The Reasons People with Eating Disorders Receive Subpar Medical Care

Patients with eating disorders worry universally about biased treatment from medical professionals. The prejudice of clinicians across the board leads to poor care, mistaken diagnoses and potentially harmful treatment.

The bias against eating disorders stems from two central issues. First, the ignorance about eating disorders in general is rampant. Second, the prevalence of bias against fat and for thinness reinforces eating disorder myths and limits thoughtful medical care.

Medical professionals learn very little about eating disorders. A lecture or two about eating disorders in training explains the criteria to diagnose these illnesses and a few basic facts about treatment and outcomes. However, for doctors not in the mental health field, this information is not useful at all. In order to be helpful to patients with eating disorders, primary care doctors or medical specialists need to know what to look for in order to recognize and treat common medical consequences of eating disorders.

Cardiologists need to identify low potassium in young people as a sign of Bulimia. For gastroenterologists, delayed gastric emptying not explained by other illnesses is often due to anorexia. Rapid weight gain and loss accompanied by vitamin deficiencies is often a sign of severe periods periods of binging and restricting.

These are only a few examples of the myriad medical issues secondary to eating disorders. Even a basic amount of knowledge can help doctors diagnose eating disorders and treat the resulting symptoms effectively.

The lack of knowledge leads to poor treatment, but the weight bias is just as prevalent and even more destructive to people with eating disorders.

Doctors frequently have a personal bias for thinness and against fat based on their own internal fatphobia. The medical establishment reinforces the purported medical consequences of being fat that doctors exaggerate and use to confirm their own bias.

The result is that doctors assume thin patients must be healthy and that their weight itself is enviable. Similarly, doctors see fat people as unwell with poor health and that weight loss is the only recommendation these patents deserve and need.

So patients with anorexia are told they are not sick, something people with anorexia often use to bolster their own false beliefs about their illness. And patients with Bulimia or binge eating disorder cannot get the medical help they need. Instead, they are always advised to lose weight.

These two facts about medical care for eating disorder patients leads to patients either ignoring medical problems or being too afraid to seek medical care. As a psychiatrist treating people with these illnesses, I see too many patients avoid medical care for treatable illnesses. The results can range from unfortunate to catastrophic.

Because of the increasing prevalence of these illnesses, the medical establishment needs to ensure basic and adequate education for doctors about eating disorders in order to provide care these patients deserve.