The atypical eating disorder

Why there is no such thing as a one size fits all treatment 

Stereotypes are harmful. Not only in a marginalization sense, but in a way that affects how people are treated. I’m not talking about how people are treated by friends or outsiders; I’m talking about how people are treated medically.  

Simply put, I have an eating disorder. I have an eating disorder that isn’t recognized enough to get proper treatment unless I lose a dangerous amount of weight. The problem with that is the health system stereotypes a person with an eating disorder by extremely underweight to determine the right to treatment.  

I have a condition called orthorexia, when an individual takes healthy eating to an unhealthy extreme. It is less about body dysmorphia, although I’ve struggled with that too, but more about an overwhelming desire to be “healthy.” I’ve had issues with disordered eating since I was around 12 years old. 

Not sick enough for treatment 

At 17 years old, when I finally decided to talk to my doctor about how this way of eating was starting to make me sick, she told me that I wasn’t underweight enough to seek treatment. She then told me to try not eating gluten (the one thing I wasn’t already cutting out) to see if maybe my stomach pain and weakness was coming from what I was eating rather than what I wasn’t eating. When I did some research, I saw that local treatment programs were mainly focused on anorexia and bulimia. 

Not everyone who purges what they eat is going to weigh 90 pounds, but that person still has the symptoms of bulimia nervosa. Not everyone who refuses to eat three days a week is going to look sickly, but that person still has tendencies of anorexia nervosa. In fact, lots of people who only have an apple and yogurt daily look perfectly healthy in magazines. Why does my weight matter for treating my mental health? Any health professional should surely know that an eating disorder centers around control and stability, and not just fat or thin. It’s also important to know that an eating disorder isn’t just anorexia or bulimia. 

I consider myself lucky to have an eating disorder that is mild enough where it won’t kill me. Every day I am trying to be better, but it is unfortunate that our healthcare system has forced me to deal with this myself. Most therapists aren’t able to tell me how to slowly and safely input the foods I cut out back into my diet and monitor my health while doing so, and most dieticians can’t counsel my disruptive thoughts and compulsions about food, it’s not in their job description. The only place where you can get effective and proper treatment for an eating disorder is at an eating disorder clinic. It seems obvious, but as I’ve already said, to get into these facilities you need to fit into a diagnosable mold. 

Outside of the diagnosable mold 

When people who don’t have an eating disorder picture what one looks like, they think someone who is extremely underweight, starves themselves or forces themselves to vomit. While this is true, these stereotypes should not influence medical treatment. The ideal look of these eating disorders should not influence how the person is treated medically. Nowhere in the actual description of anorexia does it say, “must weigh under 100 pounds,” but it says, “extreme weight loss or fear of gaining weight.” As somebody who hails from a family of curvy, muscular women, I could stop eating and still weigh the same as someone who has a fast metabolism and eats whatever they want. Trust me, I’ve tried it.  

Sometimes it comes down to genetics. I shouldn’t be left to fend for myself if I don’t follow the standard. That’s almost like telling someone with early cancer that since they’re not sick enough yet they need to wait longer for treatment. Horrible, right?  

The truth is, to get better treatment for eating disorders, we must understand how complex and unique each condition is. To further my point about stereotypes, Statistics Canada only has statistics on anorexia nervosa and bulimia nervosa. According to the National Initiative for Eating Disorders in Canada, one million Canadians meet the criteria to be diagnosed with an eating disorder. Between 10 and 15 per cent of premature deaths in Canada, result from an eating disorder. That is the highest mortality rate among any mental illness.  

People are dying from our stereotypes. We need to educate people so that more resources are available for those who don’t quite fit the mold.  

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Carleigh MacKenzie

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