“Eating Disorders are not a choice”

For this year's Eating Disorders Awareness Week, we spoke to Elena Coria, trainee clinical psychologist and DCP Faculty for Eating Disorders committee member about the eating disorder myths that need dispelling.

Elena, can you tell me where you work and what your role is?

I am currently in my second year of clinical psychology doctoral training, which is giving me the opportunity to work in different fields and with clinical populations across the lifespan. My field of interest, however, is eating disorders (EDs) in young people, having worked in a CAMHS ED service as an assistant psychologist prior to training. My elective placements in my third and final year of training will be in ED services and my thesis also has an ED theme, as I am researching young adults' experience of the ED voice. 

Being the pre-qual representative for the faculty of ED within the BPS is an extremely valuable opportunity, as it allows me to work alongside inspiring and experienced psychologists in the field and keep up to date with important themes in the area of EDs.

The theme for this year's EDAW is 'Anyone can have an eating disorder' - Can you address the myth that eating disorders only affect teenagers and young women?

Whilst the onset of EDs is often during adolescence, anyone can suffer from an ED, at any age, including younger children and adults. Someone's difficulties may not have been identified in their teenage years and may become more impactful in adulthood or they may become part of life well after adolescence. Any gender can be affected, not just girls and women. Boys, men and gender non-conforming people can also be affected, with the same severity as girls. 

What about the myth that you can tell just by looking at someone if they have an eating disorder, as they would look 'a certain way'?

It can be easy to forget that EDs are psychiatric illnesses that can also affect, and in fact often do, physical health. Despite this link between mental and physical health, someone might be struggling with an ED regardless of their shape or size. Someone might be in a healthy weight range and be suffering a great deal with thoughts and emotions which are part of EDs. On the other hand, someone may be underweight or overweight for conditions unrelated to EDs. Regardless of what someone looks like, they might be struggling, they might be healthy or they might be working toward their recovery from an ED. 

There's also a pervasive narrative that eating disorders are just a faddy diet gone wrong, or a result of lifestyle choices made in pursuit of attention or beauty - is this true?

No one chooses to welcome a psychiatric illness into their life. EDs are not a choice, but serious illnesses with very high mortality rates and a pervasive impact on someone's life. Many people will have followed a trend at some point in their life, and many will have adhered to some form of diet without becoming ill with an ED. 

Expert clinicians can help unpick the role of certain changes in someone's lifestyle or diets in the onset of the ED, but research available so far tells us that the cause of EDs is a combination of factors, different for each person, rather than one single change. As far as attention seeking is concerned, people struggling with EDs often work extremely hard to disguise the illness and can be in denial of its existence and impact for a long time, far from having any intention to expose what is happening to them. 

What would you like more people to be aware of around who is affected by eating disorders?

I would like more people to be aware of the stigma that still surrounds eating disorders, of the harmful consequences that making assumptions and comments based on someone's looks, age, gender or background can have on someone's journey. Creating boxes within which EDs can or cannot exist can be harmful and invalidating, potentially preventing people from reaching out for prompt and appropriate support. Ending with some hope, another myth to be busted is that EDs are for life: EDs are serious illnesses that can have very dangerous consequences, but, with the right support, recovery is possible.

You can read more about the DCP Faculty for Eating Disorders including the membership options available.