- Employment has been linked to improvements in eating disorder recovery but it can also trigger a relapse.
- Studies have shown that eating disorder stigma may be more negative than stigma against other types of mental health issues.
- Eating disorder-informed workplaces are those in which appearance and weight are not the subjects of water-cooler talk.
Almost a third of our adult lives are spent at work and therefore, it makes sense that many women struggling with binge eating disorder, emotional eating, and food obsessions will be in the workforce. This has never been more of an issue than during the COVID-19 pandemic. During quarantine, nearly 30% of individuals in one study reported that their eating disorder symptoms may have gotten worse. Some of the reasons include increased stress, food insecurity, the loss of usual coping or support systems, and exposure to fat-phobic messaging on social media.
But just the nature of workplace life can make it difficult to balance professional demands with mental health issues, especially if you have binge eating disorder, food obsessions, or are prone to emotional/stress eating. Stigma and stress are among the problems magnified by the workplace. For those with eating disorders living in larger bodies, weight stigma can be a problem at work as well. And the workplace can be a fertile ground for diet mentality with discussions about weight loss, the newest fad diet, and fears about the proposed connection between weight and health. For example, one of my patients in the Anchor Program said that a co-worker started telling her about a new wellness challenge (a buzzword for diet) and how much she was looking forward to it. She then slyly asked my patient why she didn’t join in. This led my patient to feel as if she was yet again being judged because of her size. Luckily, she was able to say: "I have an eating disorder and I know that going on diets will make my eating disorder worse."
Workplace stress can lead to loss of job satisfaction, absenteeism, burnout, and turnover intentions. It's also associated with reduced psychological well-being. Here are some of the workplace challenges I've heard about from my patients:
- Office furniture not designed with larger bodies in mind.
- Frequent work events that focus on food and are a trigger for those with eating disorders to overeat or binge.
- Comments and back-handed compliments from co-workers about the latest diet fads and how much weight they are losing; asking you to join them on these diets (implying that you need to lose weight).
- Food left out at work, as people randomly bring in food to share.
- Workplace wellness programs and challenges that focus on weight loss.
- Finding professional stylish clothes to wear to the office.
What an eating disorder-informed workplace looks like
“An eating disorder-informed workplace would be careful not to comment on people’s bodies, and not to encourage weight loss through competition or diet talk,” says Rebecca Eyre, an eating disorder therapist and CEO of Project HEAL.
An eating disorder-informed workplace can go a long way toward making individuals with eating disorders feel safe and valued. This type of workplace is one which recognizes that:
- People with eating disorders come in all ages, shapes, sizes, genders, and sexual orientations. The stereotype of someone with an eating disorder is typically a young underweight white female, but this stereotype only fits about 6% of people with an eating disorder, while 25-40% of those with eating disorders are male, trans individuals are 8 times more likely to have an eating disorder, and eating disorders are as common in Black and LatinX individuals as in white communities.
- An eating disorder-informed workplace is one in which employees are encouraged to leave the fat-phobic, diet-obsessed water cooler talk at home. This kind of talk can be triggering for those with an eating disorder.
- Being cautious about food-centered work events can help those with eating disorders not relapse. If a co-worker has confided in you that they have an eating disorder, just being a lunch buddy or offering to sit with them if they need non-judgmental support during work events can be helpful.
- It's important for employers and employees to advocate for coverage of mental health issues including eating disorders when choosing their insurance. Eating disorder recovery takes years, not months, and sometimes treatment is necessary. Treatment will be easier to get when it is covered by insurance.
- How we talk about eating disorders in the work place ultimately is how trauma shows up in the workplace.
An important truth is that wherever you go you take your trauma with you. Since trauma impacts over 60% of Americans and severe trauma impacts over 20%, it's not unexpected that there will be others at work with you who have experienced some trauma. For some, their trauma may show up as an eating disorder; for others, it may manifest as anxiety and depression, and in others, alcohol or drug use. Most people who carry their trauma with them do not realize it’s what causes them to, for example, be a people pleaser because their trauma led to the belief that they don’t matter. As well, few HR directors or company leaders understand how trauma can impact the workplace.
When you find yourself using food to deal with workplace issues or stress, know that your trauma may have been triggered by events at work that throw you into your pattern or make you feel something is wrong with you—all of which comes from trauma. While we can’t change the past, it’s important to understand how past or childhood trauma plays out in your life now.
Ultimately, eating disorders are a way to cope with emotions associated with events from the past and triggers in the present. Many people with eating disorders feel flooded by these emotions and use food as a way to tamp down overwhelming feelings, both positive and negative. However, the link between trauma and emotions is that when something has happened to you and you use food as a way to survive or cope, you may also have developed core beliefs such as "I'm not worthy" or "I'm unloveable." These beliefs date back to a time when you experienced adversity that led you to feel that your basic needs for safety, security, love, acceptance, and affection were in jeopardy. Therefore, it's important for individuals who work with people with eating disorders—and employers—to recognize that eating disorders are not about food: They are about how food is used. An eating disorder-informed workplace is one in which those with eating disorders are not judged based on their size, are supported in their recovery, and are treated with basic respect for the emotional distress and trauma that may have led to their disorder.
Cooper, M., et al. Eating Disorders during the COVID-19 pandemic and quarantine: an overview of risks and recommendations for treatment and early intervention. 2020. EATING DISORDERS. https://doi.org/10.1080/10640266.2020.1790271