A Case of the Bias Against People with Eating Disorders

Public health campaigns and outreach by non-profit organizations such as NEDA and AED have started to educate people about eating disorders in the last two decades. Despite the ongoing confusion and misunderstanding about these illnesses, the work of many dedicated people have led to significant advancements. Eating disorders now receive treatment parity with medical illnesses as biologically-based diseases and are legally mandated to qualify for disability benefits for people on medical leave from work. 

A less tangible benefit from the public outreach is the decrease of bias against people with eating disorders in the academic and professional setting. It has become much more commonplace for people to reveal their illness on school applications, during a semester or to bosses at work without fear of stigma and bias. As a psychiatrist typically coordinating a patient's care, I have become increasingly comfortable suggesting someone be honest and open about their illness with much decreased fear of repercussions based on ignorance and misunderstanding. 

In this environment of growing tolerance and acceptance, I was asked to testify as an expert witness for a patient of mine under review by the New York State Bar committee. In order to provide full disclosure, this patient asked for my support in any way possible after the hearing and offered unqualified support for this blog post as long as her name or personal details were omitted. 

She had passed the Bar exam several years before and had been waiting for review by the committee to assess her fitness to be an attorney because of past symptoms and behaviors directly related to her eating disorder. She has received substantive and ongoing treatment for her illness over the years prior to and since taking the exam with significant benefit and progress. 

Although it is within the reasonable right of the committee to attain professional verification that she has been adequately treated and is stable to be an attorney, the committee proceeded, over several years, to ask for all medical records, obtain many letters from providers repeating the same information and delay the hearing for years for no apparent reason. From all appearances, the committee's ignorance and bias against this person's medical illness contributed to the extensive delay. 

The hearing turned out to be a two day referendum on this woman's character. The committee attacked her and her witnesses as if having an eating disorder were a punishable offense. The members of the committee showed a thorough ignorance of these illnesses and their sequelae and, more concerning, continued to reassert their flawed line of reasoning despite multiple attempts to clarify and educate the committee about the psychological manifestations of eating disorders. Moreover, the committee continued to personally attack this woman based on her illness and placed the onus on her to convince the committee that she can function as an attorney, despite multiple expert witness testimony denying any link between an eating disorder and competent functioning as an attorney. 

As a final insult, one member of the committee commented directly about this person's appearance in the hearing in an attempt to prove she has recovered from her eating disorder. This may be a common misunderstanding for people ignorant of eating disorders, but was personally devastating in this legal context, as anyone with a basic of understanding of eating disorders would know. 

I have written extensively about the difficulty lay people experience trying to understand eating disorders and recovery. It means that public outreach is critical to protect the rights of people with this group of illnesses. However, when the ignorance of a professional committee is combined with arrogance and power, the life and future of someone with an eating disorder is seriously jeopardized solely because of her illness. It's clearly unacceptable for this group of accomplished lawyers to judge the suitability of a potential lawyer with the lack of knowledge about the problem and limited desire to listen to the expert testimony before them. 

This situation is an opportunity for the larger community of those with eating disorders and of professionals to support someone being unfairly punished for her illness. I urge those reading this article to post a comment and gather support for a person who has endured longstanding punishment for her illness. I hope this support can provide more evidence to the committee of their ignorance, bias and judgment and allow this person the career she worked so hard to attain and that has been kept from her for so many years.


  1. This is indeed outrageous. Thank you for shedding light on this, Dr. Lissak. I hope this woman is rewarded the justice she deserves although she is being judged through visibly skewed lens. God bless her perseverance and courage to pursue recovery in spite of the obstacles.

  2. Thank you for sharing this brave woman's story. I cannot imagine the courage it must have taken for her to walk into that courtroom two days in a row to defend her professional competence while a group of powerful but ignorant people criticized, shamed, ignored and devalued her. This is a very clear example of the enormous amount of societal prejudice that still exists against those with eating disorders. There are few illnesses for which it would be acceptable to display this kind of blatant, dehumanizing insensitivity. I hope this woman knows that she should never have had to go through that. I have nothing but compassion and admiration for her strength and courage.