiatric disorder.
• Eating disorders have very low federal funding, totaling to only $28 million per year. *To give you an idea of how limited that amount of research money is, Alcoholism: 18 x more funding ($505 million), Schizophrenia: 13 x more funding ($352 million), and Depression: 12 x more funding ($328 million)
• Every 62 minutes, at least one person dies from an eating disorder.
• There are more eating disorders than just anorexia and bulimia; there is also EDNOS (eating disorder not otherwise specified), orthorexia, ARFID(avoidant restrictive food intake disorder), and diabulimia.
• Only 1 in 10 people with an eating disorder will receive treatment in their lifetime.
• Insurance companies’ often refuse coverage for eating disorder treatment. *Based on level of care needed, treatment costs between $500-$2,000 PER DAY.

My Own Battle

It took me many years, and numerous rounds of treatment, to get to where I am today: recovered from anorexia. I wanted to start by saying that so that people can realize if recovering from an eating disorder was as simple as “just eat your food,” it wouldn’t have taken 4+ years, 3 different facilities, and 8 admissions to do so. For me, my eating disorder was a slow suicide, and one of the many self-destructive behaviors I engaged in. It wasn’t about the food, and if you ever are to hear anyone talk about eating disorders, they’ll also tell you the same.

Recovery didn’t come until I really wanted it, which took much longer than the people who were by my side through it all had hoped, including myself.  What it really took for me to choose recovery was a very serious medical complication. In my last relapse, I had a seizure on my best friend’s floor at 2 a.m. The seizure was caused by refeeding syndrome, which is a life-threatening reaction that the body has when it is severely malnourished, then suddenly increases its food intake.  Unfortunately, it took me losing complete control over my body to want to take back control of my life; and as strange as it may sound, I am so grateful for that seizure, and truly don’t know if I’d be here now, had it not happened.

Because of the struggles I have endured, I am an advocate for eating disorders, mental health, the LGBTQ+ community, women, and children. I believe whole-heartedly that I am here on this earth to let people know that they are not alone.

To Those Struggling

There is help out there, and it’s okay to ask for it. That’s why things like eating disorder treatment facilities, programs, and specialized therapists exist. Know that you are worthy of love, happiness, and freedom and that you are not alone. Asking for support takes a great amount of strength, so please try not to look at it as a weakness. Recovery is possible, and this big, beautiful, chaotic mess of a world needs you.  Stay strong, and keep fighting.

Resources

NEDA Helpline: 1-800-931-2237

Suicide Prevention Hotline: 1-800-273-8255

Sexual Assault Hotline: 1-800-223-5001

National Domestic Violence Hotline: 1-800-799-7233

With wishes of happiness & health,

Amy Babich

Final thoughts from MINES

Eating disorders are serious. Please don’t wait to reach out if you need assistance. Employee Assistance Programs like MINES are here to provide resources and guidance to make sure you get the help you need. We are always here to talk. Please call us at 1-800-873-7138 if you or someone you care about is struggling with an eating disorder, depression, or any other work/life issues that you may need help with.

Sources:

https://www.aedweb.org/index.php/education/eating-disorder-information/eating-disorder-information-14

http://www.anad.org/get-information/about-eating-disorders/eating-disorders-statistics/

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